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New information from the recordings of the World Health Organization as reported by Associated Press, show that during the week of January 6 WHO's lead experts were having difficulty getting information about the coronavirus outbreak in Wuhan, China. Maria Van Kerkhove, an epidemiologist and the WHO technical lead for coronavirus says she was going on very minimal information. The WHO's top official in China, Gauden Galea, says in one of the recordings that they were in the situation where information was given to WHo officials in China only 15 minutes prior to it going on China's state television CCTV. In early January Michael Ryan, the WHO's chief of emergencies, says he feared a repeat of the SARS epidemic in 2002, which was initially covered up by Chinese officials, according to the AP report shown in the Guardian. Ryan says he found himself in the same situation as in 2002 SARS, endlessly trying to get updates from China about what was going on, and adds that WHO barely got out of the SARS with its reputation intact given the transparency issues, in the AP report shown in the Guardian. By June 1 about 6.3 million confirmed cases are reported of coronavirus in the world and 375,000 deaths, and huge losses to economies and people. China's authorites did not lockdown Wuhan till January 23, by which time this report in the Guardian says at least 5 million residents had left. China denied entry requested by the U.S.on January 6 for a team of experts into Wuhan, The team was not allowed into Wuhan for a crucial period of 6 weeks during which the virus had time to spread in the western world. This is taken up in Mr. Trump's letter to the WHO, and the work of Gro Harlem Brundtland is clearly stated in the conclusion of that letter. Brundtland was head of the WHO at the time of the SARS epidemic in 2003, and acted decisively with early warnings to prevent its spread.  Because of the extremely contagious nature of the coronavirus the failure of early warning systems resulted in enormous damage to lives and economic losses worldwide.  ...

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Typical of so much of what is written about the World Health Organization and its role in the pandemic, this podcast in the WSJ fails to quickly convey the critical function of the WHO as an early warning system the world has depended on, including China. The H1N1 epidemic originated in Mexico. Asian countries including China and India depended on very quick response from the country where the epidemic originated  in allowing entry into the affected area for experts from advanced countries such as the U.S. The global response was then coordinated across countries quickly with complete transparency. The head of China's CDC himself faced a problem with transparency with the provincial authorites in Wuhan. 1.    Fundamentally this quick entry was denied the U.S. Request by U.S. to China was made on Jan. 6 for U.S. team to go to Wuhan, quick permission was denied and given only about 6 weeks later on Feb 16. This delay is the crux of the problem for the U.S.. Taiwan confirmed human to human transmission on Jan. 1, the WHO was saying this was not clear as late as Jan. 14. These costly delays are what the U.S.  letter is about.  The head of the CDC China Gao Fu called Dr. Redfield head of CDC in the U.S. on the next day after he suspected Wuhan provincial authorites were vague about what was happening. Gao Fu was alarmed when scanning the internet on December 30, 2019, about rumors of a vaguely worded lung disease in internal memos of Wuhan. He called Wuhan authorites and was not getting clear answers on that day, then deciding on December 31 to send his own team to Wuhan, as reported in German magazine Der Spiegel- Hackenbroch, Zand, 05/20/2020.  Der Spiegel says in its special report on the early period in Wuhan that Gao Fu was so alarmed about what was happening enough to be in tears in his series of calls with Dr. Redfield in the immediate days that followed. The date was shortly after the GAO Fu sent the team to Wuhan, December 31 and New Years Day 2020, as reported in Der Spiegel. See the link to Lyrarc gist of Der Spiegel's "A Failed Deception: The Early Days of the Coronavirus in Wuhan."  2.  President Trump points out the standards of the WHO- in the concluding point of his letter to WHO- when a three time prime minister of Norway, Gro Brundtland was head of the WHO during the SARS crisis of 2003. She acted quickly and decisively and no time was lost. It is this failure of the early warning system under the new president of the WHO after 2017 Dr. Tedros that alarms the U.S.  with about 100,000 deaths.  3.  This failure it can now be said was partly a result of a election in 2017 for the position of WHO president which was flawed. This was the first time a WHO head, an important position was put up for an election. The Executive Board was responsible for this appointment since the founding of the WHO as part of the UN, based in Geneva, Switzerland, after World War II. This system worked. The election was clearly a bad process for appointing the president of the WHO which should be done entirely on the capabilities of the person holding this position not on a flawed voting process. It is flawed because India and Bangladesh hit by a cyclone during the coronavirus have suffered greatly, as have other countries, but had only 2 votes for 1.5 billion people, when Barbados (385,000 population) and Laos (7 million) which had less than one  hundredth the population had the same number of votes. The U.S. had one vote. The election resulted in lobbying and a process in which many candidates stayed away because they simply would not go through such a process. The position was too important to the world- most of the advanced countries had forgotten about the danger of epidemics to let this happen by 2017, as shown in the way the austerity years led to cancellation of the preparations for pandemic in France and Britain. The austerity years and neglect of public health during these tech boom years in the western world made it possible for this to happen. 3.   Along with the 1 month ultimatum action is already being taken to restore the effectiveness of the importance of the Executive Board. The head of the health ministry in India, Dr. Harsh Vardhan, has been appointed the new chairman of the Executive Board on May 22. This restores the voice of billions of people in Asia in the process, and brings the major countries with the greatest risk in a pandemic into the decision process for tackling the pandemic, this includes the rest of the world.     ...

