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

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The British public is very conservative when it comes to reopening. 73% support prioritizing the health of citizens only 17% say prioritize the economy. This is the highest of industrialized nations, Japan being the next highest with 60% supporting prioritizing health only 16% in Japan saying the economy.  For Boris Johnson as he makes the speech on Sunday May 10 on reopening the political margin for error in decision is nonexistent. Britain's tabloid press and other media simply took the idea that to heck with it lets reopen reflecting a lack of caution in the headlines after Mr. Johnson expressed his intention to reopen. After seeing this Johnson and his closest advisers met without his hawkish ministers to reflect on what was happening in the country. The British government's scientific advisers say whether there are 100,000 deaths by the end of the year depends on many factors including testing, contact tracing, the way the lockdown is eased, the situation at nursing homes, and other government action  to prevent a resurgence in infections. At the meeting with Gove, Sunak Raab and Hancock, Mr Johnson stepped back and reversed any plans except for mild reopening- giving people more time outside for exercize, opening limited locations such as garden centres and advising strongly to wear masks on public transport. Both Johnson and Dominic Cummings his adviser had coronavirus, and Johnson spent some time in ICU. They know the impact of the coronavirus from their own personal experience.  For Johnson there is only one chance, Tory senior advisers say the public will forgive mistakes going into coronavirus, but will never forgive mistakes getting out of cotronavirus. He told Keir Starmer of Labour in parliament that he bitterly regrets what has happened in nursing homes. The scientists have warned him that the staff at nursing homes could seed communities once again. And that the coronavurus R ratio (1 being the level it starts growing again) could go up back to 1. This is the situation on May 10 as Johnson prepares to speak to the nation on Sunday at 7 pm, as he shifts to "maximum caution." ...

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China's healthcare system is overburdened and overwhelmed, says this report in the NYT. The changes in living and investment in infrastructure and housing are not matched by similar investments in the health system. Shortages of hospital beds and doctors is making tackling the coronavirus in the Wuhan region more difficult. A new hospital is being built in 6 days in late January 2020 in Wuhan for the coronavirus patients, showing how severe the situation is. 

The lack of strict regulation and lack of enforcement at the local level is leading to the situation where the virus was detected in twice- in 2003 in wild animal meat and again in 2019. Public anger and call for a ban on wild animal meat is happening today.

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Added sugar is the big culprit in the way we age, and in our general health, the diseases we get. This is not just about obesity, its about metabolic health- getting only the amount of sugar that is good for us. Unknowingly if we are not careful, not checking labels and without any advantage we end up taking added sugar when we eat packaged foods. About 70% of packaged foods contain this added sugar. Most adults in the U.S. and other countries get 17 teaspoons of added sugar a day or twice the 9 teaspoons that is recommended for men and three times the 6 teaspoons a day recommended for women. For children the recommended limit is 3 teaspoons. Just by being a bit careful and removing this added sugar from our diet we can enjoy much better health. It is not giving us much because we can still have some sugar in healthy natural foods, in fruits and vegetables, and a smaller amount of plain sugar. After the first couple of days of a change one may not even notice this. By so much has our sugar intake grown particularly with packaged foods, that a small change can bring big results in health and healthy living style. ...

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"As you know I am 5 foot 10 on the outside and I was way too fat" says the British prime minister about the time he was admitted to hospital for the coronavirus. The British prime minister now goes for a run with his dog first thing in the morning. He says about his life after the coronavirus recovery that he is steadily building up his fitness. He has good things to say about the run, the exercize in the morning. After the run says Boris everything for the rest of the day is a breeze. A quite gentle run in the beginning that is getting faster and faster as he improves his fitness.  One does not have to go to the gym to lose weight. There is always the great outdoors, space outside the home. As part of the effort to get Britain to cut all that unnecessary fat which is ruinous for healthy living, Britain will now ban all buy one get one free deals on unhealthy food products. All food in restaurants and pubs will soon be required to post the calories count on menus, starting with the bigger chains. Boris Johnson says he is supporting the NHS and the national campaign for fitness and cutting out all the unnecessary calories that have crept into people's food habits and intake. He never intended this but Johnson like others have learned from one experience that has compressed several lifetimes of experience trying to recover from the virus without the fitness of body that is needed.      ...

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Putting a distance from the negative thoughts of the mind is essential to getting a good healthy mindset. This means not believing what it says. It also means woking hard to be able to change one's life in many positive ways and believing that you frame your own destiny. It is said that a wandering mind is often more of an enemy than a friend, in ancient wisdom. Developing a new calmness, being able to meditate, requires putting a distance from negative thoughts and not believing the thoughts of a wandering mind. This is called cognitive defusion. It is also part of what is needed for yoga and meditation. 

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The best exercise routine is a consistent routine, says this health expert in The Guardian. Beware she says of sugary drink highs or coffee in excess to serve as pick ups during the day when energy is low. Instead do some short stretching or exercise routine even if it is only 10 minutes. It does not have to be a long or strenuous exercise, don't let the ads of young people doing strenuous routines fool you, says this expert. What is important is to keep doing it, to stretch and move around even if this is for a short time. Consistent routine is critical.

