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For the second time Sweden takes a laid back approach to the coronavirus during the second wave in November. Swedish prime minister Stefan Lofven is in quarantine after he went into self isolation, following someone in his circle having contact with someone having coronavirus. The government only issues recommendations but there are no required restrictions, no strict rules to follow.

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As Sweden's government adopts a relaxed approach to coronavirus by not imposing a lockdown and allowing activity to carry on outside on the streets, more than 2000 doctors and experts in universities warn about dangers of this approach. The deaths rise to 373 higher in per capita terms than the U.S. considering the smaller population of Sweden.

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As other countries imposed lockdowns including the U.S. and most of Europe, most of Asia, two countries Sweden and Japan continued to stall in restricting public gatherings and imposing lockdowns. Sweden's government is now looking at a U turn and imposing a lockdown. The government needs emergency powers to do this and it lack a consensus with the opposition parties to take this action quickly, says this report in DW.com. Japan is also looking at a lockdown to restrict the spread of the pandemic as cases mount.

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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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The rotting carcasses of the minks that were culled will be dug up to be incinerated. Environmental inspectors found that some water sources might have been contaminated by bacteria. The 17 million minks in Denmark were the target of culling after fears of coronavirus in minks. The whole issue has shown the problems in some of the Nordic countries that were seen as models for healthcare and public services. Sweden's treatment of the elderly in nursing homes was seen all over Europe as shabby and the king of Sweden called it a "failure.

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Any idea that herd immunity is the way out is dispelled by a simple look at these pictures from the NYT showing what the level of infections are today and what they would have to be for "herd immunity." No Asian nation has even mentioned the word. Most Asian nations have the most experience with virus of all sorts. The only government that supported the idea without saying so openly is Sweden as indicated in a report in FR24 on the amplification of coronavirus in Sweden compared to neighboring Denmark, Norway, Finland. Imagine with a threshhold of 60% of people having antibodies provided by experts for herd immunity, the current New York level of about 20% would have to triple, and Sweden's 7% would have to grow seven fold. It is hard to imagine New York going through something of these proportions. Looking at what works now that other countries handling it have set examples of what works provides a better way- low tech contract tracing the German way, and one used in Asian countries, and the cluster isolation through testing and contact tracing adopted in many Asian countries as well as Germany. Strengthening public health systems, and working one's way out of the crisis where there are no easy answers offers real and realistic hope. ...

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There is a major shift in world opinion among major countries in Asia and Europe and North America moving negative by double digits in Pew research surveys. The shift is gradual and negative in Germany, France, Spain and Italy, and steeply negative in Sweden, Denmark, Britain and the U.S., Japan and South Korea. The people with negative views of China in world affairs are also the people who believe China did a bad job in handling the coronavirus.  In Australia in one year alone there is a 24% increase to 81% of people who see China unfavorably, in Britain this is a 19% increase in one year to 74%. In the U.S. the shift is over 4 years by 20% to negative views for 73% viewing China unfavorably or negatively. The shift in Canada is similar to the U.S. The biggest shift is in Japan where 86% view China unfavorably and Sweden where this is 85% after China handled Swedish relations poorly. See the color graphs in the original article in DW.com by clicking on original article here in Lyrarc.com. It is rare to see the such a dramatic shift in public perception of one country. The handling of the coronavirus by China in a way that hurt all countries with lack of transparency and total cooperation normally seen in pandemics and the cost in poverty and job losses, economic losses has resulted in a massive loss of confidence in China, and in the leadership of Xi Jinping. Most public opinion in these countries now believes that Jinping cannot be trusted to do the right thing in world affairs. ...

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The Trump administration suspended all flights from Europe on March 13, about one month after suspending all flights from China. This report in the NYT says there were about 10,000 estimated undetected infections in New York on March 1 when only 1 case of coronavirus was confirmed. It also says that researchers have tracked the mutations of the virus in all American states and found that most of it came from New York. Could the Trump administration have acted earlier than March 13 to stop flights from Europe? The state and city authorites in New York did not take the threat seriously by March 13, making it not clear that they would have acted earlier.   In places like Michigan which has Italian Fiat owned Chrysler operations, and automotive connections with Munich, Germany, reports show the virus coming from Europe. Munich based auto companies have extensive operations in China. In Louisiana the Mardi Gras celebrations around Feb. 25, received large numbers of visitors from New York, with research showing the virus mutations in Louisiana originated in New York. There was little awareness of the seriousness of the virus because of lack of past experience as happened in Asian countries. So that these kinds of public events bringing huge numbers of people in close contact were allowed to happen, and people who were cautious were likely to be ridiculed or shoved aside. New York continued to hold public gatherings at Madison Square Gardens and sports stadiums well into March, with complete disregard of the dangers, a decision made by local authorites.   ...

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In an astonishing contrast to other European countries, including neighbors Norway, FInaland and Denmark, the Swedish government decided to not impose a lockdown, keeping bars, restaurants, hairdressers, gyms, primary and middle schools open. Secondary schools, museums were closed, sports gatherings, gatherings of more than 50 people were not allowed. Social distancing was not enforced, and entirely voluntary. Sweden now has 29000 cases according to Statista and its death rate of 358 per million population is higher than in the U.S. which is 267, and Denmark 93, Finland 53.  Critics such as Lena EInhorn, a virologist, say the Swedish government did not set up a broad testing program, and let a problem develop for elder care in nursing homes. She says a 14 day quarantine of household members of a person infected with the virus would have made a difference. Most action we take for granted was not taken in Sweden. Restaurants that were not required to close spread airborne transmission. Einhorn also says that the government officials have denied it but under their breaths they have acknowledged working on a herd immunity strategy. Denmark has opened schools with social distancing and other measures and reopened its economy. Sweden is in reverse with calls for stricter action and an ongoing debate. No reopening as there was no lockdown, yet considerable and nagging uncertainty. The speed of transmission of coronavirus is the biggest danger, as it can let the numbers grow very quickly if the wrong decisions are taken or something is left out. ...

