LyrArc Article Gist
The Times correspondent in Beijing says he sees two Chinas one that is showing technological advancement in 5G, in space technologies, in information technologies, infrastructure building in big cities. The other China is in rural areas away from the big cities, in smaller towns in regions away from Beijing and Shanghai. These areas have suffered neglect and have changed little over decades, with the focus during industrialization on larger cities and the coastal areas. This is evident in the manner health services infrastructure and development of medical personnel and doctors were neglected in the rush towards building manufacturing and infrastructure of road and rail. There is a shortage of doctors and hospitals, health services are costly, and waiting lists for beds at hospitals is huge. Doctors are also not held in high esteem because the focus is on profit in the market economy that has taken over the health sector.  Education of citizenry on respecting the common welfare which is expected and normal in Europe and America has also suffered during the rush to industrialization. Efforts to ban and eliminate use of certain wild animal foods not being respected by fellow citizens can be seen in this context. This caused the SARS virus epidemic and the epidemic today from the coronavirus. Seen from this angle a slowdown in construction, infrastructure building, and a slowdown in the economy, can even be healthy, so that focus can be shifted to better health, better sanitation, and better medical infrastructure including medical human resource capabilities. Investment in public education on health and self enforcement of rules by citizenry for a better society is indispensable for progress. It is in these conditions that the challenge of the national and international emergency of the coronavirus can be seen today. It also provides an opportunity to reflect on progress so far and the needs of the future. These challenges are even tougher than repeating what one has done before such as building more and more infrastructure, as they involve building a better society through public discipline along with investment in health and education services. This provides a lesson for many Asian, Latin American and African countries in the rush to industrialization. Turning over the health sector to a market economy making services costly and distributed unevenly in the population has not worked in the U.S. for the betterment of all citizens and a healthy society. Carrying this over from U.S. to China and not learning from Europe in what Europe has done well in the less costly and broad distribution of health services for the people, is one of the poorer lessons learned. This is also true for India and South Asia, South East Asian countries in their rush towards industrialization.  ...

LyrArc Article Gist
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.  ...

LyrArc Article Gist
China has used the quarantine and strict measures to contain the coronavirus. After being taken by surprise in the way the coronavirus developed in Wuhan region China shifted to large scale containment and quarantine. To do this China used technology, mobile carrier information, volunteers going from door to door and enforced quarantine action. Other countries in Europe, including Italy, are adopting measures such as quarantine and appeals to the public for cooperative behaviours.

The entire approach is new yet shows how government and citizens can work together to contain epidemics of this kind in the modern world of urbanized areas and close contact in subways, streets, and stadiums. The approach in democratic countries may vary from China yet essentially strong bold action has proved to be the way to go, not vacillating and acting one step at a time till things are out of control. 

LyrArc Article Gist
China is in isolation and in a freeze in ways that are unprecedented, that have never happened before. It has depressed world trade, disrupted supply chains of world trade, forced companies to restrict their employees movement, or bring them back home. Apple with 10,000 employees has closed operations and offices in China till Feb. 9. This is happening for many foreign companies in China as they deal with something they have never encountered before.  There is slowing down in demand fro crude oil as the lockdown affects the economy of China and world trade, Oil prices dropped 16% since the virus was detected. When the Sars virus happened in 2003 the Chinese economy was sixth in size in the world, now it is the second largest. At that time 7 million Chinese travelled abroad, today it is about 150 million, affecting international tourism. First quarter growth in China is now forecast by economists surveyed by WSJ at 4.9%, the lowest in decades. ...