Carbohydrates, whole grain breads are not to be frowned on, she says, as this provides extra energy, and is healthy when balanced with protein and fat in the diet.

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A federal committee in the U.S. now recommends no more than 6% of calories come from daily sugar intake not the 10% that is is the current guideline. It is smart to be wary of guidelines set in a different period when Americans and people in other parts of the world were not enough health conscious as they should have been. Artificially high limits set in guidelines serve as a danger to health, particularly as experts say obesity is like pouring gasoline on fire in fighting the coronavirus. Take a look at mean consumption today and it is not even the 10%, it is 13% double of what it should be. Nearly two thirds of Americans aged 1 years or older consumed more than 10% of daily calories in added sugar. And 70% of U.S. adults over 20 years are obese or overweight according to 2015-2016 figures from CDC. Today the figures from Europe and Asia, Latin America are also alarmingly high for obesity rates. Added sugar comes from processed foods from soda and pasta sauce to cereal and yogurt, and honey, sugar itself. Sugar sweetened beverages are common and dangerous. A 16 ounce grande pumpkin spice latte at Starbucks has 50 grams of sugar or 10% of a 2000 calories diet. The committee in the U.S. wants to see people eat healthy diets and does not want to discourage healthy foods like fruit and milk which people are not eating enough. It wants to see a shift away from processed foods to foods that have good health outcomes such as fruits, vegetables, whole grains, and lean meat and poultry. The beverage producers such as Coca Cola and Pepsi are a major source of resistance , as are Confectioners association, and other producers that benefit from setting the guidelines at 10%. It is not that for 3 decades as the obesity levels rose to the shocking and dismal health levels of today that the ideas of what constitutes a healthy diet were not known. It was just that we as a people did not care enough to fight for what is safe and healthy against whatever resistance was put up by producers with their vested interests, just as we as a people did not care enough to to fight to keep local manufacturing in place and the jobs and healthy communities across our land. A gram of sugar equals 4 calories. For a 2000 calories a day diet that is 120 calories to stay within the 6% that we should not exceed. Make a habit of looking at each packaged product and add up the added sugar grams and calories. ...

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Janice Turner writes about all those empty calories that are being taken without a thought. For children obesity starts with cereals such as Frosted Sugar Flakes with extremely high sugar content, and other cereals that have high sugar content with fancy names, says this report of how people unconsciously take in so many empty calories. Sugar content that can range to as high as 37%. This builds up disease in our bodies, and obesity. Obesity acts during this time of coronavirus to create a wild fire.

 

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Indian finance minister Sitharaman announces a new stimulus package "Atman Nirbhar Bharat." This includes an effort to incentivize creation of employment opportunities for people making less than Rs. 15,000 a month ($215 a month), called "Atman Nirbhar Rozghar Yojana, for a period of 2 years. Sitharaman cited stock market rebound and foreign reserves reaching $560 billion to show that along with the government efforts and planned infrastructure the economy would make a robust recovery. Because of India's large informal economy help to street vendors and other small retail is critical in the Indian economy. The finance minister cited the "One Nation, One Ration Card" which allows street vendors and other retail merchants to access foodgrains from FPS of choice in 28 states and union territories in India. This is part of the effort to build demand and upward mobility in the economy. The names given for these efforts or yojanas are unique- PM SVANidhi stands for PM's Street Vendors Atmannirbhar Nidhi. Atmannirbhar is the overall plan for self reliance in the economy and the prime minister Modi has pushed for buying Made in India, to promote jobs and technology + capital accumulation in Indian manufacturing. India took a blow from the coronavirus with close to 9 million infected by the virus and lockdown in March. By September 20 the daily cases reached 100,000, and by November 10 the daily cases have dropped to 44,000. Social distancing and mask wearing are widely accepted in India. India has other advantages in the large pharmaceutical industry and access to drugs at government regulated and low prices as part of the planned effort after independence in 1947. Other aspects of Indian life are cultural preference for vegetables and fruits in the diet, and spices, herbs in cooking, yoga practice, which are anti-inflammatory and promote healthy living.  With the largest population in the world the region in the Indian ocean comprising the countries of India, Bangladesh, Pakistan, Burma and Indonesia, former parts of the British and Dutch empires, is a region where the coronavirus posed a great threat to human life. An early carefully orchestrated lockdown by prime minister Modi  helped with the message in March that India faced a singular choice - between going back 21 years in development or controlling the coronavirus in 21 crucial days. The setting up of the direct transfer of money to bank accounts  of farmers, urban street vendors and lower income people in rural areas by giving everyone a bank account under a government plan early in the first term of the current administration enabled it to send aid directly when coronavirus hit the country. Other schemes included cooking gas for women in rural areas who depended on firewood for cooking. These schemes and sanitation infrastructure setup under the Clean India campaign, helped India build an element of resilience when coronavirus hit.  The government plan to remove interstate barriers to commerce and integrate tax system collection at the federal level, bringing parts of the informal economy into the formal economy, have increased revenues that now finance an infrastructure plan that hopes to match the one in China over the next decade.   ...

