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The source of a repeat infection is a mutated form of the virus. In one case the viral genome belonged to a different strain of the coronavirus the second time. Mutations are the likely cause of the new infections in Netherlands, Belgium, and Hong Kong.

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Hospitals in Europe are filling up quickly in the second wave of coronavirus. Coronavirus patients had to be transferred by helicopter to Germany from the Netherlands because of overburdened Dutch intensive care units. National Guard troops were flown in from the U.S. to the Czech Republic to help. In France as cases approach cumulative 1 million about 2000 patients are admitted to hospital for coronavirus every day on October 29. At some point French hospitals could be overwhelmed this winter, and doctors having to choose which patients to save, says president Macron. In the Czech Republic a collapse of the health system is expected by mid-November says the prime minister. No one expected this to be this severe, he says.  About 40,000 patients are hospitalized for coronavirus in the U.S. During the last week the case are increasing by over 40% in the U.S. and increase in hospitalizations are expected. Recovery rate is improving from the first wave. At NYU Langone hospital system in New York with 5000 coronavirus patients hospitalized recovery rate is improving from 25% in March to 7% in October. Better handling of cases and knowledge gained by doctors is a big part of this. ...

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Senay Boztas writes from Amsterdam, Netherlands, that the strict lockdown in the Netherlands is a result of a badly handled coronavirus policy response. The Dutch experience is offered as a lesson other countries can learn from. It too long to form a government after Dutch elections in March, 271 days so that it took too long to have a policy response. When a policy response was made it faltered badly with too relaxed a lifting of restrictions without essential distancing and mask use. Restrictions at super spreader events at night clubs and stadiums were lifted all at once. The government failed to develop a policy of anticipating the next wave from variants by planning early for a booster campaign. (Israel is already into its fourth booster shot as reported in NYT).  The result is that instead of a calibrated response, because infections make up 15% of tests, Netherlands is in a sharp lockdown. A policy of prime minister Rutte that put too much into the idea of freedoms with different meanings in the west calling Holland a "slightly anarchistic country that doesn't need a preachy government," rejected vaccine mandate of any kind as in France and Austria for public transport and restaurants.   ...

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By dropping most coronavirus restrictions including masks, social distancing and size of gatherings, and opening night clubs, England is risking the same sudden rise in new cases from variants that hit the Netherlands last week. Analysis of what happened in the Netherlands shows nightclubs and bars as the origins of 40% of the new cases in the Netherlands. Prime minister Rutte of the Netherlands apologized for this kind of reopening after a big jump in cases in Netherlands.Seven day average in the UK is at 46,000 for the last week. With 40% of the UK population not fully vaccinated, the new variants can spread faster and mutate in the unvaccinated population.  There is a basic difference in priority- getting to work and doing essential shopping compared to going to nightclubs. The Dutch government shut its nightclubs after reopening them in June. At this point England is split in how to reopen. The Mayor of London says masks will be compulsory in all public transit in London. And 55% of the UK public in a recent survey from YouGov think reopening in this way is the wrong thing to do. Another poll by Ipsos shows 70% of people surveyed saying they wanted mask wearing to be compulsory indoors for another month. One bar club owner says that he thinks what they are doing is wrong. Some students think that this is a recipe for transmission to happen quickly. ...

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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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Disagreements on how much to fund an education recovery effort in the Toy government of Mr. Johnson. Sir Kevan Collins resigns after his program designed to help students recover from the loss of study time from coronavirus at a cost of 15 billion pounds is rejected. The government plans to put 1.4 billion pounds, which Sir Collins calls too narrow, and not doing enough, delivering too slowly. Sir Collins had hoped to give 6th Formers and extra 100 hours of schooling and help prepare students for GCSE exams. He would have extended school time by 30 minutes in 2022 and setup a 35 hour week for students.

Netherlands plans to spend 2500 pounds per student, the US 1600 pounds per student, the UK 50 pounds per student. 

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France and Germany support the EU coronavirus rescue package of 750 billion euros with 500 billion euros in grants to struggling businesses. Four countries- Austria, Sweden, Denmark and Netherlands- which supported the austerity policies that hurt working families in Europe for a decade after the financial crisis of 2009, do not support grants and instead call for loans to be made. This time Germany has swung over to the French side and southern European countries such as Italy and Spain that suffered badly from the virus. Without solidarity in such a situation the EU concept becomes meaningless and Merkel says these countries that oppose common borrowing do not understand the gravity of the crisis facing Europe's economies after the virus. 

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This Times leading article on UK government's coronavirus policy says it is inconsistent, and a muddled effort just as the third wave is accelerating. It asks the public to be cautious when going outside and still opens nightclubs with covid passports not required till the end of September. By August cases could reach 100,000 say experts so that the nightclub and bars reopening can only fuel the rise in cases. The British government must be aware that the Netherlands opened nightclubs and bars in June and this led to a sudden jump in cases with 40% of new cases coming from nightclubs.  The policy is undermining public confidence. It is doing this at the same time as it is asking people to self isolate for 10 days. The policy also does not require covid vaccination pass for all events and for shops and restaurants as is being done in France and in other countries on a regional basis as in Germany. 

