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The Moderna and Pfizer vaccines are effective against the virus variant identified in Britain. It is less effective against the virus variant from South Africa. The U.S. banned all travel to and from South Africa effective Jan 30. U.S. coronavirus cases were at 125,000 on Jan 24 down 20% for the week. 

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Dr. Ezekiel Emmanuel of the University of Pennsylvania gives this early warning on the risks of the sudden U turn in China's zero covid policy to complete reopening. He says the switch from zero covid to population wide immunity via viral spread is coming on too suddenly without preparation. He says China made three mistakes. First, the economic cost of zero covid that dropped growth and created high youth unemployment of over 20%. Second, not procuring Pfizer and Moderna mRNA vaccines with newer technologies. Third, moving to abruptly end the zero covid policy 180 degrees in a sudden move that lacks preparation. Precipitiously ending the zero covid policy for 800 million people means rapid spread says Dr. Emmanuel. He says the key variable the R statistic that measures how many people get infected from one covid patient on average, has moved from 2 to 3 during the early stages of the pandemic to 10 with the omicron variant. Chinese officials report the R to be at 16 in China today, says Dr. Emmanuel. ...

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Germany faces the possibility of a pandemic surge of the unvaccinated, something that is happening today in the southern United States.  For days the percentage of people that are fully vaccinated remains at 62%. Some vaccination centers are closed. A vaccination center outside the train station in Cologne offers passersby free vaccinations. Berlin's Social Democrat mayor Michael Muller is very frustrated. He says "I am now coming to a point where I think we have exhausted what we can do in politics."  At 62% the rate of fully vaccinated people in Germany is too low to prevent a surge of the Delta variant in the way that it has hit the southern US, and California. Vaccination rates of close to 85% are needed to tackle the risk of another surge in highly contagious delta variant. Not everyone remaining is die hard opposed to vaccines. The Robert Koch Institute estimate is that 5 to 10% of people are in that die hard category. The remaining 20-30 % are people who have various other concerns and fears, hesitancy, that may be changed.  The chairman of the World Medical Association Frank Ulrich Montgomery favors a vaccine mandate, what he calls a 2G rule, that should be introduced in Germany requiring vaccination to attend events, sports, restaurant visits, adopted nationwide. German government has rejected idea of mandatory vaccination of health personnel, that was adopted in France. Vaccination drives are regionally based. Some are ineffective such as the Deutsche Bahn train system vaccination drive for commuters that only had a few hundred doses of J&J vaccine and ran out quickly in Berlin. One prick J&J some say is better for vaccine skeptics. Vaccine skeptics think they may get away without getting covid infection. How does one get over this misconception? Others including members of the Greens party say vaccine needs to be delivered where people are- transit points, bus stops, doses offered in evening and early morning hours, trying new ways to reach people and inspire confidence. Germany now ranks behind France but ahead of Bulgaria in terms of vaccination percentage in September 2021, not a good situation. ...

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Hospitals in New York City are coping better in the current wave of coronavirus variant in December 2021 as the symptoms of patients are milder and patients are going home quicker. This report covers NYU Langone, Northwell and Mt Sinai, Presbyterian  health systems. Only about 2% of healthcare workers were lost through dismissals because of the vaccine mandate at Northwell, which is the largest health system in New York City with about two dozen hospitals. About 400 covid patients turned up on Friday Dec. 17, a fraction of the 1350 last January and of the 3500 in early spring 2021. The head of integrated operations,, Dr. John D'Angelo says Northwell has enough staff to meet projected needs. Most covid patients had underlying health problems and a quarter are vaccinated up from 10-15% a month ago. Vaccinations and two years of experience make for a different picture now, though there will be challenges and I think we're going to have to think through a bit carefully, says Dr. D'Angelo. ...

