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The coronavirus pandemic death toll reaches 700,000 making it the deadliest in history. In 2021 the death toll increased with another wave now in the southern and western states such as Florida, Texas in the south, and California, Idaho in the west, with deaths concentrated among the unvaccinated.

The vaccination drive stalled by August 2021 leaving a large number of people between 18-35 unvaccinated mostly in the south and some in western states. States with large Republican support tended to show higher vaccination resistance though the reasons for not getting vaccinated were complex and some misinformation played apart in fear of vaccines. Vaccine supplies were ample in the US.

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The two waves of the coronavirus in India can be compared looking at the graphs and this report in the Times of India. The case volume and deaths in the worst hit state Maharashtra is shown here. The case volume increased by about 50% in the second wave but deaths were about half that in the first wave. Most of the deaths were in the people over 65 and most of the cases in the ages below 40 years. In the over 65 age only 5% have been vaccinated which means that medical management is still the best way of tackling the coronavirus. Vaccine supplies are the bottleneck and this is beginning to change- so that by August ample supplies of the vaccine should make the difference in bringing down cases and deaths.  Lockdowns are managed carefully so that the economy can recover in the second half of 2021 and in 2022.  Any assessment of the crisis management must take into account the speed of the response, its effectiveness, and keeping in mind the economic recovery needed following the pandemic. ...

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About a third of recent coronavirus infections in the UK are from schoolchildren ages 10-19. The UK after a headstart in its vaccination drive has fallen behind other European countries and the US in the vaccination of children and teenagers. UK began vaccinating children in August far behind the US and Europe. On top of this UK under Boris Johnson decided to drop almost all public health restrictions during the summer. The change in Health Secretary happened on June 26, 2021 with Matt Hancock's resignation. The new Health Secretary Javid was to review the health restrictions in place till July 19. The sense of caution and preparedness that prevailed earlier as fallen short since July 2021 with the lack of coronavirus prevention measures such as masks, social distancing and vaccine mandates that were taken in Italy, France, Germany and other European countries, as well as in the US.

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A look at countries in Europe shows different strategies for tackling coronavirus Delta variant as schools reopen in September 2021. Italy requires all teachers to carry a covid digital certificate that shows vaccination or PCR test results. France, Germany and Spain do not require vaccination for teachers to go to schools, and rely mostly on social distancing and mask requirements in schools. Britain not only does not require vaccination digital certificate, but also has not made masks and social distancing mandatory. Health experts say there are serious risks in this approach with mass return to schools and offices after August 2021, and the fall weather with more time indoors. This could lead to a surge in coronavirus as in the US where the reopening of schools and Delta variant has led to surge particularly in states such as Texas, Florida, California. In UK 65% of total population is now fully vaccinated, in Italy 62%. Teachers in Italy fully support the new rules. In Lombardy region with Milan as the capital, only 300 out of 300,000 workers returned to schools without the green pass, according to regional officials. Britain remains an outlier says this report in the WSJ, taking more risks than is proper at this time, and simply hoping for the best. Not the best strategy in this situation.   ...

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The University of Washington Institute of Health Metrics and Evaluation has doubled its forecast of coronavirus deaths in the U.S. to 135,000, about twice what it is today at 69,000, by early August 2020. This is based on the assumption that with reopening the economy and return to actively operating in offices and shops, in construction and factories, the social distancing will be relaxed. Factors such as rising temperatures are not seen as offsetting the increased mobility in reopening. Dr. Fauci, top U.S. infectious disease official said on My 4, that the relaxing of social distancing could get a rebound started considering the coronavirus "phenomenal capabilities of spreading like wildfire." There is concern that the cases may be much higher in Brazil where there is not much testing, even higher than in the U.S. according to one university study. Argentina is a contrast having imposed a lockdown much earlier and has only 246 coronavirus deaths. ...

