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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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Indian prime minister Modi talks to chief ministers of all the Indian states by videoconference as he prepares for gradual reopening of the economy. A key concern- that the coronavirus should not spread to rural areas. Chief ministers were asked for their ideas on reopening. Indian railways sets up train services to take 45 million migrant workers to their home regions.

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Is India relaxing its earlier tight vigilance for the coronavirus? This report in DW.com points out that the earlier vigilance has slackened after the reopening of the economy leading to a jump in cases.

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Health authorites in Italy, France, Britain India and the U.S, have hesitated in reopening schools. Germany and Denmark have reopened schools with no increase in infections with schools following specific policy including mandatory masks, air circulation rules, and careful preparation of schools to ensure social distancing rules are respected. Other countries reopening schools are Austria, Norway, Finland, Australia, New Zealand.

Schools in German states are reopen for about 1 month now, with a positive experience after careful preparation. Italy faces difficulty reopening its economy as people going back to work find it difficult, particularly women,with childcare provided by grandparents no longer an option, and lack of daycare. Opening of schools in Italy would help in reopening the economy, as well as provide relief to parents and children, when done carefully.

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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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The NYT provides a good look at the situation in India in September where cases are over 4.5 million, the world's second largest after U.S. During the lockdown in April and May India had successfully stemmed the coronavirus. After reopening in June a lot has changed as can be seen in this look at the steep curve in June, July, August and September. Cases are now at the rate of 95,000 daily and deaths at 1172 daily as of September 9. The deaths are up 16% and cases up 29% over 2 weeks. Maps show the situation in the states with Maharashtra, Andhra, Tamilnadu, Karnataka, and Uttar Pradesh showing the highest cases. Maharashtra has about 1 million cases and the two states in the south east Andhra and Tamilnadu have about 1 million combined with Uttar Pradesh at about 250,000 cases. Delhi has about 200,000 cases. So that about half of the 4.5 million cases are in three states in the southeast and the western state where Mumbai (Bombay) is located. The increase was seen after increased testing from 200,000 a day to 1 million a day by the end of August, a steep jump being seen in late August and September. At the end of July the coronavirus recovery rate of 70% in India and 90% in Delhi were the favorable signs, until things changed in August with increased testing and the spread to rural areas. India is doing over 1 million tests daily. On September 3, 1.1 million people were tested, taking the total to 45 million tested throughout India.  As in Europe and America the reopening which is essential for the economy and jobs has resulted in a big jump in cases. The laws for lockdown were carefully obeyed without many of the problems seen in America and Europe, the early complete lockdown was implemented with success, and Indian pharmaceutical companies are some of the largest in the world giving the public wide access to essential medicines and drugs. The postal service has functioned remarkably well during the lockdown for delivery of essentials throughout the country, and earlier action to establish bank accounts for each and every individual in the country, has enabled rural Indians to get through this most difficult period. This has given the government some breathing room as it faces the cases from reopening in a vast country of 1380 million people.   ...

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A drop in the positivity rate to below 5% and cases dropping to below 100,000 after peaking at 400,000 in May. This report in the Indian Express looks at the details behind India's successful effort at bringing down the cases that was done over a period of 30 days with a combination of effort from the central government, state governments and healthcare workers. The turnaround was achieved effectively in Uttar Pradesh a state of 210 million people so that per thousand population had dropped to below that in the US state of Michigan about 2 weeks before that was achieved in Michigan. This was the result of an extraordinary effort at all levels in India.

Risks of the new variant exist in all countries that are reopening aggressively. Talk about huge open air concerts and filled sports stadiums in the US show that complacency can happen as countries reopen.

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India continues to reopen its economy even as cases surge for reasons of keeping the economy's reopening and ensuring the livelihood of millions of people. The Taj Mahal draws 7 million tourists every year and it has reopened. Fatigue with extreme measures has set in and the government is reluctant to go back to the lockdown measures that affected the economy in April and May. India's economy contracted by a quarter in April- June. A million people are being tested daily and still this is not enough.

India has recorded 5.4 million cases and could overtake the U.S.

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Merkel say to Gemany in a weekly video message that "the danger posed by coronavirus remains serious. "Take it seriously because the situation is serious." It requires everyone to act responsibly. "By following the rules for social distancing, hand hygiene, facial coverings, every one of us contributes to our shared destiny, " she said. It is a message that should resonate in the U.S. India, Brazil and other countries hit hard by the virus. Germany's cases are approaching 200,000 with fresh outbreaks in some areas. Reopening everywhere creates new risks, vigilance is essential.