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Lessons can be learned about careful reopening in fighting the coronavirus from other countries. Here the Netherlands experienced a rise of cases by 500% within two weeks of reopening after some poor decisions. The Mark Rutte government decided to open all bars and nightclubs resulting in a twelve fold surge in these locations in one week. Most of the new coronavirus cases were in people 18-29. Data from Dutch public health institute shows 4 out of 10 new cases linked to bars and nightclubs with 262% surge in cases for young people 18-24 years. This goes to show that with the vaccination drive what we see is the cases shifting to younger people, the unvaccinated, and to activities like nightlife. People going to work, or doing hybrid remote work with trips to the office, workers in factories, people doing essential shopping, are not causing the rise in cases. Much can be learned from these examples in working out reopening that does not lead to new crises with surging cases in new waves of coronavirus. Earlier in 2020 summer tourists who ignored mask and social distancing restrictions in Croatia brought on a post summer coronavirus wave to Germany and Austria. This time Greece and Portugal are introducing restrictions. Greece plans to make vaccine health pass required effective July 21 to go into restaurants. Another lesson from Netherlands this week is that a 20,000 person music event of 2 days in Utrecht where QR codes were required showing vaccination or PCR tests failed. About 1000 cases were attributed to the Utrecht event alone. Reasons given are that people faked the QR codes, or that the covid testing system produced too many false results as much as 20%. The same QR code system was followed at nightclubs resulting in big problems. One can never be sure that things work as expected and the risks are great as this adds up. Even vaccines offer limited protection and only if fully vaccinated depending on the type of vaccine. One dose of the vaccine is simply inadequate, and obesity, other morbidities can lead to problems. Withdrawing the mandatory use of face masks in most situations is also a risky decision of the Dutch government. Face masks offer the added protection at a time of variants that spread quckly, and when large parts of the population have only one dose of the vaccine, some elderly are still not vaccinated, and young people have not been vaccinated in large numbers. ...

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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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Contrast the slow US vaccine export response with that of India, Russia, EU and China. Only in May 2021 after India's daily Covid cases were close to 400,000 a day did the US make a serious offer of vaccines to other countries in need of assistance. U.S. president Biden says that 80 million vaccine doses would be exported by the end of June 2021. The WSJ says citing Airfinity, a London research firm, as of May 10 more than 333 million doses of vaccine were produced by the US and only 3 million vaccine doses were exported. Contrast that with the European Union which has shipped 111 million doses overseas one third of its total production, Russia which has exported 27 million doses.  India has exported 66 million doses according to the Ministry of External Affairs website as of May 17, 2021. This includes 4 million doses to Brazil, 4 million to Nigeria. Within its own region Bangladesh received 10 million and Sri Lanka 1.2 million doses, Afghanistan 1 million. Mexico received about 1 million doses. In Africa the Democratic Republic of the Congo which has suffered from many epidemics including Ebola virus received 1.7 million doses, Nigeria 4 million doses, Kenya 1 million, Uganda 1 million. Of the 66 million about half of it is a direct grant assistance and Brazil, Mexico, Morocco received all vaccine as grant assistance, 70% of Bangladesh's is grant assistance. The list on the Ministry of External Affairs site of the Government of India shows 95 countries including many of the most struggling nations of Latin America and Africa, bringing hope to countries which are struggling to hold onto hope for a better life beyond the pandemic. Sending help overseas through vaccine supplies is suspended for the moment but will resume in July after India has pulled in all of its pharmaceutical manufacturing industry under a government guided effort to go all out. Never has so much help bringing much needed hope gone to so many countries of the world in the twentieth or twenty first century from a nation that is struggling to meet its own needs. The US in pursuing a US first policy of vaccinating all its citizens has not taken into account the need to bring this evolving vaccine technology into the hands of as many qualified pharmaceutical manufacturers as possible. This in a rapid response to expand manufacturing capabilities to meet world wide demand. The risks of not doing so were not taken on early- the very same way the virus spread in January to March of 2020 can be repeated as people travel around the world particularly for tourism, business family reasons. This risk takes on anew dimension of contagious mutations of the virus which are 50% more- the Indian variant being 50% more contagious by some estimates than the UK variant, which itself was estimated to be 50% more contagious than the original one.  The result a pandemic that stretches out indefinitely unless billions of doses are made in a short timetable to beat the timetable of Nature through the coronavirus. India is doing this for the first time with plans to produce billions of doses by engaging the whole of the Indian pharmaceutical manufacturing industry in the effort in a rapid response so that July to December would see 1.2 billion people vaccinated. The US effort, the European effort is left to the individual effort of pharmaceutical makers in the US and Europe, not a government guided effort to engage the entire pharmaceutical industry of the US and Europe in a rapid response timetable of 2-6 months.  ...

