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President Trump extends the U.S. lockdown for social distancing till April 30, on the advice of health experts. China meanwhile resumes industrial production and schools reopen. Factories, offices and retail outlets were shutdown for 2 months nearly nationwide in China. The U.S. has a social distancing lockdown not a complete quarantine of hotspots such as New York, New Jersey. Mr. Trump planned to quarantine New York but faced opposition from the governors of New York and New Jersey, including possible legal challenges. U.S. governors have acted imposing travel restrictions to their states from hotspots in other places in the country, forcing people traveling to self-isolate, stopping vehicles with out of state license plates and asking them to stay away. The U.S. cases have jumped from 100 in early March to 143,000 as of March 28, 2020, and 2514 deaths, according to John Hopkins. New estimates from president Trump and his team of experts are for the peak to be reached by April 15, and recovery gradually taking place by June 1, 2020. Based on the timeline in China shown below the time from the first set of 27 cases by December 15 to March 28 when China's factories were back to work and schools reopened across the country, is a period of 75 days. Based on this president Trump's timeline of June 1 for recovery has some foundation. China quarantined strictly compared to the U.S. yet in the early days it had no warning which the U.S. had in particular from Italy. The Trump administration by extending social distancing and lockdown restrictions till April 30 without a strict quarantine of the East coast areas yet with states outside imposing their own restrictions for outsiders, is doing what other countries such as China, South Korea, have to control this epidemic. The first coronavirus case was reported on November 17, 2019 according to the South China Morning Post, By December 15, the number of cases had reached 15. On December 27 on a single day 180 cases were recorded and the Head of the Respiratory Department at Hubei Provincial Hospital reported this to health authorites in China, according to the South China Morning Post, based on data collected in China.   ...

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China has used the quarantine and strict measures to contain the coronavirus. After being taken by surprise in the way the coronavirus developed in Wuhan region China shifted to large scale containment and quarantine. To do this China used technology, mobile carrier information, volunteers going from door to door and enforced quarantine action. Other countries in Europe, including Italy, are adopting measures such as quarantine and appeals to the public for cooperative behaviours.

The entire approach is new yet shows how government and citizens can work together to contain epidemics of this kind in the modern world of urbanized areas and close contact in subways, streets, and stadiums. The approach in democratic countries may vary from China yet essentially strong bold action has proved to be the way to go, not vacillating and acting one step at a time till things are out of control. 

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Why the lessons of Wuhan have not been understood correctly says this WSJ report. Merely putting lockdowns is not enough, systematic testing and quarantining of the affected persons is needed for controlling the outbreak. The outbreak in Wuhan was controlled by sending affected persons to makeshift hospitals and temporary quarantine centers. Two hospitals were quickly setup in Wuhan in 2-3 days to isolate affected people from the rest.

It is slow but this is being done as New York sets up a makeshift mobile hospital with 1000 beds at the Jacob Javits Convention Centre. And London sets up 4000 beds at a conference centre in the city.

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Spain and Italy, the New York region, delayed their response, just as Japan and Sweden are doing today, resulting in the severity of the pandemic in these countries and regions. This pandemic is showing the earlier you act to lockdown, quarantine, use contact tracing and isolation of clusters method, the better it is with fewer people infected and fewer deaths. This is the single most important lesson of this crisis, which health experts worldwide, including Dr Birx, head of the White House Response, and Dr. Fauci, never get tired of repeating.

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Massachusetts governor Charlie Baker gets an order in with a number of Chinese manufacturers for supply of over a million N95 masks. The hard hit east coast states of the U.S. face a critical shortage of N95 masks for health care workers in hospitals. The problem is getting them shipped from Shenzen, China to to Boston's Logan airport. Someone suggested using the Patriots football team's Boeing 767 jet. Robert Kraft, Patriot's owner agreed and the passenger plane was converted to carry cargo. The Chinese consulate in New York stays open over the weekend to process the flight crew's visas. Approval for landing without the crew being asked to quarantine for 14 days was another hurdle. Chinese authorites agreed to permit the landing for about 3 hours to pick up cargo only, with the flight crew staying on the plane. Chinese internet company Tencent sent some of its employees to help prepare the shipment and send it to Shenzen airport. The Boeing 767 makes a stop in Alaska before flying to Shenzen and completes the flight back to Logan airport in Boston. Governor Baker and the Patriot's Mr. Kraft send 300,000 of the masks to New York. ...

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This report shows the level of coronavirus testing as of March 27, 2020 in different states in the U.S. The U.S. testing program and supplies of tests are being ramped up quickly. About 65,000 tests are being done on Americans each day. The need is for 150,000 tests a day say public health officials. Testing is slow in California compared to aggressive testing in New York which has 60% of all coronavirus cases. California with twice the population of New York has done 77,000 tests compared to 122,000 in New York. Texas has done only 21,000 states by comparison. Every week new testing technology is being developed in different labs, medical companies, and universities. Including tests that can be conducted quickly and not requiring health workers or health workers with protective gear. Speed of processing test, least point of testing contact, and the protocol for quarantine, are all part of the testing and isolating of clusters mechanism to tackle the virus. This is critical in the coronavirus action plan being developed by Dr Brx of the U.S. White House team. ...

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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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The White House faces alarm as the U.S. president's valet and vice president Mike Pence's press secretary tests positive for the coronavirus. The cramped quarters at the White House and lack of the recommended social distancing at meetings of the U.S. president, most of the meetings being conducted maskless, are also cause for concern. 