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As the growth of coronavirus cases slows in the U.S. and Europe, cases in India surged by 9000 in a biggest single day increase with total cases passing 200,000. Deaths in New York dropped below 50 on June 2. Outdoor dining opens in upstate New York as this part of New York enters second phase of reopening- tables 6 feet apart and staff wearing masks at all times. Customers required to wear masks when not seated. New York City enters Phase 1 of reopening on June 8. New York City will distribute 1 million face masks and it will be mandatory to wear masks on mass transit. Hand sanitizer will be provided at stations. Every other seat will be blocked off on buses. 

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Concern about school reopenings in the U.S. One fraternity party at the University of New Hampshire leads to 11 cases which the Dean calls reprehensible. Schools are shifting back to remote learning as cases increase with inappropriate behaviours. Nationally the U.S. sees a decline to 25,000 cases daily on average and India the decline is to 75,000 cases daily.

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The reopening of the economy is being stalled and lockdowns, restrictions, reinstated in July 2020 as the pandemic surges. The lockdowns are being reinstated in parts of Australia, in Bihar, India and other countries, and in other places such as California restrictions are back in place. Wearing masks in public spaces is also mandatory in Britain and France as prevention measures are being taken. In Japan wearing masks is a habit from before the pandemic. India, the U.S. and Brazil, Mexico are seeing a surge.

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India's efforts to reopen parts of the economy- agriculture, some manufacturing and construction, industries where shifts can be run and workers can be isolated. 

Smaller factories had difficulty reopening because they could not meet stringent workplace requirements. About a third of rail employees were asked to return to work, but attendance was poor because of the difficulty of getting to work. 

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The SCHOOL survey by eminent researchers shows that that 37% of rural school children in India are dropping out- an alarming piece of information. Only 8% of rural school children have access to online classes regularly. The figure for urban areas in India is 24% of school children having access to online learning regularly. This could have serious consequences. Getting primary and secondary schoolchildren back into classes is an important goal during the pandemic. Online learning has only a limited reach at this time. Many households have no smartphone or only one smartphone that is used by adults. The SCHOOL survey covered 15 states and 1362 sample households. Between 51 and 58% of students had not met their teachers in the preceding month according to the survey.  This also affects nutrition as schoolchildren are missing the midday meals given at school. Midday meals were discontinued with the closure of schools. Overall this report says 97% of parents support reopening of schools. ...

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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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!5,000 of the 25,000 coronavirus cases recorded in India on March 14, 2021 are in the state of Maharashtra, with the rest mostly in 6 other states, including Kerala. 

A team sent by the government in New Delhi to Maharashtra found the increase in cases in the state due to- "lack of fear of the disease," pandemic fatigue, missed cases, super spreading events from recent panchayat elections, marraiges, reopening of schools, and crowded public transport. The report  says that these factors are not unique to only Maharashtra and apply for other affected states also, including Kerala, Punjab, Karnataka.

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The low number of confirmed cases and small number of deaths in India and Pakistan is being analyzed for what to expect in the coming months from June to August. Some experts see this as just the beginning that the peak will come later on. India has about 75,000 cases and Pakistan 35,000. Testing has lagged behind with only 1.5 tests per thousand people compared to 26 per thousand in the U.S.  one reason the confirmed case count is lower. Some confidence is being drawn from the deaths- 2415 in India and 737 in Pakistan. This is because only 2.2% of cases in India and 3.3% in Pakistan led to deaths, compared to 14.3% in UK and 5.5% in China, 6% in U.S., using John Hopkins database. One reason given is that only 6.4% of India's population and 4.3% of Pakistan's is over 65 years age. Compare mean age in Italy 46 years to 27 in India and 23 in Pakistan. And there is plenty of sunlight which appear to destroy the virus. Other factors that may influence the virus- taking of the tuberculosis vaccine and routine exposure to more pathogens in both countries. Prime minister Modi in India is taking no chances considering the size of India's population. He has put forward a $280 billion economic package and is moving in deliberate carefully prepared steps to lift lockdowns with the current phase No. 4 allowing more reopening. The shift now is to a more self reliant economy in industrial production making "local more vocal."  During the lockdown the large rail network and postal networks with their millions of employees, IT technology driven banking with Aadhar identification for direct deposit to hundreds of millions of the most needy citizens, and farmers, proved to be the most reliable and supportive. ...