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CDC has given no explanation for its new guidelines that say testing for coronavirus needs to be done only for those with symptoms, not for those exposed to someone within 6 feet who has symptoms. About half of all new cases are from people who are exposed to people with symptoms but have not yet developed symptoms. One of the reasons the virus spread quickly in February is CDC failure in developing of its own test on February 9 and policy that did not let private labs and labs of teaching hospitals develop their own tests and use them for another 3 crucial weeks.  CDC and Health and Human Services Department errors in February, combined with the stalling of an American team for 3 weeks by China to enter Wuhan in January,  have combined to let the coronavirus spread to the wider population. Once it spreads to a wider population the strategy of test and trace cannot be implemented the way it was first in South Korea and Taiwan, and later in Germany. ...

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South Korea has tested about 300,000 people for coronavirus. About 20,000 can be tested daily for coronavirus through 40 drive thru locations. South Korea invented this method of testing. Another feature of the South Korean method is the tracking down of people who have come into contact with those testing positive for coronavirus. The South Korean government is able to do this because it can access the credit card and cell phone information of people in the country. This is possible through laws that were passed after the failures during a previous epidemic of MERs. The government then tracks down and isolates the people who came into contact with infected persons. This includes people who show no symptoms, an important aspect of the South Korean program which needs to be adopted in other countries once the production of test kits and testing is ramped up. The reason is that about 30% of people who tested positive in South Korea were not showing any symptoms but acted as silent carriers. This is similar to the figures for people in the Wuhan region of China. This testing capability is one of South Korea's key strengths, though Germany's Robert Koch Institute says it has a similar capability to test 160,000 people a week. The U.S. has tested about 30,000 people by comparison. The U.S. government is procuring 60,000 test kits under the Defense Production Act. South Korea also enforces social distancing though a $2500 fine and a 1 year prison sentence. Germany now has a 2500 euros fine in some states for curfew violations.  By comparison the fine in Britain is insignificant.  Another difference between China and South Korea with Germany and the rest of Europe, the U.S., is that in China and South Korea self-isolation is monitored, tightening the control over coronavirus spread at every turn.   ...

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Friedman in the NYT says China overreached especially since 2012 on trade, technology transfers, and in relations with American allies Australia, India, Japan, and America underperformed for its people by not investing in infrastructure, in workers incomes and in health and public services, education. Underinvestment in the very structure and backbone of American society while billions were wasted in foreign wars and in misallocation of investments by Silicon Valley and other investors. The coronavirus failure to get adequate warning through WHO and China's cooperation for American teams to be admitted immediately after January 10 request by the U.S. for Wuhan was a turning point.  

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Italy faces tighter restrictions and a national lockdown at Easter for the coronavirus, Italians who were the first to go into lockdown on March 10, 2020, now think they will be the last to exit lockdowns. The mood in Europe is of frustration with the slow vaccination drive and the failure to procure enough vaccine supplies and to approve vaccines in time. The US and Britain have vaccination drives that are moving rapidly leading to a reduction in cases and deaths. In Europe new cases are rising since mid February 2021, and there is the spread of the new variant first detected in the UK.  The variants make up 70% of new cases in France says Health Minister Olivier Veran. ICU's in France are 80% full. Elections in France in 2022 and in Germany in September 2021 are leading to government reluctance to impose tighter restrictions. The government strategy is now being questioned. Only 30% of Germans now have confidence in chancellor Merkel's ability to make competent decisions. The CDU's partner in the government, the SDU socialists have even less trust with SDU getting less than 10%. There are signs of a third wave of coronavirus in Germany resulting from variants of the virus, slow vaccinations, and reopenings. ...

