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So far Italy has resisted the second wave of the coronavirus by adhering to the strict social distancing and mask guidelines better than other parts of Europe. After the traumatic experience in March and April Italians especially in the north near Milan are strictly following the guidelines. The daily number of new infections is at 1851 on October 1, and fatality rate is low.

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With coronavirus spread out over wide parts of each country and with so many people infected it is very difficult to do the contact tracing and isolation that was tried during the first wave. In Germany during the first wave efforts for contact tracing and isolation worked reasonably well. During the second wave in November things have changed. In Germany authorites do not know in November where 75% of the people testing positive for coronavirus got it. In Spain this figure is 93% for the last week of October. In France and Italy it is at 80%. In New York it is over 50%. Other problems are the increasing number of cases where the coronavirus is spread in an home setting, the lack of restaurant data collected on who visits, and the delay in getting test results. In Germany frequently people say they cannot remember where they were. Researchers from the German version of the FBI, the Pasteur Institute in France and the Koch Institute in Germany are getting involved in November to understand in what settings the virus spreads most. ...

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Economies have fallen back sharply but banks have not had to recognize bad loans as government support and repayment moratoriums have covered a quarter of all outstanding loans for companies and households. As a result there is a strange crisis in which defaults have not happened. Banks have not had to recognize bad loans. The question is what will happen once this government support and other support ends.

The European Central Bank says bad loans in eurozone could go as high as 1.4 trillion euros or $1.7 trillion, if the economies face further setbacks in the second wave of the coronavirus. European government support has been more generous than the U.S. In Italy over 25% of loans to businesses and 15% to households, totaling 300 billion euros were given payment holidays, according to Scope Ratings.

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Genome sequencing is a way to tell if there are mutations in the virus. This is a very important part of the battle against the virus. About half of the genome sequencing in the world is done in Britain. 
Lessons learned are pointed out by the Science Editor of The Times.

During the first wave with the origins of the coronavirus in Wuhan, China, focus shifted to selected countries without much attention to Europe next door to Britain. Much of the mutated virus strains from Europe, from Italy, Spain and other countries cause the epidemic to get out of control. This is being repeated in the second wave.

When the epidemic surged in Kent British health authorites conducted genome sequencing for the virus to find out that there was a variant, a mutation of the virus that was causing a surge. This has helped Britain prepare to tackle the pandemic as it changes with new strains of the virus.

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About a third of coronavirus cases in France of three or more cases are in schools and universities as France tackles a second wave in October 2020. France has decided to keep schools open as a priority over closing schools as soon as there a couple of cases and there are no uniform rules across schools for masks to be worn. In France mask requirement begins in junior high with exceptions for lunch and gym class. In Italy the mask requirement is present for all grades until they take seats in class. Some schools ask children to keep masks on in the classroom. UK has no mask requirement in schools. Spain requires masks for all school children over age 6 years. Parents in lower income households lack the flexibility to keep children home while they go out to work. Many parents look forward to keeping their children in school after the long lockdown.

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Some local governments in China are making vaccination mandatory. China is setting a goal of getting 64%  of the population fully vaccinated by the end of 2021. In European Union countries mandatory vaccination by country or region is now being put in place to fight new coronavirus variants that spread faster in the population. The reopening of economy, business and tourism is increasing the risk from variants in summer 2021. The mandatory vaccination is a way to increase the percentage of the population that is vaccinated. Getting younger people who lag behind to get vaccinated is important to protect the percentage of the elderly population that is still not vaccinated. There are risks also to the younger population as seen in previous waves of the pandemic. The initial hesitation to make health pass showing a person is vaccinated mandatory was because only a small fraction of the population was vaccinated in Europe. Now that over 50% are vaccinated in most EU countries and UK, that hesitation thinking that it is discriminatory to those people who did not have access to vaccines no longer exists. Ample vaccine supplies and the misinformation spread about vaccines are making action on health pass necessary to protect the overall population. National governments in France, Denmark, Austria, Greece, and local governments in Germany, Portugal and other EU countries such as Ireland, Italy, see the danger from coronavirus variants that spread quickly as too big to take any risks a second time. ...

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Hospitals across Paris are stockpiling drugs and protective equipment to tackle a second wave of coronavirus. About 163 deaths were reported in France on October 20, up 50% from the 100 deaths average the previous week. During early April the deaths in France were about 400 to 600 a day.  Spain is drawing "elasticity plans" to add more beds for coronavirus. In Lombardy region of Italy hit for the second time similar plans are being made as Italy records 70 deaths a day. 

The head of the Delafontaine hospital ICU unit in Saint Denis suburb of Paris says the first wave left the staff exhausted and he finds it hard to imagine having to go through it all once again. ICU beds in Liverpool England are 95% occupied, in Madrid 39%, in Paris about 50%. Poland and Czech Republic are being hit hard in the second wave after avoiding the worst of the first wave.