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The variant first identified in India called the Delta variant is 60% more infectious than the Kent variant found in the UK. The Delta variant is now the dominant variant in the UK. There is concern that this could lead to another wave just as the UK is reopening in the summer. There are over 6000 daily cases in the UK this week. The estimated R number is now 1.00 to 1.2 following the number being 1.00 to 1.1 in the earlier week. A R number over 1.0 suggests greater spread of the coronavirus. An R number of 1.1 suggests the number of cumulative cases is taking off meaning that the UK is at risk of a sudden surge in the coronavirus in June or July 2021. India faced a wave from the new variant's higher rate of infectious spread. leading to a sudden surge in May 2021 to 400,000 daily cases before it was brought down by June 1 to about 100,000 The number of hospitalizations in such a wave is estimated to be higher in UK than the previous waves, requiring the government to be more vigilant today. Restrictions on travel from Portugal are being put in place in UK as a precaution. After repeated waves as a consequence of complacency with the coronavirus the lesson now is to take steps early and take aggressive action in advance. ...

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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. ...

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Justin Lahart of the WSJ says the positive news from the May unemployment report comes as a complete surprise. No one expected the addition of 2.5 million jobs, and the reduction of the unemployment rate from 14.7% to 13.3% for May, as reported by the Labor Department. Lahart says that even though the response rate for the Labor Department survey measuring the jobless rate had only 67%- instead of the usual 82%- it is broadly reliable. About half of the jobs bounceback comes from the leisure and hospitality industry. Some of this from the creative ways restaurants responded by doing an active takeout business and bringing in some of the workers.  Other businesses also responded in creative ways to keep running. As long as the reopening of the economy can be done safely, more people can be back to work. The significant relief from the government for small business could also help these businesses weather the crisis. The Global Vaccine Summit recently opened provided more positive news. Plans are underway for India's Serum Institute to produce 400 million doses of the Oxford vaccine by December, providing more hope for recovery. ...

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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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About half of people in Britain in a recent poll taken during the second wave of coronavirus say they see a negative impact on mental health. Depression is affecting a fifth of the population in Britain. It has never been more important to be kind to each other and ourselves as the second wave hits a weary and fatigue stricken society.  People found many activities and hobbies to do during the 6 week lockdown period and there was an expectation that spring would bring better conditions. During the second wave of coronavirus there is a sense of a dreary period that goes on through Christmas. The uncertainty from the U.S. elections, Brexit in Britain, the reopening in countries such as India, the loss of jobs and income in countries that range from severe in Brazil, Mexico and Argentina to moderate in China, adds to the anxiety of daily life with surging cases. Creating what amounts to a low grade depressive effect during the second wave that needs to be addressed by the authorites, by health agencies, and in other ways, says this report in The Times. ...

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Britain recorded the most deaths in Europe. Brazil and Russia have over 10,000 cases of coronavirus each, and the U.S. records cases close to that in the peak in April. Cases were up worldwide for May 6 to 92,000 with a quarter of these cases or about 24,000 in the U.S. The jump in cases takes the total to 3.77 million with a third of them in the U.S., according to John Hopkins database. Russia and Brazil had a slow start but are now registering large numbers of cases showing that India and other countries with limited testing could face the same situation. Russia has ramped up testing, and so have the U.S. and the UK. Moscow's mayor Sergei Sobyanin says for example that about 300,000 of the 12 million people in Moscow have the virus based on sampling surveys, more than 3 times the confirmed cases. Restrictions remain in place in Moscow beyond May 11.  Countries that were hit earlier by the virus such as Spain and France are reopening gradually after May 11. France will use red and green zones to handle restrictions so that the restrictions are customized to each place in the country. ...

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The U.S. unemployment rate shows a surprising improvement. The unemployment rate drops to 13.3% in May dropping from 14.7% in April. Employers added 2.5 million jobs, as states reopen in phases. Hiring was seen in the hospitality, construction and education sectors. This is a piece of good news suggesting that the pandemic is likely to follow a pattern of rapid decline in economic activity and rapid gain in economic activity in 2020, till it gets back to close to the original level in January before the pandemic hit the U.S.  One of the reasons for the rapid gains after steep loss in economic activity is that the errors in preparing for the pandemic led to a loss of crucial weeks before responses were made giving the very contagious virus time to spread. Yet once the response was made in mid March it was coordinated - with U.S. and India acting together, and Europe also moving together with the U.S. The economic response was unprecedented in scale with the U.S. putting in close to 1.5 trillion and the European Union and British response also about $1.5 trillion. Jobs were protected in different ways either by loans to business, or payment of wages by the government or from funds for this purpose. After some vigorous debate the reopening also was done rapidly with regions less affected, and others following soon afterwards even taking some risks so that the economy could recover. ...