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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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The coronavirus surge in southern states in the U.S. is different from the surge earlier in the northeast including New York and New Jersey. More young people are getting the virus. About half of those testing positive are now 18-35 years of age in Texas and Florida. Social distancing and masks is not mandatory with young people not practicing these safety guidelines. Many took the reopening to mean they could go back to the usual summer routines. Not taking it seriously is leading to more infections of young people. Cultural issues with practicing the guidelines and a tendency to not take it seriously has been a problem in the U.S. and parts of Europe since the beginning of the crisis leading to larger number of cases.

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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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Contrary to a lot of what is written Mr. Bolsonaro has regained popularity in Brazil with a new poll showing him with an approval rating of 37% (Datafolho), and a sharp drop in disapproval ratings. Bolsanaro has pushed for keeping lockdowns to a minimum and reopening the economy. Brazil has a large informal economy making it very difficult for people  in lower income situations dependent on work to survive. The aid of 600 reals a month ($110 a month) for the coronavirus relief is making him popular with aid recipients and the poor. 

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The critical variable in knowing whether lockdowns of cities and countries are working is called the coronavirus RO, or reproduction ratio. This ratio measures the average number of people infected by a carrier A. It could be that he infects 1 person at work and transport call it B people , or in large gatherings call it C people he infects 2 persons, or in other surroundings such as restaurants he infects 1 person call it D people. The people A has infected B+C+D are the ones now not infected by A with the lockdowns such as in New York, Italy, Germany, UK and France. It is determined by global health experts that the number of B+C+D is about an average of 4 persons infected by 1 person A with coronavirus, though it may be much higher in practice in some areas. The natural rate of RO or reproduction ratio is considered by the European Centre for Disease Prevention and Control to be 3.86 or about 4, if no lockdown or social distancing or other prevention is practiced. This in a situation where people behaved as before unaware that the virus was around them. Governments such as New York and France, UK, Germany are including this key variable in their determination of how long a lockdown lasts, and for determining if the reopening is not going the right way or failing. In such situations the lockdown would be reinstated, or if it is a phased reopening such as in the U.S. and other countries go back to the previous phase. In Italy and Germany the RO reproduction ratio for coronavirus is estimated by official experts at 0.8. Germany's RO estimated by the Robert Koch Institute and Italy's by Franco Locatelli, scientific advisor to the government. In New York the margin is thin- with RO of 0.9, estimate from the state's governor. In France which has one of the tightest lockdowns of all with a document required to go outside it is at 0.6, the figure coming from the prime minister Mr. Philippe. In the UK it is below 1.0 but no accurate figure is reported. As Dr. Birx- leading the coordinated response in the U.S. - emphasizes over and over again this is a very contagious virus, about which not much is known. Social distancing, wearing masks, basic prevention measures such as frequent handwashing, and not gathering in large numbers of people, is essential for defeating this virus. This has to be followed up with extensive testing and contact tracing to win this fight.   ...

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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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The southern U.S. which was early to reopen the economy after the lockdown with some states having only partial lockdowns, is emerging from the coronavirus in much better shape than the rest of the U.S. The unemployment rate fell to 6.9% in August, the lowest of any region. The number of people employed was only 6% lower in August than in February, when most of the U.S. went into lockdown, compared with declines of 10.6% in the Northeast, 8.2% in the West, and 7% in the Midwest. Some of this was a result of aggressive reopening in Texas and other southern states. Overall deaths in the south were 60 per 100,000 people compared to 132 in the Northeast including New York and New Jersey, Midwest at 52, and West at 40. The Northeast numbers are high because of the elderly in nursing homes hit hard in New York and New Jersey.  In the southern states by comparison the deaths came later and among young people taking risks. The virus hit the northeast early and parts of the midwest, southern states had the advantage of some of the work already being initiated in March to fight the virus nationwide. Many of these states are also Republican and residents feared the virus much less. Republican Governors followed their instincts and aggressively reopened putting the economy first. The numbers tell the story. In South Carolina 44% of Republicans say they aren't afraid of the virus outbreak in the local area, compared to just 2% of Democrats, according to Civiqs poll. Georgia and Florida have similar numbers, all with Republican Governors. One factor favoring southerners is that cities in the south are much less dense and less populated than in the North and West. Smaller cities than Los Angeles and New York. ...