Admiral Gilday of the Joint Chiefs will quarantine for one week. Self-isolating for 2 weeks are Dr. Fauci, Dr Redfield head of the CDC, and Dr. Hahn head of the FDA.

A senior economic adviser to president Trump, Kevin Hassett, says on CBS television program "Face the Nation" that it is scary to go to work now.

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The southern and southwestern U.S. which were expected to peak late are now seeing a surge in the coronavirus cases. This includes Alabama, Florida, Texas and Arizona. New York imposes a quarantine of 14 days on residents of these states travelling to N.Y.

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President Trump's failure to followup on his decision to shut down all flights to China on January 29 with speedy action on preparing for the coronavirus as suggested by some of his advisors is the subject of this article in the NYT.  There were two distractions one was the trade deal with China that was being negotiated, and then the impeachment trial in the U.S. Congress that was set in motion by Democrats. Another problem was the lack of good information about the extent of the virus spread in China and infected case numbers. As it turns out no one really knows the real scale of infections in China. If is was known that there were as many cases in China as there are in the U.S. today this would have resulted in shaking up any complacency in the Trump administration and in the states. Considering the experience of Europe and the U.S. it could be that China had the same number of infected cases as the U.S. does today for a population three times the size. China had a strict quarantine but it also did not realize what it was up against in the first weeks of the crisis in January. It appears now that China, Europe and the U.S. all lost some time from 2-4 weeks before realizing the severe consequences facing each region. This report says one of the vital pieces of information that was learned about infected people in China, was learned as late as the end of February by leaders of a government team looking at the coronavirus threat. It was that seemingly normal healthy people without symptoms but infected by the virus could spread the virus. This meant that this was very, very contagious. The lack of good information played a significant part, adding to the level of complacency in states such as New York and in the Trump administration. Politics such as the impeachment trial and political infighting added an unnecessary distraction. ...

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This BBC report shows how contact tracing works in Singapore to control the spread of coronavirus. On 4 February 20 Chinese tourists visited a traditional Chinese medicine shop in Singapore. Only 18 coronavirus cases had been recorded in Singapore on that date. That visit to the medicine shop created a new cluster for the disease to spread. Singapore's contact tracing units traced such locations through its well developed and extensive contact tracing programme, which follows the chain of the virus, identifying and isolating people before they can spread the virus further. For about 40% of the 243 cases so far on March 19 the first indication they had was a call from the Singapore Health Ministry.      About 6000 people have been contact traced so far, using a combination of CCTV footage, labor intensive detective work with phone calling. This includes an incident of a taxi ride of 6 minutes in which the person a yoga teacher was identified and contacted by the Health Ministry. Enforcement is done as the person was contacted at her home by three people who showed her a quarantine order, which said you could not go out or its fine time and jail time. With about 8000 people per square kilometre, Singapore is small and densely crowded. It could easily be overwhelmed with hospitals not able to cope and the health system collapsing if this was not done. Wuhan could have happened here, says infectious diseases specialist Dr. Leong at Mont Elizabeth Novena hospital, who advises the government.  Because the crime rate is low the police were given this task of tracing as a priority in addition to hospital units working on tracing. It also included the armed forces personnel helping with tracing so that it could be done quickly without delay. This provides a lesson on how countries that have faced the health crisis have used innovative methods to tackle it with good results. ...

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Two divergent approaches to the coronavirus are shown in this report in the WSJ. One in Italy which relies on quarantine and lockdown and mandatory social distancing, and the other on keeping borders open and aggressively tracking down the infected using data and testing. In South Korea infections have stabilized at 8000, and in Italy the are rising at 15,000. The divergent approaches and the results vary with the people's history, culture and recent experience. The cultural difference in Asian societies with people willing to cooperate and work together with health authorites for the social stability and good of the country is different from the more individualistic nature of western societies. In addition Italy has a long period of foreign rule of Hapsburgs nd French that has created an attitude of working around authority, the tendency to being furbo which prime minister Conte referred to in a nationwide address.  South Korea and Taiwan also have experience with the SARS and MERS virus during which public health regulations were instituted and comprehensive databases setup that are now being used to combat the new health crisis by tracking down people with health needs. The precedents have taught people in South Korea and Taiwan of how serious this kind of crisis can become, which was absent in Italy in the early stages. Both South Korea and Italy are democracies. The difference being that one has experience with public health crises from experience with SARS, MERS, H1N1, and has developed policy tools, broadened public support and increased state powers in anticipation of such crises. In South Korea there were fines of $8300 for those not willing to be treated and the government aggressively tracked down people. Public support and awareness also helped in controlling the situation. Taiwan has done better than South Korea as covered in a separate article in the WSJ, and shown here, controlling the situation from the beginning including shutting down flights from China early because of its close proximity to China.  ...

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The problems Shanghai residents are facing during the covid lockdown in 2022. The experience of a 34 year old technology worker in Shanghai who is sent to a quarantine center in a 16 hour bus ride shows the difficulties people are facing in Shanghai, China. The zero covid policy is affecting the economy and the daily lives of people in China. In the US Democrats shifted away from strict covid protocols in 2021 after realizing that there were economic costs and costs for daily living of ordinary people, with lockdowns becoming less frequent in states such as Michigan, New York and California.