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In a factory the size of 5 football fields located in Gurnee, Illinois, Abbott Labs makes its BinaxNow Covid-19 home tests. Abbott turned out 1 billion tests in 2021 and at one point had 80% of the market. Along with Pfizer vaccine, BinaxNow Home covid-19 tests are a dominant product during the pandemic. Abbott generated a fifth of its $43 billion in revenue from these home tests. Abbott faced several hurdles along the way. It gained when the US government authorized it to make the test. Yet after vaccination took off by mid 2021 the demand for tests declined and Abbott nearly idled its giant factory in Gurnee. Delta and Omicron variants led to a sudden reversal and surge in demand. Abbott developed its test based on an existing design it used in the US for flu tests, by a company it inherited by acquisition called Binax. To do that test one sends a swab up the nose, add that sample and a liquid mixture to a rectangular paper card, and close the card shut. The liquid then travels up the paper strip, revealing one or two pink lines, one for negative, two for positive. This is done in 15 minutes and the simple design described as a lollipop shape, put Abbott far ahead of competitors. The US FDA authorized Becton Dickinson and Quidel to make the tests before it authorized Abbott, but these rival companies had a poor and complex design. The Trump administration gave Abbott a $760 million contract to buy 150 million tests for distribution to health departments, long termcare facilities, nursing homes, and schools. And by October 2020 Abbott was already making 50 million tests a month. When it comes to distribution Abbott tapped into its pharmacy connections for baby products such as Similac baby formula. This gave it an advantage over Quidel and others who also lacked the manufacturing knowhow for large scale ramp up. The BinaxNow in pharmacies was sold at $24 for a box of two tests, while government paid $5 for one test. Abbott says it makes $ 7 per single consumer test. Yet there was one problem waiting to hit Abbott in 2021- demand dried up as the vaccination campaign took off. In fact the plant manager, Mr. Rodriguez, planned to move to another job inside Abbott as production declined. Then came the Delta variant and he was asked to ramp up production again. With Omicron demand soared. The Biden administration committed $3 billion to help boost test production and asked Kroger and Walmart to sell over the counter tests at cost for 3 months. Abbott had to lure workers from Amazon at $25 an hour for the Gurnee plant expansion. What was learned by the government and Abbott from this experience? The US government now looks for ideas in meeting demand volatility, supply challenges and production needs,. Sustaining production capacity is important for future virus flareups- a new government-industry partnership is required for maintaining test making infrastructure. With government help Abbott plans now to keep the facility at Gurnee operating indefinitely. ...

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The latest Covid 19 vaccine introduced in September 2023 has a very low uptake in the US, at about 18%. The JN.1 Covid variant is for which this vaccine is effective is now making up about 50% of the cases of Covid in the US. It was at 7% in November. It is very transmissable and masks are now advised.The Covid related hospitalizations are up 10% to 26,000 in the fourth week of December. Symptoms of this variant are cough, fever, body aches, and fatigue that last for 3-4 days, says this NYT report.

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Most American large companies support president Biden's decision to mandate vaccinations for all employers with more than 100 employees. Smaller business also supports the decision as it makes this decision for them. The US Business Roundtable of the largest US companies issued a statement saying it "welcomes the Biden Administration's continued vigilance in the fight against Covid." It went on to applaud the decision of some companies to implement a vaccine mandate before the president's decision. Companies would like to see a rapid ramp up in testing capacity as they see testing capacity levels not the vaccine mandate as the real problem today with the surge in Delta variant. These companies such as Target, Nike, and retailers see testing capacity as "stressed" and say "testing capacity must be scaled immensely to meet the new requirements." Labor unions clearly support president Biden's decision including teachers associations, and the AFL-CIO. Some companies including Delta Airlines are imposed health surcharges for unvaccinated employees, and United Airlines has brought in its own vaccine mandate. The president's vaccine mandate has broad and deep support of the American people and business, according to this WSJ report, with recognition of the huge risks posed by the transmission rates of the Delta variant in the surge of coronavirus in September 2021. However companies say the Biden Administration has to scale up testing capacity quickly to make it work. ...