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Public health experts warn that it is essential that countries reopening their economy have a reproduction ratio of much less than 1.0 so that the rate of increase is under control. Germany's Robert Koch Institute which advises the German government says the reproduction ratio which was 0.70 in mid April is now up to 0.96 after creeping back up. This is based on a mathematical model and extrapolated from infection numbers several weeks back.  It doesn't reflect the change by recent easing of lockdown measures starting with reopening smaller stores. This validates the careful approach adopted by France which was put forward by prime minister Edouard Philippe in his address to the National Assembly. The Assembly approved the plan 368 to 100. More legislation will back up the French government's authority to ban non essential travel between French departments and the creation of a large brigade to perform contract tracing. That involves finding testing and isolating everyone potentially infected, using dedicated locations. Detailed restrictions on travel, work and gatherings will take effect when France reopens partially on May 11.  France is also putting resources behind its testing program to test every person having coronavirus symptoms, and all they are in contact with. That means about 700,000 tests a week. Officials will generate a color coded map from this with red areas facing more restrictions than green areas. Student size is capped at 115 per class. Cafes, restaurants, movie theatres and large museums will remain closed. Gatherings of more than 10 banned. Those who can work from home asked to do so. Public transit users will be required to use masks, and marks on platforms will indicate the social distance required. Only essential travel is allowed more than 62 miles from home. These rules remain till June 2, when new ones will be set. Large music festivals and sporting events are canceled till the fall. Mr. Philippe says "these efforts will not be in vain and should allow us to arrange for a better summer season." ...

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People in California did not feel the early blows of the coronavirus like New York. This is now turning into a disadvantage as people in California have now failed to follow the guidelines for social distancing and masks as carefully as they should be. The state reopening  took place as the case numbers were increasing as the economy and unemployment became an issue.  State hospitalizations are up 40% on July 1 from 2 weeks ago. Percentage of tests coming positive are close to 6% but in some counties much higher- in Riverside county has rate positive in tests at 11.7% and bars are only recommended to close. In Los Angeles county it is 8.2%. On June 20 the day after the bars were allowed to open 500,000 people visited bars in Los Angeles County. A big problem is that for lockdown the whole state was asked to lockdown by the governor. For reopening it is done by county and each county is doing this differently. Pressure to reopen has led to counties with increasing and poor metrics for cases still reopening. Some counties felt pressured to open when other counties had reopened. Even when a county such as Riverside or Los Angeles county is doing poorly the governor waits 14 days for it to be on a watch list before acting. This is too long for the extremely contagious virus giving it time to spread quickly. Governor Newson is now facing serious problems tackling the coronavirus. ...

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It seems like good common sense -surely studies come later that masks can cut coronavirus cases by 40%- as Texas is learning the hard way. As coronavirus cases jump in Texas the governor makes wearing face coverings or masks mandatory in the state. Texas recorded over 8000 cases in a single day on July 3, 2020. "wearing a face covering will help us to keep Texas open for business." As a grim warning to Texans he said "we are now at a point where the virus is spreading so fast there is little margin for error." As the virus cases surged Mr. Abbott, the governor of Texas, ordered all bars shut and cut restaurant capacity by 75% last week and reversed step taken to open the economy. Another lesson learned the hard way when it seems like common sense- consider that on June 20 as reported in the WSJ a staggering 500,000 people went to bars in Los Angeles county the day after bars reopened. It is this type of activity that makes Dr. Fauci, say cases could reach 100,000 a day in the U.S. Infection rates are now increasing in 40 of 50 states with the southern states, western states doing badly.  A lot of it was plain common sense. A German study shows a 40% reduction of coronavirus cases when masks or face coverings are worn. For those arguing for the reopening so that economic hurt is mitigated there is even more reason to wear masks as it makes it possible to get back to work by following strict social distancing and mask guidelines. Everything in life is about adapting and making small changes for the larger good. Younger people have badly failed to show fellow feeling with lack of following social distancing guidelines on beaches and gatherings leading to the numbers now showing that people 18-34 are now equally at risk. ...

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There are differences between the governors of 10 worst hit states and the president of the U.S. on when to reopen the economy. The seven on the East Coast including New York, New Jersey, Connecticut, Massachusetts, and three on the West Coast including California and Washington, all but one have Democrat governors and want to wait beyond May 1, till it is believed to be safe to reopen.190,000 of the 592,000 infected cases and over 10,000 of 25,000 cases of deaths are from New York alone. This is as though a third of the problem is in one state. The feeling in New York is that it should be the last to reopen, other states can go first in the middle of the country. The position in the U.S. Constitution is for states to maintain public order and safety. This was the basis of the president's position to work with the governors and continues to be the case, though there is pressure from economic advisers to the president to reopen earlier balanced by the opinion of health experts around the president.  Some states are taking action to reopen because the virus has not severely affected these states. President Trump says it is for governors to decide what is best for each state in consultation with the federal government. The U.S. government would step in if a state is taking risky action with the coronavirus. On the issue of whether the president could have acted quickly in February following his decision to stop flights from China and set up quarantines in January, the BBC has this to say. Dr. Fauci, the president's respected health expert was one of many public officials who did not see the magnitude of the crisis evolving with lack of good information from China. BBC North America Editor Jon Sopel cites Dr. Fauci's comments on February 13- that the coronavirus danger is "just miniscule" compared with the "real and present danger" of flu. As it happened the president acted alone in his sense of the danger from the outbreak in China through incoming flights and not relying on others. Here is what the situation of each country on reopening is- India -  has extended the lockdown to May 3. France - has extended the lockdown till May 11. U.S. - has extended the lockdown to May 1. States are taking the responsibility. UK - continues lockdown restrictions till May. The French president Macron had a simple answer to the question " when will we be able to get back to a normal, prior life?" Macron said "Quite frankly, humbly, I have no definitive answer to that." Some nurseries and schools will reopen May 11. Not restaurants, hotels, museums and theaters. By May 11 France will be able to test and quarantine anyone with symptoms and general public masks will be available to all. This is what Dr. Fauci in the U.S. also wants to see before being able to reopen, that testing and tracing, isolating, procedures be efficient and reliable. ...