LyrArc Article Gist
The deep deterioration in U.S. China relations as the U.S. sees itself in a disadvantage in trade with China and the Trump administration imposes tariffs, calls for changing existing supply chains and trade to safeguard U.S. interests. The lack of transparency from China about the coronavirus and the underreporting that led to the U.S. and Europe not taking the threat seriously enough or taking defensive steps is also seen as a part of the deeper problem as the U.S. and Europe bear the brunt of the coronavirus in terms of deaths and cases.  This presents a deeper problem than the trade issue by itself as the U.S. had a trade issue with Japan which was later resolved. The way the Trump administration sees itself as the only protector of U.S. interests in trade, security and international cooperation creates a new level of tensions. Other countries such as Australia, India, Japan, and countries in South East Asia are seen as having similar concerns as supply chains are being remade to reflect the new trading conditions and economic structures. ...

LyrArc Article Gist
This WSJ report is part of its ongoing investigation of the origins of the coronavirus and the role of a risky coronavirus research study in Wuhan, China.

LyrArc Article Gist
Dr. Zhong Nanshan, China's leading epidemiologist and head of the Guangzhou Institute for Respiratory Health, talks to doctors in the U.S. at Temple University Hospital and Harvard University, about China's experience tackling the coronavirus. Other collaboration is happening between John Hopkins doctors and 80 other American doctors with Wang Jian-an president of the Second Affiliated Hospital at Zhejiang University. This hospital in China sent about 170 medical workers to Wuhan, the epicenter of the coronavirus in China.  Three areas of interest for American doctors are the clinical course of the virus, what treatments work and what does not work, treating pregnant infected women, and preventing infections among medical workers.

LyrArc Article Gist
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.   ...

LyrArc Article Gist
U.S. frustration with China as coronavirus toll reaches 300,000 deaths worldwide. President Trump says- "They could have stopped it in China where it came from. But it didn't happen that way. " Worst hit are countries in Asia and Africa with food security threatened. After the coronavirus he says of the trade deal he signed in January- So, I make a great trade deal and now I say this doesn't feel the same to me.The ink was barely dry, and the plague came over. And it doesn't feel the same to me." Under that trade deal the China agreed to buy $250 billion in additional goods and service for 2 years in an effort to correct a huge trade imbalance - built up on the advice of American economic theorists and experts who advised American presidents for three decades that it was of no consequence - in exchange for a roll back of American tariffs in stages of part of the tariffs. 

LyrArc Article Gist
China is gradually getting back to normal. With few new infections from coronavirus, factories are starting production again, and stores are reopening, people gradually coming outdoors.

For factories there is one problem- as Europe and the U.S. battle the coronavirus and impose their own lockdowns demand has evaporated. Factories are seeing canceled orders and having to operate with smaller number of workers.

All the graphs shown in this report for Beijing traffic congestion, Guangzhou subway rides and property transactions show the curves for 2020 way, way below the curves for 2019.

This also gives some idea of what the road ahead will look like in the U.S. and Europe. That the recovery will take time and patience after a difficult period ahead tackling the coronavirus state by state. Lost jobs, diminished confidence and fallen income will take time to recover.

 

LyrArc Article Gist
China reports no new coronavirus infections for the first time on March 19. The outbreak in Italy now surpasses that in China.  The U.S. government is now shifting to social distancing as the most effective way to control the spread and away from focus on widespread testing as a containment tool. The experience in China shows social distancing works, quarantine works. Countries and regions that have neglected to do this early are the ones worst hit, including most of Europe.  The reintroduction of the infection after its containment is addressed by quarantine and social distancing and use of masks, government disinfecting hard surfaces in all public areas, a program implemented strictly in Asian countries such as Singapore, China, Taiwan, and other Asian countries. Use of masks was common in Asian countries in earlier episodes of SARS and other epidemics, making it widely used long before this crisis. This is making a significant impact in addition to social distancing and other quarantine measures taken in China.   ...