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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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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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A few events in the last 50 years are rewriting the rules for business, finance and economics, says the WSJ in this analysis. The admitting of China to the World Trade Organization under president Clinton in 2001 was one, another was the global financial crisis in 2009 with the selling of bad mortgages by the financial industry, the euro currency financial crisis with the bad accounting, real estate industry speculation, and lack of financial oversight in countries such as Greece, Ireland, Spain. The coronavirus pandemic is one more addition to this string of crises and events that have made the working class and middle class in US and Europe poorer and in worse shape after the recovery following World War II.  The changes indicated here are some of the surface changes- such as the shift to the suburbs for cleaner air and better living, the work at home as a serious option, the new focus on health care, wellness, exercise, nutrition and mental health, remote learning and community college as a realistic option to high tuition costs by the education industry, and a pharmaceutical industry refocused on public health and vaccines as it was in its early years before its shift into a simply profit driven industry. The underlying thread for all these changes on the surface is a deeper change in the public mind- a change that redefines what the people believe in just as happened after World War II. Rebuilding the devastated economies of Europe, America and Asia required a new vision at the time after World War II. And reconstruction could only happen with all the people involved and working for the public interest.  This also created a new hope for the future. President Biden's vision is for a new set of priorities that make child care, women's position in the economy, community college education as a right for all as a first step to opening the access to education that existed after the war in 1945. Investment in infrastructure, in building new roads, bridges and rail, water, internet connections, public services in transport, better layout of urban areas, better lives for retirees, are all part of an effort to improve quality and ease of living for all parts of society, not just those who can afford it.  This is uppermost on people's minds and administrations or governments that fail to deliver or simply talk with no action, will not have the support of ordinary working men and women in all countries. This is true for countries and regions as varied in their level of development as the US, Northern Europe, Southern Europe, Japan, India, Brazil and Mexico, and African nations. Democracy, government adminstration, technology and business structures exist for the people, to improve the ease of living, quality of life, through better health, education and public services.  ...

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

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The coronavirus pandemic and the disaster in nursing homes, the chaotic conditions in the first wave, the lack of staff and poor attention to residents during the pandemic, has exposed the major weakness of nursing home care in western countries. Much of this sector is in the hands of private operators seeking a profit.  The staff is paid low wages and lacks the experience and empathy needed for care of older people. During a virus all these factors turn deadly. With some staff sick the other staff is overburdened. If the sick turn up for work they are likely to risk the safety of other staff and the residents. With the incubation period lack of testing there is no way to know. When deaths occur and the nursing homes are sealed from the outside world the deaths happen with no goodbyes as happened in U.S., Britain and Sweden. This has exposed the scandalous and shocking way in which the elderly are treated in today's environment where ridiculous amounts of money are being spent on other things and the the most basic "one's parents" are neglected and allowed to die in horrific manner in a pandemic. The new trend for home care for the elderly is a welcome trend and long overdue as one of the worst aspects of the system in the west is the treatment of elderly parents in nursing homes run for profit. The new technology tools available for monitoring a elderly person at home, and the help of stores such as Best Buy which are serving elderly at home, is making this more and more a choice for the elderly. Even older patients and ones needing significant care can recover and spend time at home in a better environment, a less costly one, as hospital managers and families have learned in 2020. Some hospitals in the U.S. say they never want to go back. That the drive to get every patient home who can be home is the right one for patients and families and for the government paying for the care so that dollars are well spent in quality of care. Home health care companies are working on providing new services for sicker patients recovering at home. Technology helps do better monitoring. Medicare now pays for digital doctor visits and intense hospital type care at home after coronavirus showed this as vitally needed.  Both the Biden and Trump administrations are firmly focused on this issue. Seema Verma as head of Medicare is clear about the need for a national conversation on how we take care of the elderly, of our parents. And Mr. Biden wants to spend $450 billon to make certain that people who need long term care can get the support they need in the home and the community. This report looks at the home health care companies and how they are improving their services. This and telemedicine are two of the major constructive changes coming out of the pandemic, clearing out some of the worst aspects of the old system of living the older years in the western world.  Nothing speaks more about humanity and a human world than the story here of Savanna Hollar, 90 years old and almost blind. She broke her shoulder in August, Her sons decided not to send her to a the rehab facility she went to after a broken hip 3 years earlier. The sons brought her home to recover in the farmhouse near Yadkinville, N.C., where she has lived since 1951. One of her sons himself 63 years says that at a nursing home she would be lonely, scared and afraid to move. The sons hired two people to help her during the day and a rotating system was used for having people help her. At home Mrs. Hollar could enjoy her gray cat, Buddy, her favorite recliner and tomato sandwiches made with produce from her garden. Really, if we can't do this much what good is the U.S.A.? or Britain? or Sweden? or India? ...