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State run programs that help businesses to retain employees and avoid layoffs are a great way to operate during the lockdowns and gradual reopening. In these workshare programs workers work reduced hours and collect prorated unemployment benefits to offset lost wages. This avoids full layoffs. As the coronavirus is a temporary setback companies need their employees in a healthy economy. How to retain employees. Shift some of the cost of retaining employees to the U.S. or state governments funded by the federal government which comes in the form of unemployment benefits. Workers can then do shorter hours and get through this period.

Such programs are now set up by states in more than half of American states covering about 70% of payrolls. The problem is getting companies and employees to use this program. As of March 28 only 1% of 8.2 million employees have used the program, but it is growing.

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Schools, shops, restaurants, cafes and offices are reopening and people are getting back to work and outdoors. What are the ways to reduce chances of getting the coronavirus and what is the latest advice from public health experts.  More attention is now being given by CDC and other experts to the aerosols, the smaller particles that are airborne that can spread the virus to people unawares in breathing, talking and singing activities. larger droplets come down to the ground, smaller droplets can be airborne for hours. This makes masks wearing very important, call it essential protection. Air filtration and proper ventilation is also important. What about social distancing? Experts now say 6 feet is good, 10 feet is better. This is from Joseph Allen director of the Healthy Buildings program at Harvard School of Public Health. No magic number but 6-10 feet or more is good for safety. Can one start expanding one's social circle? The fewer contacts the better says Dr. Allen. You can he says expand the circle but this depends a lot on how serious the other family is in taking precautions. Are elevators risky? If one can one should take stairs but do not board a crowded elevator unless the lobby is more crowded. Do not touch buttons, if you do use elbow or use sanitizer from your shirt pocket after pressing. This is where mask is essential. Here a tip is useful. Talking does not help as talking emits 10 times the particles than when you are quiet and this is true for small spaces such as elevators. Continual talk is not a good idea such as a long time spent talking, here watch that habit of getting into long conversations face to face.  Is it good to take a summer vacation. Here the answer is yes, as no one really knows how the winter will be. And remember outdoors is good for renewal of health, and one can look for places that are not crowded where the 10-12 feet or more can be easily done. One tip here is to take your own food and supplies from home so there is no need to go to crowded restaurants. Swimming in a lake or ocean is fine. Camping outdoors is fine and actually a good idea if you are with your own family. Try to use an empty restroom and one that is clean and wear the mask. While camping keep the 6-10 foot rule with people outside your immediate family, do not share food and drinks and try not to touch each other's supplies, and sanitize your hands or wash if you do. When hiking keep the mask in your pocket so you can wear it when you see others passing on trails. In hotels skip the cleaning service, in a rented property ask the owner to keep the windows open before you arrive, and put a day or two between your coming and the last person who rented the place. Renting a car is tricky allow a couple of hours to elapse between you and the last rental, open windows. Public restrooms. Always wear a mask many are poorly ventilated. Open the door without use of hands if possible,or use a paper towel to open and discard. Do not use air dryers. Is it safe for your house cleaning person to return. Keep the windows open to let in fresh air. Make sure your cleaner wears gloves. And all should wear masks. How to visit grandparents? Experts advise keeping visits outside and wearing masks when not 6-10 feet apart. Anyone not feeling healthy should avoid the visit. And bathrooms should be sanitized after people leave even wait a day if there is another bathroom. Experts advise against sharing food and buffet type meals. Ten feet distance is better than six feet. Can one use a gym? Here the advice is to exercize outdoors or at home if one can. It says be cautious unless your gym is limiting the number of people or spacing the equipment adequately. Ask about open windows, air filtration systems, ventilation.  This is excellent advice from experts with the latest information. Over the last few months from March to May most of the information was during lockdown, and a lot can be forgotten or seen as not necessary as things return to normal, as shops schools and cafes, office reopen, and cases remain steady and under control. Being vigilant is good for safely navigating this period through the summer and into winter till a vaccine is found. It is also about being a good civic minded person aware of one's own responsibilities, as when all take safety seriously and practice it everyday, it builds another layer of protection for everybody- because it creates a safer environment for all.     ...