LyrArc Article Gist
During question time in the US Congress US Senator Rand Paul stated that the US money was used to fund research at the Wuhan Institute of Virology. A ban on gain of function research on virus was lifted by the US in 2018. Following the lifting of this ban which was strongly opposed by scientists at Cambridge, Massachusetts, research was conducted that many of these scientists considered dangerous and risky. This report in the BBC shows Dr. Anthony Fauci. director of the NIAID, the Institute for Allergy and Infectious Diseases responding to Dr. Rand Paul, Senator from Kentucky. Much of the discussion goes into definition of "gain of function research" and misses the broader implications. Scientists in Cambridge had warned early of the danger of doing research because of earlier mishaps such as the one involving anthrax research from accidents that are always a risk. Epidemiologist Marc Lipsitch of the Harvard Chan School of Public Health warned of just such an "accidental pandemic" in Three Questions, Three Answers in the January 2018 issue of the Harvard Chan School of Public Health journal. He stated that an "accidental pandemic" could result from the lifting of a ban on a risky kind of research favored by some virologist professionals. Most of the medical and scientific community in Cambridge fiercely opposed the lifting of the ban on what they saw as risky research with little benefit in 2018.    ...

LyrArc Article Gist
Face masks work and cut down infection by 85% say studies, but it is important to make sure that it stays on and leaves no opening for air from outside to get in. This means not taking calls in areas where infection can occur and not touching the mouth, eyes or nose with the hands. 

LyrArc Article Gist
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.

LyrArc Article Gist
China has used the experience gained from an earlier SARS outbreak to tackle the virus outbreak in 2019 which started at a food market in Wuhan. Early detection, strict quarantines, and other measures, were taken. A viral pneumonia outbreak happened in Wuhan, a city of 19 million. 59 people were quarantined and the largest food and seafood market in Wuhan was shut down quickly. Between the first case on December 12 to the detection of the new strain of coronavirus in 1 month, China acted with speed, showing China's strength in public health resources and research labs.

LyrArc Article Gist
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.

LyrArc Article Gist
Underreporting of coronavirus cases in China poses risks for other nations in not giving them a sense of the magnitude and severity of coronavirus. This leads to a false sense of security- in Japan, Sweden and other countries, much delayed action and a sense of exceptionalism that we can ride this thing through like an ordinary virus, In the U.S. and Italy, Spain, UK and Germany, loss of crucial weeks before taking action. Looking to the future this poses new risks as it still leaves people without a sense of how long to continue lockdowns.  The pandemic poses huge risks for Asia and Latin America because of poverty, crowded conditions and sanitation levels. The early action by prime minister Modi was a huge step in the right direction before coronavirus spread could damage the economy and people- as Mr. Modi said if not done right such as with a 21 day lockdown this could set India back by 21 years. It had value in that it alerted other countries such as Philippines, Indonesia, Malaysia, Bangladesh, Pakistan to take strong action early. As the WSJ says here in this essay by what is important for China and all other countries reporting on coronavirus is that this reporting is vital only because it can save many other countries from making costly mistakes. Which is why the direct doctor to doctor contact between Chinese doctors and American doctors is an encouraging right step, says WSJ.  ...

LyrArc Article Gist
The Trump administration suspended all flights from Europe on March 13, about one month after suspending all flights from China. This report in the NYT says there were about 10,000 estimated undetected infections in New York on March 1 when only 1 case of coronavirus was confirmed. It also says that researchers have tracked the mutations of the virus in all American states and found that most of it came from New York. Could the Trump administration have acted earlier than March 13 to stop flights from Europe? The state and city authorites in New York did not take the threat seriously by March 13, making it not clear that they would have acted earlier.   In places like Michigan which has Italian Fiat owned Chrysler operations, and automotive connections with Munich, Germany, reports show the virus coming from Europe. Munich based auto companies have extensive operations in China. In Louisiana the Mardi Gras celebrations around Feb. 25, received large numbers of visitors from New York, with research showing the virus mutations in Louisiana originated in New York. There was little awareness of the seriousness of the virus because of lack of past experience as happened in Asian countries. So that these kinds of public events bringing huge numbers of people in close contact were allowed to happen, and people who were cautious were likely to be ridiculed or shoved aside. New York continued to hold public gatherings at Madison Square Gardens and sports stadiums well into March, with complete disregard of the dangers, a decision made by local authorites.   ...