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The head of the European Centres for Disease Control ECDC, Dr. Andrea Ammon, says the Delta variant of the coronavirus will make up 70% of all cases in Europe by early August, and 90% of all cases by the end of August. ECD modeling shows that there is a risk of another wave like the one after last summer in Europe. The Delta variant is much more infectious than the UK Alpha variant and the UK variant much more infectious than the original variant. A 50% reduction in non-pharmaceutical interventions such as allowing the staging of events would lead to an increase in infection in all age groups. Latest ECDC data show 34% of people in Europe fully vaccinated and 57% with one dose. One dose offers much less protection. Younger individuals have a lower vaccination rate and are vulnerable. Also vulnerable are the older people not vaccinated yet. About 40% of people over 60 are not yet vaccinated, and 30% of people over 80 years are not yet vaccinated in the European Union. As in the US vaccination varies by region within the EU. All these vulnerable groups can be affected in another wave of the coronavirus similar to after last summer when restrictions were removed. Dr. Ammon is a former advisor to the German government. She says it is important for young people who are not vaccinated to continue to follow the strict social distancing precautions.  This is not happening today as governments are relaxing mask mandates in Britain, France and Spain. Soccer games are coming back to fan filled stadiums increasing the risk. Tourist spots in Portugal and Greece are now looking similar to the vacation spots in Croatia that increased infections in Europe after summer 2020. ...

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Even though volatility is high in stock markets, the U.S. stock market has rebounded to levels in August 2019. The level on March 10, 2020 after effects of the coronavirus on the global economy was for the DJIA average in the U.S. to be at the level it was on August 14, 2019, as shown on the graph in the WSJ, in the neighborhood of 25,000. In the last quarter of 2019 there were steep gains in the Dow Jones averages that could not be fully explained, these gains have disappeared. Considering the suddenness of the crisis from the coronavirus in China, and the double whammy of impact on global manufacturing supply chains of first the tariffs on Chinese exports to the U.S., followed by the coronavirus, the impact on stock markets seen in this overall context is comprehensible. Particularly the sharp gains in the last quarter of 2019 which now appear to be muted. There is also some good news for economies such as China and India, which are large oil importing countries, and the rest of Asia, in the sharp drop in oil prices that helps cushion some of its impact on the global economy. For the U.S. this also happens at a time when the economy is in much stronger shape than at any time in the last ten years. ...

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On the first day of the new vaccine policy on June 21, 2021, India has vaccinated 6.9 million people. India has now vaccinated 287 million people out of a population of 1.2 billion. This is a race against time as new variants caused the second wave of coronavirus in April and May of 2021 with cases peaking at over 300,000 a day.  The shortcoming of the old vaccine policy are being corrected. The entire vaccine supply process and the vaccination drive is now being handled by the federal government. Earlier during the second wave vaccine supply and the vaccination drives were under an arrangement with no clear overall responsibility. States shared responsibility with the federal government and target vaccination goals were missed, vaccine supplies were inadequate.  A similar arrangement in Germany failed and Germany's vaccination supplies were inadequate and vaccination drive stalled. This caused immense frustration in Germany in April-May 2021. Germany's troubled history before World War II led to a reliance on decentralized actions, and state governments imposed different rules in a relatively small country compared to India. This was corrected with the federal government taking on the entire responsibility for the vaccine supply and vaccination drive leading to good results today in vaccines. With India's huge population and political process of different state governments, some lacking experience in administration for a complex process, and others failing to coordinate well with the federal government, the lack of overall responsibility at the federal government posed serious risks of missing targets for vaccines and letting the coronavirus wreck the economy and public confidence. Complex negotiations with other governments in Europe and the US for vaccine manufacture in India could only be handled at the federal level. The resources and planning at the federal level were already in place in India for infrastructure and other projects, experience and setting targets in that area at the federal level could now be transferred to this task in vaccines. Somewhere in the range of 8 million vaccines a day need to be reached and sustained from August to December 2021 for India to reach the goal of vaccinated all 1.2 billion people ahead of any further attack from a third or fourth wave, say experts. This is not a choice for the federal government, it is simply something India has got to accomplish to be a healthy nation that can grow with neighbors in Europe, the US, Australia and Japan and build confidence in its Asia-Pacific region. The entire Asia-Pacific region has a lot resting on how well India achieve this goal and moves on to the next phase of assisting its neighbors in the region.  ...