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The World Vaccine Summit raises about $7 billion to immunize about 300 million children for polio, diphtheria and measles, over 5 years. Prime minister Boris Johnson who opened the summit called it "the greatest shared endeavour of our times." Bill Gates donated $1.6 billion and Britain pledged 1.65 billion pounds over 5 years, making Britain the largest donor. Mr. Trump also addressed the summit in virtual manner- "we will work hard, we will work strong... good luck, let's get the answer." Mr. Johnson called for renewing "the collective resolve."  Specifically he stated: " Just as we have great military alliances like NATO.... where countries collaborate on building their collective military defence, so we now need that sam spirit of collaboration and collective defense agains the common enemy of disease." Referring to failure of early warning systems for coronavirus with crucial weeks between Jan 6 to Feb 16 lost for the West with lack of international cooperation- "It will require a new international effort to cooperate on the surveillance and sharing of information- data is king- that can underpin a global alert system, so we can rapidly identify any future outbreak. And that will mean a rapid scale-up of our global capacity to respond."  ...

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 South Korea has run about 300,000 coronavirus tests, double that in Italy and ten times that in the U.S., says this report in the WSJ. This report shows how the South Korean testing works and the workday of Lee Hyuk-min, a clinical microbiologist at a testing lab of Yonsei University Health System Severance Hospital in Seoul, who is working from 4.45 am to 11 pm. South Korea's effectiveness in controlling the spread is based on a strategy of efficient testing that enables isolating quickly people and areas. South Korea's testing network is a legacy of the MERS coronavirus outbreak in 2015, and the government failure at that time to control it.  It brings together doctors, medical staff, labs, and political leaders in roles following the protocols established since then. Dr Lee and others are the final checkpoint in the system which coordinates a diagnostic operation that combines together 633 test sites and 100 labs. The protocol includes a uniform setup- same testing equipment, same training, same decision making process. At 8 am each day all labs upload results to a shared database, which allows public and private hospitals to monitor patient results and report them to Korea Centers for Disease Prevention and Control. Hospitals upload testing details to an online directory. This surveillance allows South Korea to predict where to concentrate its efforts for controlling spread, says Dr Lee who advises the South Korean government on lab testing issues. Action plan took 2 years for the new rules to be implemented following MERS in 2015. The plan included accelerated bio testing company approval for tests. The first company got approval on Feb 4, followed by 4 other firms. Dr Lee says testing is only part of the equation as labs are needed to process and confirm results. Another key is innovation. South Korea setup testing in drive thru locations, that limit contact and speed up testing, which the U.S. is adopting. Dr Lee says early identification is key, and identifying the first coronavirus patient which was done in South Korea on January 20. Other countries including the U.S. took too long to identify the first patient, says Dr. Lee. ...