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Researchers at Gottingen University in Germany analyzing data from a study published in the Lancet Infectious Diseases monthly journal say countries around the world have only discovered on average about 6% of all coronavirus infection cases. The true total of infections could be tens of millions worldwide. Why this is important- the recurrence of the virus is a real danger even after it appears that it is under control, making relaxation of essential guidelines for prevention very risky.

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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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Most people would not guess or recognize that this place where elderly people in society were treated shabbily is a country in northern Europe, and a country where citizens pay high taxes for precisely better healthcare across different age groups. Sweden is where about half of the 6000 people dead from coronavirus were elderly people.  Over the last two decades Sweden has cut hospital capacity and discouraged elderly people from entering hospitals during the early period of the pandemic, says this report in the NYT. The for profit nursing homes in the centre of Stockholm were unable to cope. Having turned the work in these homes to low wage workers, it put these workers and the elderly at risk with lack of staff, lack of adequate PPE oreven  basic masks, says this report in NYT.  One of the lessons of this pandemic is the failure not just in turning over manufacturing of health care equipment and pharmaceuticals to China, but also turning over the basic care of elderly to for profit institutions that were totally unprepared and could not give elderly the dignity and care they deserve. Year of cuts to public services and health services now showed in a glaring way what can happen when this is done. It has lessons for countries from Europe to North America, and to Latin America, India and other Asian countries as they redesign policy and allocate resources to public services in the next 10-20 years. ...

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Underreporting of coronavirus cases in China poses risks for other nations in not giving them a sense of the magnitude and severity of coronavirus. This leads to a false sense of security- in Japan, Sweden and other countries, much delayed action and a sense of exceptionalism that we can ride this thing through like an ordinary virus, In the U.S. and Italy, Spain, UK and Germany, loss of crucial weeks before taking action. Looking to the future this poses new risks as it still leaves people without a sense of how long to continue lockdowns.  The pandemic poses huge risks for Asia and Latin America because of poverty, crowded conditions and sanitation levels. The early action by prime minister Modi was a huge step in the right direction before coronavirus spread could damage the economy and people- as Mr. Modi said if not done right such as with a 21 day lockdown this could set India back by 21 years. It had value in that it alerted other countries such as Philippines, Indonesia, Malaysia, Bangladesh, Pakistan to take strong action early. As the WSJ says here in this essay by what is important for China and all other countries reporting on coronavirus is that this reporting is vital only because it can save many other countries from making costly mistakes. Which is why the direct doctor to doctor contact between Chinese doctors and American doctors is an encouraging right step, says WSJ.  ...

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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. ...

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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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The coronavirus pandemic and the disaster in nursing homes, the chaotic conditions in the first wave, the lack of staff and poor attention to residents during the pandemic, has exposed the major weakness of nursing home care in western countries. Much of this sector is in the hands of private operators seeking a profit.  The staff is paid low wages and lacks the experience and empathy needed for care of older people. During a virus all these factors turn deadly. With some staff sick the other staff is overburdened. If the sick turn up for work they are likely to risk the safety of other staff and the residents. With the incubation period lack of testing there is no way to know. When deaths occur and the nursing homes are sealed from the outside world the deaths happen with no goodbyes as happened in U.S., Britain and Sweden. This has exposed the scandalous and shocking way in which the elderly are treated in today's environment where ridiculous amounts of money are being spent on other things and the the most basic "one's parents" are neglected and allowed to die in horrific manner in a pandemic. The new trend for home care for the elderly is a welcome trend and long overdue as one of the worst aspects of the system in the west is the treatment of elderly parents in nursing homes run for profit. The new technology tools available for monitoring a elderly person at home, and the help of stores such as Best Buy which are serving elderly at home, is making this more and more a choice for the elderly. Even older patients and ones needing significant care can recover and spend time at home in a better environment, a less costly one, as hospital managers and families have learned in 2020. Some hospitals in the U.S. say they never want to go back. That the drive to get every patient home who can be home is the right one for patients and families and for the government paying for the care so that dollars are well spent in quality of care. Home health care companies are working on providing new services for sicker patients recovering at home. Technology helps do better monitoring. Medicare now pays for digital doctor visits and intense hospital type care at home after coronavirus showed this as vitally needed.  Both the Biden and Trump administrations are firmly focused on this issue. Seema Verma as head of Medicare is clear about the need for a national conversation on how we take care of the elderly, of our parents. And Mr. Biden wants to spend $450 billon to make certain that people who need long term care can get the support they need in the home and the community. This report looks at the home health care companies and how they are improving their services. This and telemedicine are two of the major constructive changes coming out of the pandemic, clearing out some of the worst aspects of the old system of living the older years in the western world.  Nothing speaks more about humanity and a human world than the story here of Savanna Hollar, 90 years old and almost blind. She broke her shoulder in August, Her sons decided not to send her to a the rehab facility she went to after a broken hip 3 years earlier. The sons brought her home to recover in the farmhouse near Yadkinville, N.C., where she has lived since 1951. One of her sons himself 63 years says that at a nursing home she would be lonely, scared and afraid to move. The sons hired two people to help her during the day and a rotating system was used for having people help her. At home Mrs. Hollar could enjoy her gray cat, Buddy, her favorite recliner and tomato sandwiches made with produce from her garden. Really, if we can't do this much what good is the U.S.A.? or Britain? or Sweden? or India? ...