LyrArc Article Gist
The knowledge that the virus  caused human to human transmission and that it spreads to wide parts of the population very quickly were critical pieces of information that remained with Chinese epidemiologists, doctors and medical researchers, and were suppressed by local authorites in Wuhan.  Yet China's version of the U.S. CDC, China's Centre of Disease Control and Prevention, modeled on the U.S. control efforts worked effectively to identify the problem. Virologist Gao Fu, heads China's CDC. This report in Germany's Der Spiegel says Mr. Fu made it a habit to scan China's internet before bedtime for any signs of possible disease outbreaks. On the night of December 30 he came across rumors of an internal memo from the Wuhan Health Commission of an outbreak of a vaguely worded lung disease. When he called the Wuhan health authority he found their answers to be evasive which alarmed him. The next morning December 31 Mr. Fu sent the first of three teams to Wuhan which is how China was able to identify the problem, in the sense that Chinese authorites in Beijing were to rely on Dr Gao Fu to overcome the problem of Wuhan provincial authorites. He informed the World Health Organization Beijing office on that day. The Der Spiegel report says "shortly afterward," the Seattle Times in its report says this was about New Years Day 2020- Mr Fu made a call to Dr. Redfield, head of the U.S. Centre for Disease Control, who was on vacation. Redfield is deeply disturbed on hearing this from Fu and they have conversations over the next few days to the point that Dr. Gao Fu is in tears about what has happened. On January 1 Taiwanese public health authorites shared the information with WHO that the cornonavirus was a human to human transmission, would the Taiwanese authorites not have shared it with the U.S. the same week during calls from the U.S. CDC or other public health authorites alarmed about the situation. (The WHO was proving useless by Jan 14 when it contradicted Taiwan's more reliable assessment  on Jan 14 going by the letter from president Trump to WHO). On January 6 a few days later Dr Redfield and Dr. Azar head of Health and Human Services ask China for permission to send a team of CDC U.S. experts to China. This is cited in the U.S. letter to the World Health organization- the lack of human to human transmission information being given to the U.S. officially early by China. A risk that could have been a topic of conversation between the U.S. and China heads of CDC. That letter from president Trump also points out that the team of experts the U.S. planned to send was not accepted by China till Feb 16, one and half months after that series of conversations between Dr. Gao Fu of China CDC and Dr. Redfield of U.S. CDC in an alert message.  In effect removing one of the key defences for the U.S. and Europe in making their own defensive actions and plans, laying the basis of the worldwide coronavirus pandemic affecting millions of people. Dr Redfield is a AIDS researcher at the University of Maryland who spent most of his life trying to control spread of HIV and was appointed by president Trump to head CDC agency in 2018. He set a goal of eliminating AIDS by 2030 and is more comfortable with aids patients and research than the bureaucratic nature of agencies- CDC has about 11,000 employees. Once it was clear that a team of U.S. experts was not given permission to make its own assessment in Wuhan in the few days after January 6 offer to sent the team to China by Redfield of U.S. CDC and Dr. Azar, would it have alerted the U.S. that something was seriously heading the wrong way for a epidemic risk. That letter of president Trump cites how the head of WHO during the first SARS crisis in 2003, Dr. Harlem Brundtland acted when she faced China's lack of cooperation during that crisis by saying openly that this was a danger to world public health and millions. Could CDC in the U.S. and the other connected health authorites have taken the responsibility and filled Dr Brundtland's role in this crisis, that the WHO failed to perform?    ...

LyrArc Article Gist
Maps of U.S. coronavirus by state as of April 1, 2020, that reached 189,000. How coronavirus is surging worldwide with 75,000 added on March 31 to reach 874,000 coronavirus cases detected worldwide. China's numbers have not included coronavirus cases that are asymptomatic. 

China continues to see coronavirus cases with 166 new cases on March 31, showing that it public health authorites have to be vigilant about a restart of the epidemic once it comes under control.

LyrArc Article Gist
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.