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

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

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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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What is the best way to reopen schools. This is being discussed in many European countries including Denmark and Germany. Cut class sizes by half. Have teachers take self adminstered tests. Hallways are one way. Stagger the breaks. Open up doors and windows for circulation- have students wear layers if needed. Students and teachers wear masks. Nothing is left purely to chance. Even with this the reproduction ratio is up to 1.13 in Germany - it must be kept close to 1.

Yet one nation of 85 million and others in Europe and Asia can show the way through a well planned and executed effort with lessons for all.

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Public health experts warn that it is essential that countries reopening their economy have a reproduction ratio of much less than 1.0 so that the rate of increase is under control. Germany's Robert Koch Institute which advises the German government says the reproduction ratio which was 0.70 in mid April is now up to 0.96 after creeping back up. This is based on a mathematical model and extrapolated from infection numbers several weeks back.  It doesn't reflect the change by recent easing of lockdown measures starting with reopening smaller stores. This validates the careful approach adopted by France which was put forward by prime minister Edouard Philippe in his address to the National Assembly. The Assembly approved the plan 368 to 100. More legislation will back up the French government's authority to ban non essential travel between French departments and the creation of a large brigade to perform contract tracing. That involves finding testing and isolating everyone potentially infected, using dedicated locations. Detailed restrictions on travel, work and gatherings will take effect when France reopens partially on May 11.  France is also putting resources behind its testing program to test every person having coronavirus symptoms, and all they are in contact with. That means about 700,000 tests a week. Officials will generate a color coded map from this with red areas facing more restrictions than green areas. Student size is capped at 115 per class. Cafes, restaurants, movie theatres and large museums will remain closed. Gatherings of more than 10 banned. Those who can work from home asked to do so. Public transit users will be required to use masks, and marks on platforms will indicate the social distance required. Only essential travel is allowed more than 62 miles from home. These rules remain till June 2, when new ones will be set. Large music festivals and sporting events are canceled till the fall. Mr. Philippe says "these efforts will not be in vain and should allow us to arrange for a better summer season." ...

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Prime minister Boris Johnson says he will proceed with "maximum caution" as he plans reopening of the economy. The reproduction R ratio for the virus is just below 1.0 and may have gone up recently, say public health officials. Britain faces a problem of deaths in care homes that is not under control.

Prime minister Johnson will announce Sunday new moves which will be limited- allowing people to go out to take as much outdoor exercize as they like, and restart activities such as tennis, golf and fishing. Businesses will get guidance to prepare places for social distancing when people return to work. Restrictions on limiting people contact to those within their household will remain.

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On May 11, NYT shows the rail network in India opening with the first trains taking 45 million migrants to homes in all parts of the country. Australia calls for an international inquiry into the cause of the coronavirus pandemic and its origins in China. Russia begins a cautious reopening with the governors of provinces having powers for reopening based on local conditions. In Spain restrictions are gradually being lifted but the major cities of Barcelona and Madrid are still in lockdown. And as Germany the first country to reopen opens up its business and schools the crucial R ratio of reproduction of the virus -with 1 being the number at which it grows again and below 1 showing control of spread- moves up to above 1.

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The deputy chief medical officer, Dr. Jenny Harries, asks people in Britain to limit themselves to what is sensible and not what is possible, to use common sense, so that reopening works. The Housing Secretary, Mr. Jenrick says the room for maneouvre is limited with the reproduction R ratio for Britain at somewhere between 0.7 and 0.9. There is also a lag period for data making it so that the current situation is not known. Germany's after reopening is now estimated by Robert Koch Institute at 1.14 so that there is some shift to be expected as the opening happens, the idea being to limit this to around the 1.0 figure. Britain reopens cautiously and in  in a patchy way with primary schools reopened, and people from different households allowed to meet in groups of six as long as they stay 2 metres apart. Outdoor markets and car showrooms are also reopening. Also stated is the need to be sensitive to geography as areas such as London which were hit early and with severity are now better off than areas in the north of England. ...

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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. ...

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Tech is not going to fix this, say software experts from tech companies. Google and Apple's efforts in coming up with an app have fizzled out, says this report in thee WSJ. Has the U.S. lost precious time in waiting for an app by tech companies to be developed, instead of doing what India and Britain have done. India introduced its own app Aarogya Setu app from the Indian government. Britain had the National Health Service develop its app. India acted quickly. Is an app needed or essential? Germany decided that contact tracing based on Asian country experience was mainly about human contact tracers with skills to make the phone calls. All they needed was a centralized database on a computer and a phone. Germany set up teams at offices in each district in Germany and quickly plodded ahead even if all the offices were not fully staffed. In fact a third of the offices needed more people and resources. Yet the speed of action is something like 80 to 90% of the contact tracing effort when the team has the skill set to call. This is because clusters of infections do not wait - they spread. There is simply no time to waste. The German effort has produced the best results so far of any country of this size- Germany has 85 million people. The reproduction ratio is at 1.13 and Germany remains vigilant. It is the first country to reopen in Europe, and is methodically doing the right actions, much that the world can and should learn from. Contact tracing teams worked round the clock in the early days, they are still hard at work today, using their human skills to talk to people and find out who they were in contact with, calling the contacts in turn, at each step working to isolate where needed with followup calls from the state health departments. ...

