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Years of poor funding of public health departments in the US, Europe, and other countries have left public health departments lacking basics, lacking staff and resources. Here the WSJ shows how this has affected Alabama in the southern US. Alabama has the slowest vaccination program in the US with 10,000 doses given per 100,000 population. Positivity rate is very high at 29.1% for coronavirus, one of the highest for positive coronavirus tests in US in the past month of  Jan. 2021.

A large portion of the population of Alabama lives in rural areas. These rural areas are some of the worst hit in healthcare in the US. Since 2009 7 hospitals have closed in Alabama resulting from poverty of patient populations and population loss. This is part of the general erosion of rural healthcare infrastructure across the US in the last 20 years. A problem that now faces the Biden and future administrations. to tackle the problems of rural US communities.

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The U.S. and India see a surge in coronavirus cases. Per day cases surged to 40,000 on June 25 in U.S. and 17,000 in India. Alabama, Idaho, Nevada, Arizona, California, Florida are seeing a surge in new cases. Texas, California and Florida all recorded more than 5000 cases each. In California cases for hospitalization surged 32% with more than 4200 in hospitals.

India now has 490,000 cases with death toll of 15,301. Indian Railways cancelled all bookings. In the U.S. Texas is paused reopening plans.

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Already vaccination experts at the Baylor College of Medicine cited here say they foresee another wave of the coronavirus in the Southern US because of vaccine skepticism barriers to vaccination, and much of the population not being vaccinated. The percentage of the population in the Carolinas, Georgia, Georgia and Louisiana, that has both doses of vaccine is low. About 50% have had just one dose. In southern states Mississippi and Alabama the vaccination rates are much lower leaving large parts of the population unvaccinated. The widespread presence of the Delta variant in the UK and the R rate being between 1.00 and 1.2 in UK shows that the UK even with higher vaccination rates than the US is still facing a danger of another wave as it reopens.  The ominous aspect of this is that from just over 400,000 the vaccinations per day dropped to 316,000i n the US. This means there will be a period when vaccination drive is stalled while the reopening is fully underway with a new contagious variant twice as contagious as the original coronavirus. This leaves the US at risk of another wave, with the south and western US, younger people who are out more and unvaccinated, more at risk.  ...

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States in America's Deep South have a much lower rate of people having taken one shot of vaccination, in the 30-40% range by May 2021. This report says states such as Alabama, Arkansas, Georgia, and others in the South are at risk of seeing a new wave of the coronavirus  because people will spend more time in airconditioned spaces in the summer. In contrast to the north with cold winters and indoor heated spaces people in the southern states can spend more time outdoors because of the warmer weather in winter. This may have protected southerners during the winter and spring months. This may reverse with more time spent in airconditioned indoor spaces in close proximity where the coronavirus infections can increase. This report comes as new reports show the Indian coronavirus variant becoming more prevalent in the UK and other countries. This variant spreads about 50% more rapidly than an earlier UK variant, say experts. Another analysis in The Times of London shows that the imperceptible rise phase of the new coronavirus variants is the most dangerous part of the coronavirus as it dulls the sense of danger in the population that makes it take notice and prepare countermeasures early enough. India is an example of how this can happen as the sudden rise actually started with a first imperceptible increase in March and early April 2021 that changed into a rapid escalation of the virus in the population by May 2021. The vaccinations give a strong sense of confidence, however the vaccination rates vary widely state by state in the US. ...

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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 Biden vaccination target of 70% of American adults at least partially vaccinated with one dose by July 4, 2021 remains elusive as vaccination rates have dropped. From a high of 2 million a day vaccinations have dropped to 400,000 a day during the first week of June 2021. Vaccination skepticism particularly in the south and western part of the US is making it harder to vaccinate the rest of the US population. This poses increasing risks as the new variants of the virus such as the Delta variant found in India, and now the most widely prevalent strain of virus in the UK, remain a serious problem. The unvaccinated population in the US is too large for any degree of safety in numbers vaccinated. Consider that at the press briefing given by the White House on June 3, 2021, only 28 states out of 51 states have fully vaccinated 50% or more of their population. There is a large variation between different states with states in the south such as Mississippi as low as 34% at least one dose and a similar situation in Alabama. In Arkansas, Georgia, Carolinas, and Louisiana  it is higher at about 50% with at least one dose. Even these figures are deceiving as in some parishes in Louisiana only 20% have even one dose. Studies show that only after the second dose are enough antibodies released to protect well against coronavirus. This is why vaccine experts at Baylor College of Medicine cited in NYT foresee a second wave in the southern US because of the South so underachieving in the case of vaccination.  ...

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The southern and southwestern U.S. which were expected to peak late are now seeing a surge in the coronavirus cases. This includes Alabama, Florida, Texas and Arizona. New York imposes a quarantine of 14 days on residents of these states travelling to N.Y.

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About a quarter of Michigan counties are among the top 20% of counties in America for increase in unemployment and deaths per 1000 residents from the coronavirus. Only Massachusetts and New Jersey have fared worse. This WSJ analysis was based on federal government county level unemployment data. In May Michigan's 21.2% unemployment rate was the third highest in America after Nevada and Hawaii, two states where tourism drop hit hard. In a place like Muskegon the loss of about a million tourists and loss of jobs at Howmet Aerospace hit hard. Recovery of tourism could bring down the rate quickly, yet manufacturing will take longer.

Other states with many counties in the top 20% for deaths from virus and unemployment are Indiana, Ohio, New Hampshire, Alabama, Mississippi, Pennsylvania, New York.