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The knowledge that the virus  caused human to human transmission and that it spreads to wide parts of the population very quickly were critical pieces of information that remained with Chinese epidemiologists, doctors and medical researchers, and were suppressed by local authorites in Wuhan.  Yet China's version of the U.S. CDC, China's Centre of Disease Control and Prevention, modeled on the U.S. control efforts worked effectively to identify the problem. Virologist Gao Fu, heads China's CDC. This report in Germany's Der Spiegel says Mr. Fu made it a habit to scan China's internet before bedtime for any signs of possible disease outbreaks. On the night of December 30 he came across rumors of an internal memo from the Wuhan Health Commission of an outbreak of a vaguely worded lung disease. When he called the Wuhan health authority he found their answers to be evasive which alarmed him. The next morning December 31 Mr. Fu sent the first of three teams to Wuhan which is how China was able to identify the problem, in the sense that Chinese authorites in Beijing were to rely on Dr Gao Fu to overcome the problem of Wuhan provincial authorites. He informed the World Health Organization Beijing office on that day. The Der Spiegel report says "shortly afterward," the Seattle Times in its report says this was about New Years Day 2020- Mr Fu made a call to Dr. Redfield, head of the U.S. Centre for Disease Control, who was on vacation. Redfield is deeply disturbed on hearing this from Fu and they have conversations over the next few days to the point that Dr. Gao Fu is in tears about what has happened. On January 1 Taiwanese public health authorites shared the information with WHO that the cornonavirus was a human to human transmission, would the Taiwanese authorites not have shared it with the U.S. the same week during calls from the U.S. CDC or other public health authorites alarmed about the situation. (The WHO was proving useless by Jan 14 when it contradicted Taiwan's more reliable assessment  on Jan 14 going by the letter from president Trump to WHO). On January 6 a few days later Dr Redfield and Dr. Azar head of Health and Human Services ask China for permission to send a team of CDC U.S. experts to China. This is cited in the U.S. letter to the World Health organization- the lack of human to human transmission information being given to the U.S. officially early by China. A risk that could have been a topic of conversation between the U.S. and China heads of CDC. That letter from president Trump also points out that the team of experts the U.S. planned to send was not accepted by China till Feb 16, one and half months after that series of conversations between Dr. Gao Fu of China CDC and Dr. Redfield of U.S. CDC in an alert message.  In effect removing one of the key defences for the U.S. and Europe in making their own defensive actions and plans, laying the basis of the worldwide coronavirus pandemic affecting millions of people. Dr Redfield is a AIDS researcher at the University of Maryland who spent most of his life trying to control spread of HIV and was appointed by president Trump to head CDC agency in 2018. He set a goal of eliminating AIDS by 2030 and is more comfortable with aids patients and research than the bureaucratic nature of agencies- CDC has about 11,000 employees. Once it was clear that a team of U.S. experts was not given permission to make its own assessment in Wuhan in the few days after January 6 offer to sent the team to China by Redfield of U.S. CDC and Dr. Azar, would it have alerted the U.S. that something was seriously heading the wrong way for a epidemic risk. That letter of president Trump cites how the head of WHO during the first SARS crisis in 2003, Dr. Harlem Brundtland acted when she faced China's lack of cooperation during that crisis by saying openly that this was a danger to world public health and millions. Could CDC in the U.S. and the other connected health authorites have taken the responsibility and filled Dr Brundtland's role in this crisis, that the WHO failed to perform?    ...

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What is the difference between South Korea and the U.S., Europe in the handling of coronavirus? It is tracking and testing.  President Trump and health adviser Dr. Fauci, see South Korea as the successful model to be followed in controlling the coronavirus. What has happened till now it is accepted with shortage of basic medical supplies and equipment, stress on hospital systems, are merely mitigation actions. South Korea was prepared for the coronavirus crisis because of the MERS and other epidemics, and failures resulting in corrective actions. Labs were centralized and better equipped for testing and tracking the infected. One of the key tools is testing. President Trump says the goal is for the U.S. to exceed and far surpass tests per capita in South Korea. Five million tests are planned by the end of April in the U.S. Where the U.S. falls short is in use of multipronged digital tracking using data from people's use of mobile phones, credit card usage, and use of apps designed to separate infected people from others. South Korea is a democracy with a population of 52 million people, about the size of France. People who were student activists in the democratization era in South Korea say the use of digital technology is a need today. We have to adapt in emergency situation they say. Ki Mo-ran, epidemiologist, and adviser to South Korean government says this is a key part lacking in the European and U.S. efforts to control coronavirus. She says in South Korea we know the patient's contacts, where he goes and stays, so we don't have to lock down everybody. Without digital tracking one cannot know which place is contaminated, which place is clean, so that there can be a lockdown of just that area and not the whole country, says Ki Mo-ran. She asks the question- is one person's privacy more important than the lives of a family or other people who are affected. Is it OK to lockdown every child in the country in a home as in Spain for over a month so that particular people's privacy is respected? These are serious questions for western society, are they exceptions or is democracy not just a western idea but equally cherished in Asian societies, people talk about Confucianism in China and the Asian culture forgetting that the biggest democracies are quite large and functioning well in India in addition to South Korea, Taiwan Indonesia, Malaysia, Bangladesh and Japan, far larger in area and population than China. The French government has chosen the app TraceTogether as the least intrusive one adaptable to France for use there. The U.S. is having Google and Apple develop one of its own. India will be developing one of its own. The NYT raises the question will it be watered down so much in France or in the U.S. and UK to be less effective than the  dire need for an alternative to lockdowns? ...