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An important investigation by the Wall Street Journal looks at the 60 day sprint to find the origins of the Covid virus that killed about 6 million people worldwide, with excess deaths three times that. Did labs in the US and in China and scientists experiments cause this or did it happen naturally in the wilderness or in wild animal markets in China. Were other points of view excluded, asks the WSJ by NIC in it's 90 day sprint meeting with president Biden on August 24, 2021. WSJ Investigation says the FBI WMD scientist Banaan and scientists at the Defense Intelligence Council Hardham, Cutlip and Chretien were kept away from the president at a crucial final meeting of National Intelligence Council with Biden on the 90 day sprint to discover where this virus came from. Comparable is the  25 million people who died in the Black Death plague in Europe in 1348- Europe's population did not return to its pre-1348 level till the 16th century, says Britannica.  A scientist working at the FBI offices in Virginia Banaan was brought to main FBI offices for WMD to look into the origins of the virus in Feb. 2020. He and the FBI expected to be called in to see president Biden at a special meeting with Avril Haines, James Murphy of NIC. The FBI and Defense Intelligence Council scientists were not called in to see the president. Scientists on the DIC Council section on the Virus were not given a chance to share views or join the meeting by the Director DIC Scott Berrier who had his own theory on the virus, says WSJ. These scientists had done genomics research that showed a spike protein part of the virus that enable it to enter human cells was constructed in a lab, says WSJ. The WSJ investigation says the investigation sought by president Biden in a 90 day sprint was done with the National Intelligence Agency officials under Avril Haines, a State department official who joined the agency after the 90 day sprint, and James Murphy of the NIC who headed it's WMD section. WSJ report says the heads of Defense Intelligence Agency and NIC believed in what is called the zoonotics theory that the virus was of natural origins and simply transferred from animals to humans. A Lancet article in Feb 2020 by a group of scientists including Daczak of EcoHealth Alliance that supported coronavirus research at Wuhan had supported this theory in the interest of global cooperation to fight the virus but called any alternative explanations conspiracy theory, says WSJ, politicising something that should never be politicized.     ...

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A Phase 1 trial of over a thousand volunteers shows the Oxford vaccine works well with minimum side effects that can be handled with acetaminophen. Phase 2 trial is underway with volunteers in UK, Brazil and South Africa. Participants given the vaccine had significant increase in antibodies to neutralize the disease, and T cells for long term protection. About 70% reported fatigue or headaches which can be handled with acetaminophen. After the Ebola crisis of 2014 in West Africa the British government invested 120 million pounds to form a group to develop vaccines for top 10 likely threats dubbed "Disease X." On this list was the coronavirus. Scientists at the Jenner Institute at Oxford formed a team as part of this effort. Sarah Gilbert and Adrian Hill led the scientists at Jenner and pioneered research for  a new way to do this- to first replace a part of the virus with a component of the new virus. Then to remove the part of the virus that allows it to replicate in humans. This method is called recombinant adenovirus vector. The Oxford scientists used existing technology in new ways to increase the chances of getting a good vaccine early.  The first vaccine could be developed and tested for mass production by September. A 30,000 participant trial begins in U.S. in August. About 1 billion doses could be manufactured by end of 2020. India's Serum Institute has the manufacturing facilities to do this near Pune, India.  ...

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Efforts by Indian Council of Medical Research to have a vaccine ready by August 15, 2020. India already has 700,000 cases of coronavirus. Bharat Biotech is developing Covaxin in partnership with the National Institute of Virology.

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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? ...