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Kerala state of 35 million people who speak the language Malayalam, is one of the rare places today that has only 4 deaths from coronavirus, 524 cases confirmed and no community transmission. Here the Guardian looks at the reasons why. The Health minister KK Shailaja started very early on January 23, with a meeting of her rapid response team when the virus was still in China.  She setup a control room and instructed Kerala's 14 districts to do this on Jan. 24. When the first case arrived on Jan. 27 on a plane from Wuhan, Kerala had already adopted the WHO  protocol of test, trace, isolate and support. These passengers were checked for temperature, tested and quarantined. With some at a nearby hospital and others in home isolation. This is all the more amazing considering that Kerala is a state in southern India on the west coast that has a large number of people living and working overseas. Many are in the Gulf countries and the arrival of these refugees could have triggered a second outbreak. This was prevented by careful testing, and contact tracing of clusters.  When one group was evasive and concealed information from an airport surveillance team -arriving from Venice, Italy,  in late Feb- a case was detected back to them.  Contact tracers tracked down all of the hundreds whom they had been in contact with and quarantined them.  By 23 March all flights to 4 Kerala airports from overseas were stopped, including Cochin and Trivandrum. On March 25 India went into lockdown.  Some of the achievements in Kerala include quarantining 170,000 people early. with strict surveillance, which is now down to 21,000. Accomodating and feeding 150,000 migrant workers from other states, before returning them on charter trains to their home areas. A big reason for the success is the high literacy rate in the state. A big emphasis on education and healthcare is a part of the Kerala model. Shailaja is a secondary school teacher, and Health minister. From the days since independence of India in 1947 the state has a strong socialist tradition of taking care of the basics- health, education and public services. It also generates a part of its GDP with income from workers who are overseas.  Another reason for the success in dealing with coronavirus is experience. The state had a virus epidemic called Nipah in 2018 which has become the story for a movie called Virus in Malayalam. There is decentralized public health system in the state and people value their health care facilities, understand and trust the health care authorites. There are hospitals at every level of administration and 10 medical colleges. But trust and education, experience tackling the virus before, are key. Kerala is showing that poor countries can deal effectively with the virus, and create a better life by adopting the right model of creating good societies that value education, healthcare services, better economic structures and distribution of wealth, and  a degree of trust and responsibility found in a state that values public spiritedness. ...

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A look at two crises in 1918 and 1957 of virus pandemics shows early and decisive action to prevent public from gathering and intermingling, are critical. In today's densely populated urban environments this translates into lockdowns and quarantines that are strictly enforced. The 1918 pandemic took 50 million lives worldwide, the 1957 pandemic took 1 million lives worldwide, says this report based on some estimates. MIstakes were made then and science was not as developed for vaccines and new drugs. Which is why health authorites are taking this very seriously. Greg Ip of the WSJ looks at coronavirus health crisis in relation to earlier disasters- SARS 2003 originating in China, 1957 flu epidemic, 1918 Spanish flu epidemic, to draw insights on what measures have worked best. Previous epidemics and crises provide clues on what makes things worse or better and the long term consequences of actions. The more health and safety are prioritized there is some impact on the economy. But crises have proven that the economic impact is temporary and short lived with the economy and jobs bouncing right back once the crisis has passed. The second insight is that early on in the crisis there is a great deal of uncertainty, leading to fumbled or delayed, or timid response. Sort of like lets wait for more information coming out of China, or now Italy, which happened first in February, and then again in March. Tim Adams who worked in the U.S. Treasury Department during 9/11 and Hurricane Katrina, and is now the president of the Institute of International Finance, says if you look to plan a perfect response you lose valuable time. Time is of the essence. Learning to make speed the priority, to think in tranches, be visible, and worrying about how to pay for it later, is what he says he has learned from these crises response efforts. In the case of the coronavirus, some valuable time was lost becausee of the uncertainty and lack of early information, making speed and rapid comprehensive action very critical. The Spanish flu epidemic of 1918 infected over 500 million people worldwide and killed 50 million or more, including 675,000 in the U.S., according to the Centers for Disease Control and Prevention. During this epidemic the Chicago public health commissioner flatly opposed closing businesses, saying worry kills people more than the epidemic. A 2007 study shows cities that took that attitude saw higher death tolls in the Spanish flu epidemic of 1918. Philadelphia waited 16 days before restricting social gatherings, St Louis took just 2 days. The result: the daily death rate from the epidemic peaked at level five or more times higher in Philadelphia than in St. Louis. Social distancing was not much of an issue then as people worked in jobs that required less contact, such as farming, fishing and forestry, as well as other jobs that did not require that contact in large offices.   ...