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German chancellor Merkel is interviewed by DW.com's Max Hofmann as her 16 year period as Germany's leader comes to a close. She discusses immigration to Germany, climate change and other issues. Not discussed are the issues of neglect of infrastructure and failure in preserving upward mobility in Germany society during that period. She is described as a "compromise machine," which she refutes by saying "I'm not a machine, of course, but... a human being." Through compromise she was able to extend the Christian Democrats hold on power for this long. Yet for much of the time she kept the Social Democrats, who were lacking in conviction at the time for real upward mobility, out of power; by compromises that meant she would do just so much not enough on social values. In the end her party the CDU fell to a low of about 22% support of Germans in the 2021 election. The Greens with more conviction and the Social Democrats surpassed the CDU under Baerbock and vice chancellor Scholz. Her achievements came reluctantly in the end in the face of the coronavirus pandemic. This time she put all her convictions and support behind the German and European Union financial package for trillions of euros of support that would enable Europe to get back on its feet after the pandemic's devastation. This may be her singular achievement, long after everything else is forgotten. Yet not one word of this interview talks about this achievement made with the full conviction of both Scholz and Merkel. Scholz and Baerbock will lead a new Social Democrat+ Greens coalition that will finally rebuild Germany along new lines on pillars of social mobility, infrastructure building, and climate change action for the New Germany. Baerbock is just 40 years, and Germany now moves to be run by a new generation so unlike the last in conviction and vision, and more in line with the vision and aspirations after World War II. With both Willy Brandt's vision of the Social Democrats, and the vision of Konrad Adenauer of the Christian Democrats, now carried forward with the help of the Greens Baerbock and the young generation of Germans. ...

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This important WSJ report shows how the CDC labs failed to come with the test after contamination of a component and failure of the third part of the three part test components. In the absence of a working test from CDC where delays cost three weeks of February the private labs all over the country and state labs could have developed their own test, yet HHS and FDA required approval for these labs to develop their own test and use it. From Feb. 8 when state and city public health labs detected problems with the CDC test to Feb 29 when solutions were developed including simply excluding the third part of the three component test, and letting labs around the country do their own test, were 3 crucial weeks that let the virus spread out of control. The CDC, HHHS, and the FDA and their managers and heads of departments bear responsibility for these errors. Week after week the delays continued, instead the two component test which detects if the genetic material in the sample is coronavirus material, could simply have been approved at the outset instead of the approval for this given weeks later. The third component of the test checks if the virus mutated, according to this report. There is no explanation why the labs all over the U.S. were not allowed to go ahead on February 9 itself or within a few days after that to develop their own tests once it was clear the CDC test did not work on that day. CDC officials failed to recognize that there was a possibility that they may not be able to fix the faulty third component of the test and the risks if they gave false reassurances. There is also no explanation of why a German designed test was not used once the CDC test failed on Feb. 9, which would be a proper way for action considering that this pandemic had already shutdown parts of China by this time. Alarming also is the mention in this report that on Feb. 22 a FDA official in charge of lab diagnostics  flies to Atlanta where the CDC Respiratory Diagnostic lab which developed the test is located. His boss FDA medical device center director is cited from later information as describing the lab as "filthy" meaning the lab had the potential to contaminate, and going so far as saying that if it had been any other lab it would have been shut down. Considering that investment in public health has deteriorated over the last two decades and that there has been a massive misallocation of capital in the country away from public infrastructure this is appalling. The thought of critical labs for emergency health needs as not being up to high quality standards in the U.S. as a result of two decades of misspending, that this shows, is very disturbing.  This WSJ report is based on interviews with people who know about the testing crisis, and undisclosed emails, correspondence on the issues involved. Community transmission began in January 2020 in the U.S. These delays were costly in February and could have been prevented either by going with the German design on Feb 10 or asking labs across the U.S. to develop their own test, and letting other labs immediately use the modified 2 component test of CDC that worked instead of doing this action weeks later. Mardi Gras on Feb 25 and other places where large crowds gathered in sports stadiums could have been stopped had testing gone forward and shown the true extent of the community transmission in these critical weeks.  First China delayed a U.S. team of experts coming into the country for weeks, and then the CDC, FDA, HHS, failed to get testing started, creating  a false sense of complacency. Two crucial errors outside and inside the country that caused so much damage to America and the world.   ...