 

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A supply chain crisis with shortages of goods is affecting all economies in the world. The price of oil has increased to $80 and supply chain shortages are affecting most industries. Power shortages in China lead to cutbacks in consumption for industry and some large cities not having essential  electricity for traffic lights. Coronavirus pandemic has disrupted supply chain factories in Vietnam and Malaysia because of lockdowns. Once a product is manufactured it still has to be shipped from far flung places in today's cumbersome and costly supply chain. Cost of shipping is up 3 times according to one shipping index in one year. Prices to ship from China to Rotterdam in Netherlands is up 6 times in one year. Global supply chains at such high cost of shipping means that companies will look to invest in manufacturing at home so that they do not pay high shipping costs and also create jobs at home, and are able to build critical experience in manufacturing technology. ...

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Wonder who makes the Lysol and Dettol so common in the U.S. and Europe, India, other parts of Asia. It is a British Company Reckitt & Colman, going back to 1817, founded in Lincolnshire, and based in Slough, that merged with Benckiser of Netherlands in 1999. It operates in 60 countries with 40,000 employees and 3.5 billion pounds in sales last quarter. Dettol soap is a household name in India and its push for better hygiene can be seen in ads on Indian television. A 32 million pound fund was set up to promote better hygiene after sales increased by double digits.

This fits in with prime minister Modi's effort for good sanitation, toilets for 1.2 billion people, and the Clean India or Swacch India campaign that is helping India in the fight against coronavirus today.

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So far 17 million people in the UK have received the Astra Zeneca vaccine.  35 cases of blood clots, 15 of pulmonary embolism and 22 of deep vein thrombosis have been reported across the UK and EU. In a normal year more than this number of cases of blood clots are seen say experts. These occur naturally in the population, including elderly population. Astra Zeneca's chief medical officer, Ann Taylor, says the number of blood clots in the 17 million people who have received the vaccine across Europe is actually lower than would be expected in the general population. The EU countries of Germany, France, Netherlands and Italy have temporarily stopped using it after 3 healthcare workers in Norway had blood clots. In Germany 7 out of 1.6 million had a rare condition of cerebral sinus thrombosis. Both EU and medical regulators say that there is no evidence that these blood clots are caused by the vaccine. The number of clots are similar to what was seen in the population before the coronavirus. Also this report in The Times says taken together there is no difference between the number of clots in the population that received the Pfizer vaccine or the Astra Zeneca vaccine.  The Daily Telegraph reports that one in 1000 people have blood clots every year, so that for 17 million people in vaccinated population with the Astra Zeneca vaccine there would be 17000 cases of blood clots over 12 months. During the clinical trials Astra Zeneca reported there were fewer people with blood clots who had been vaccinated than in the people who were not vaccinated. ...

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Germany is trying not to choose sides in the trade and security disputes between China and the U.S. Yet it owes a lot to the U.S. from the days of the Marshall Plan and U.S. taking on the role of defending Germany after the Berlin Wall. China was then a partner with the Soviet Union in the Cold War.  Today China is Germany's top market for its car industry. Yet the U.S. export market is much larger than China at $119 billion with China's at $96 billion. In Germany 28% of jobs are linked to exports, and in manufacturing this goes up to 56%, according to Germany Ministry of Economic Affairs. Germany supplied much of the factory  equipment from its engineering companies and the infrastructure that powered up the China transformation. A transformation now underway in India.  There are signs of a shift as engineering companies in Germany grew faster in the U.S. than China, increasing by 6-10% a year. India remains a key growth market for Germany over the next 10-15 years as growth in China slows and India accelerates with its younger demographics and investment in infrastructure. Much of the infrastructure in China is built and it is approaching the saturation Japan reached in the 1990's with additional investments adding little in the way of productivity. Longer term Germany has more potential for growth in countries in South and South East Asia  that will need to make huge investments in infrastructure and technology for manufacturing to meet the aspirations of the people there. Other issues related to freedom going back to the Berlin Wall and the rebuilding of Germany after World War II will emerge. German companies are running out of patience says this report in the WSJ with the bureaucratic obstacles, forced technology transfers, subsidies by state model to extinguish competition, and protectionist approach to home markets, even as state funded companies in China put other companies in Europe, Asia and the U.S. at a disadvantage. Germany will need to transition to a shift in its global relations, a process that is only now taking place. Just as with austerity policies in which it has now made the shift from going with the northern European countries (Sweden, Denmark, Netherlands, Finland) to the Southern European (France, Italy, Spain) in favor of common solidarity even at the short term cost of common debt, Germany now is facing the shift for solidarity with the U.S. for its support of Germany from the period of the Berlin Wall in the 1950's, for the U.S. and European solidarity in the face of the post-coronavirus world. The U.S. showing its generosity and openness to Germany and war torn Europe even as it took on the added responsibilities for creating a new alliance with Europe.   ...

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Sweden's king Gustaf says the coronavirus policy of voluntary action has failed. Sweden now has 350,000 cases and deaths at 7800. This is more than all other Nordic countries combined and one of the highest rates per 100,000 of the population. Most are elderly who never had time to say goodbye. The makes Sweden a target of worldwide criticism for neglecting older people who never got a chance to say goodbye and died in chaotic conditions. It puts into spotlight the values of Swedish society of self centredness. Sweden, Netherlands and some Northern European countries also opposed the large stimulus planned by Merkel and Macron for the EU. showing lack of sensitivity for the plight of poorer countries in Europe such as Greece Portugal, Spain and Eastern Europe that were already hit by the eurozone financial crisis. The king said 2020 "was a terrible year" for Sweden. Now that the second wave has hit Germany hard, Sweden has acted to close schools, limit gatherings for Christmas and is following the restrictions practiced in the rest of Europe. To get some sense of how hard the second wave is hitting countries Germany recorded  952 deaths a day December 16, close to one third of that in the U.S. on Dec 15. ...