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As the pandemic continues to spread and numbers grow with reopening of the economy the question remains -what can we learn from other countries positive experience in controlling spread? Here the Times provides the example of German contact tracing- chancellor Merkel has emphasized that a lot depends on "total" contact tracing, and contact tracing "above all else." Germany's experience is that even if you don't get everything right, you make an honest effort with everything you've got and do it early it makes a real difference. Some of the offices across Germany are stretched and short of staff but they have been working since the beginning of March, sometimes in the early days 7 days a week. Only 33% or one third of the offices throughout Germany for contact tracing have the required 5 person team for every 20,000 people, and 35% are overstretched or at their limit, according to one survey. No apps, just a low tech effort with people from the state administrations who were not working during lockdown trying doing something else, or volunteers. Mainly using the phone, talking to people and tracing the contact chain of people testing positive. Putting this information on the computer with a central database.  The Berlin office has 115 workers and has tracked down every one of 666 virus cases it was given. Because of privacy concerns at the Munich office sometimes even the patient's name is not given and office staff have to locate the name and the person. It requires dedication, flexibility and above all resilience, says Harold Rau, the deputy Mayor of the Cologne office, cited in this Times report. The doctor alerts the local office with a test result. The office calls the person and finds out who he has been in contact with for the last 14 days. Then the people who were in contact with are grouped based on the directness of contact, face to face, so on. These people are asked to quarantine for 14 days, sometimes with the rest of their household. They get daily call to find out how their doing for symptoms. The effort goes back to Robert Koch in the 1892 cholera epidemic in Hamburg. Robert Koch, microbe hunter in Germany, was called in after the epidemic spread from Moscow. It devastated Moscow and Tokyo, but Hamburg suffered far less about 8605 deaths as a result of the contact tracing and strict closing off quarantining of affected chains after isolating them, closing off affected parts of the city. Bit by bit the cholera epidemics sparks were put out before turning into flames, says Koch. In the current pandemic Germany has suffered 8241 deaths and 178,000 confirmed cases. So far this is in line with the cholera epidemic in Hamburg 1892, and this for all of Germany. And it is not just affluent nations that can do this. where there is a will there is a way. In Kerala state in southwestern India, similar efforts have worked to limit spread  with even better results than Germany. ...

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Germany has shown that low tech contact tracing efforts work- no apps needed, a phone, a desktop computer with a centralized database, and most important the human relations skills of the person doing the calls. The  sensitivity to the situation facing each person being called, being able to talk to the person in the language they speak in a multilingual environment such as California, is shown here. A 40 person team operates in San Francisco consisting of public health officials, clinicians, medical students and librarians. They call the contacts of people with coronavirus, arrange tests, and as needed send packages of food and medicines to hotel rooms or homes. Every call is expected to last 15 minutes but all sorts of questions are handled.  English and Spanish are used. Here one of the persons doing the contact tracing says she does not use apps, just an open source software used in the fight against Ebola. Definitely low tech, no waiting, get going is the message to every city in the world. She says apps software such as what Google and Apple are putting out can tell you whether the person went to some place, but cannot tell you more about that person, cannot tell you about problems the person is having being tested, and how they are having difficulty providing for families. One of the big lessons from Germany and efforts such as this one in San Francisco, and in other places such as Paris, Singapore, Taiwan, is that there is a complex nature to contact tracing that cannot be solved by tech. In fact the best thing to do is to get started immediately, with a phone and a database on a computer, as long as you have a person who has the motivation and skills, empathy with people, a lot can be done. Waiting for apps is a dangerous waste of time is shown by the low tech German experience, and the experience in other places. Most important is starting immediately. The example shown here of working with migrant workers in contact tracing shows in the most vulnerable places it is these human relations skills that count, that no tech app can do. It requires detective skills to find out and get people to share their history of movements and contacts for 14 days . In Singapore crowded dormitories house 300,000 of 1.4 million migrant workers. Singapore using an app also but its use is secondary. Apps don't work in many situations but fail in the most critical situations such as these dormitories and other eccentric or atypical situations such as faced by South Korea with religious groups and gay communities, elderly people in Europe, that generate the worst dangers of spread and need to be cluster isolated quickly. Human contact tracing has a history of being an effective method and was used in China and South Korea during the 2003 SARS epidemic. More countries need to adopt the method used in Asia and in Germany, particularly Britain, the U.S., France and India. It is OK that Britain's NHS and India's national government with Aarogya Setu app have put out their own apps which balance privacy concerns with the need to act immediately and cover the entire country, but the hard slog of human contact tracing teams in each district is indispensable. This is why the former Health minister in Britain calls it Britain's national mission to do this. Speed is key- putting together teams across the country in every district from skilled volunteers or government workers, and pulling together the phone and a centralized database on a computer as basic equipment. The fact that this is easily doable and people with human skills needed can always be recruited as they have been in Germany- from public officials in local government who are less busy in lockdowns, medical students, clinicians, volunteers, people from different professions- makes it inexcusable not to learn from others experience and get going. Just Do It. You want to reopen business, professions, offices and public services- Just Do It, it makes this possible. You want to prevent spread of the virus- Just Do It, it makes this possible. You want to limit damage to the economy and get the recovery going- Just Do It, it makes this possible. People of all shades of opinion can agree on this- its the only thing that works, even when there is a lack of enough proper accurate testing. ...