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Britain staged a rehearsal for a pandemic called Cygnus in 2016. Till that time the preparations for a pandemic that started years earlier during the SARS crisis were conducted vigorously. Yet the by this time Britain was becoming immersed in the Brexit struggles in the ruling Conservative Party. Prime minister Cameron resigned on July 13, 2016  and was replaced by Theresa May. From that time on the struggles with pro Brexit factions led by Boris Johnson consumed the COnservative Party and sucked the life out of the pandemic planning that Britain had conducted for years before. The recommendations to correct deficiencies from the pandemic rehearsal exercize were ignored. The second failure happened as the crisis approached. Again the Brexit date of January 31 intervened and the months long struggle to get Brexit had taken so much energy and tired out most of the British public including new prime minister and leader of the Conservative Party Boris Johnson. Johnson did not attend the first Cobra meeting of the highest level ministers and military, convened on January 25, 2020, as reported in the Times. Such meeting are convened only for a national threat. Only 5 weeks later on March 2 did the prime minister attend a Cobra meeting. During this time the situation was grave in Italy with rising cases and infections. The entire process was conducted during this time by the Health minister Mr. Hancock who had assured the public that the situation was under control. Britain now has the highest number of infections in Europe exceeding that in Italy- at 240,000 on May 15, 2020. The prime minister and his adviser Mr. Cummings, were also infected by the virus, and Mr. Johnson spent time in ICU before recovering. Queen Elizabeth addressed the nation on Easter day, the first such address since 1940, to boost Briain's spirits. Never had Britain been less prepared as in 2020 when earlier preparations were ditched for austerity plans and events such as Brexit fatigue conspired to strip the nation of the crucial 5-6 weeks of preparation since the first January 25 Cobra meeting of the highest people in government.  Never had such preparation even for 6 weeks been more crucial than in February and March as the infectivity ratio was determined by infectious disease specialists at the best British universities and scientific institutions to be between 2.6 and 3.4 compared to the Spanish flu pandemic of 1918 which was somewhere between 2.0 and 3.0. This means every one person infects another 3 persons, compared to about 1 person in a regular flu season. This reproduction ratio and the nature of coronavirus remain a threat today as Britain, Europe, the U.S. and the world reopens.  As reported in the Times the infectivity ratio was also the reason for the mindset that refused to believe that the virus was real because at 3.0 infectivity the only way to tackle it was a "lockdown," and this was itself an "apocalypse" scenario for many in the pro-Brexit Conservative party that won the election, which badly wanted to get back to economic activity after Brexit. ...

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As Dr Harsh Vardhan, India's representative and Health Minister, takes on responsibilities as the Chairman of the Executive Board of the World Health Organization this can be said about this critical juncture.The WHO is going through soul searching and a reevaluation of how it has implemented the vision of its founders during the closing years of a world torn apart  by war in 1945, and actual founding in 1946.  At the UN conference in San Francisco in 1945, Dr. Szeming Sze of China, Dr. Geraldo da Paula Souza of Brazil and Karl Ewang of Norway, were keen to set up an international organization for cooperation on health. The Indian representative was Arcot Ramaswamy Mudaliar, a member of Winston Churchill's War Cabinet, who chaired the committee on economic and social problems. He was the president of the Economic and Social Council which called for an international health conference in Feb. 1946. It was at that conference on 19 June 1946 that the World Health Conference came into being. A native of Madras he then returned to Mysore as chief minister. The vision at the time for international cooperation on problems such as smallpox which killed 2 million people each year were quite different from the fast moving epidemics with international travel in 2020. Today 4.4 billion passengers traveled by air in 2018, according to International Travel Association, 100 times compared to less than 40 million in 1950, and about 10 times the 400 million when Nixon's visit opened up China in 1972. The world we live in is different and the World Health Organization needs to be redesigned for the 21st century. The entire process of how the WHO operates has to be rethought. Immediate steps include- 1. The appointment by Executive Board should be reinstated as this is more representative of the world population and the major centres of advanced public health, including the major countries. Throughout its life the WHO made appointments through the Executive Board not by election. The election in 2019 by 200 countries was actually not representative of the world population as it gave India, Brazil and other early founders at the 1945-46 conferences only 1 vote each with population of 1.2 billion and 210 million, the same as tiny countries Barbados population 385,000 and Laos 7 million. 2. Reassessment of the entire process in which nations are requested to give permission of teams from major countries in Europe, North America and Asia, major population centres, so that the 6-7 week delay between the U.S. request to China for a special team to go to Wuhan on January 6, 2020 and the permission granted Feb 16, a costly delay of 7 weeks which added millions of cases and hundreds of thousands of deaths. In a super fast moving pandemic with international sports stadiums and 4 billion air passengers spreading it like wild fire around the world, there is little room for error, every day counts. Never should this happen again, as Dr. Sze Szeming China's representative said once in 1945 we must learn from mistakes, as mistakes were made in the years before World War II that were costly for China, India, North and South America, Other Asia, Africa, large population centres. 3. As was the effort then in 1946 and the early years, the effort to keep the staffing positions of leadership in the World Health Organization should be kept far from politics. Very experienced and capable people are needed from major countries with long records of public health experience and committed to the huge task, as was the vision of the founders.     ...