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This report in The Times shows that from April to October the Tory red wall seats in the north of England have been hit hard by the coronavirus, much harder than the south of England. The infection rates in October are about three or four times in the north of England. The second lockdown came earlier in the north, in Liverpool Greater Manchester and Yorkshire. The result is that instead of levelling up the great disparities in wealth and income that are seen between the south, London and the north of England the gap is widening under the impact of coronavirus. Deindustrialization in the north after their prominent role in Britain's industrial revolution was followed by the same type of decline seen in parts of the American midwestern states. Imports from China and globalization, hit these areas in a sort of second wave, just as America was hit first by the wave of Japanese imports, followed by an even bigger wave of imports from China and complete loss of manufacturing. With it the loss of well paying jobs for workers in manufacturing and the decline of industrial cities. Influx of cheap labor from other parts of the European Union also affected the north. The result is that the popularity of Boris Johnson and the Conservatives with 58% approval rating in April in the north of England is replaced by a rating of about 31% in October 2020. The 40 Tory MP's in the Northern Research Group expressed their serious concern to the prime minister. ...

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It took a week longer for each country to impose a lockdown. In China first Wuhan then the whole country went into lockdown and quarantine. The same process is repeated in Europe and in America as authorites see numbers of infections increasing rapidly without strict controls. First the Lombardy region in Italy around Milan, then the provinces in Northern Italy, followed by a complete lockdown in the country on March 10 as infection spread faster without lockdown and enforcement of lockdowns. Germany and Britain follow Spain and Italy on March 20. France followed Spain in the days after Italy's complete lockdown. Macron ordered the lockdown on March 16 with stringent enforcement. Infectious Disease specialists at Imperial College warned of "unintended consequences for the entire nation" if a lockdown of Britain did not take place. The goal is to limit the spread of infections from rapid to slow as public health systems and economic measures are ramped up in preparation for the crisis. Most countries were lacking the preparatory steps having lost time waiting to see what happens next or analyzing data in the vain hope the virus does not spread.  Bad economic results of lockdowns were initially a concern, but this concern became less important as the coronavirus spread rapidly in Europe. Decision makers in Europe decided that not acting forcefully would lead to equally or worse economic outcomes. Public health systems overwhelmed would diminish public confidence rapidly and lead to equally bad or much worse economic outcomes. The European Union executive body has supported state aid, stimulus action and border controls in this crisis. In America and in Europe the hope is that shoring up the safety net with massive aid to businesses and households would buy time to tackle and overcome the coronavirus through a combination of lockdowns, quarantines, contact tracing, large scale testing and medical technology measures. The examples of China, South Korea, Taiwan showed this pathway exists for phased control and reducing fatalities to zero. ...

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For the first time deaths in Britain from coronavirus exceed 100,000. Deaths reached 103,602 on January 27, 2021, with all of the UK in lockdown again. Britain now has the highest coronavirus deaths per million population in the world. Analysis in The Times looks at what went wrong.

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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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Jeremy Hunt, head of the Health Select Committee and Health Secretary 2012-2018, says Britain needs to take up mass contact tracing as its next national mission. Britain he says has passed 20,000 tests a day for coronavirus. America has passed 150,000 tests a day. Both more than South Korea. What is missing when compared to South Korea and Taiwan is mass contact tracing.  The app TraceTogether is not enough, as it was used by only 20% of Singapore's population. Only South Korea and Taiwan are able to open up the economy, have workplaces and life function close to normal through extensive testing and mass contact tracing, with feet on the ground. This is the only path that has worked with South Korea successfully out of the lockdown. This means "feet on the street." Making these calls requires skills, getting information, getting cooperation, offering guidance, and ensuring people isolate themselves after contact with an infected person. Sometimes it is by phone and sometimes in person wearing full PPE. They need to be sensitive enough in talking to someone feeling ill and to see how home isolation can be achieved, who else the coronavirus infected person or someone in the chain of contacts has been in contact with. Mr. Hunt says no effort should be spared in doing this as the millions of jobs in Britain, of people without work, the economy, and the need for light at the end of the tunnel of lockdowns, requires a way out. A huge task but a lot of impossible tasks are being tackled in the health services. The resources of Britain, every spare civil servant, every administrator not working, every one who can do this, needs to be enlisted to do this. The same task needs to be tackled in America, and in other countries as a national mission. ...

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Britain protected about a third of its workforce during the months of lockdown for coronavirus. As a result Britain has protected workers from unemployment and effects of job loss. The job retention scheme protected 9.1 million workers, and the self employment scheme 2.6 million workers. The figures for the 3 months to April form the Office of National Statistics shows unemployment at 3.9% and the employment rate at 76.4% about 0.3% more than in 2019. 

As the government ends these schemes with reopening the economy by August some effect will be seen of job loss but not to the extent that this could have been without strong government action.

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The British public is very conservative when it comes to reopening. 73% support prioritizing the health of citizens only 17% say prioritize the economy. This is the highest of industrialized nations, Japan being the next highest with 60% supporting prioritizing health only 16% in Japan saying the economy.  For Boris Johnson as he makes the speech on Sunday May 10 on reopening the political margin for error in decision is nonexistent. Britain's tabloid press and other media simply took the idea that to heck with it lets reopen reflecting a lack of caution in the headlines after Mr. Johnson expressed his intention to reopen. After seeing this Johnson and his closest advisers met without his hawkish ministers to reflect on what was happening in the country. The British government's scientific advisers say whether there are 100,000 deaths by the end of the year depends on many factors including testing, contact tracing, the way the lockdown is eased, the situation at nursing homes, and other government action  to prevent a resurgence in infections. At the meeting with Gove, Sunak Raab and Hancock, Mr Johnson stepped back and reversed any plans except for mild reopening- giving people more time outside for exercize, opening limited locations such as garden centres and advising strongly to wear masks on public transport. Both Johnson and Dominic Cummings his adviser had coronavirus, and Johnson spent some time in ICU. They know the impact of the coronavirus from their own personal experience.  For Johnson there is only one chance, Tory senior advisers say the public will forgive mistakes going into coronavirus, but will never forgive mistakes getting out of cotronavirus. He told Keir Starmer of Labour in parliament that he bitterly regrets what has happened in nursing homes. The scientists have warned him that the staff at nursing homes could seed communities once again. And that the coronavurus R ratio (1 being the level it starts growing again) could go up back to 1. This is the situation on May 10 as Johnson prepares to speak to the nation on Sunday at 7 pm, as he shifts to "maximum caution." ...

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Hospitals in Europe are filling up quickly in the second wave of coronavirus. Coronavirus patients had to be transferred by helicopter to Germany from the Netherlands because of overburdened Dutch intensive care units. National Guard troops were flown in from the U.S. to the Czech Republic to help. In France as cases approach cumulative 1 million about 2000 patients are admitted to hospital for coronavirus every day on October 29. At some point French hospitals could be overwhelmed this winter, and doctors having to choose which patients to save, says president Macron. In the Czech Republic a collapse of the health system is expected by mid-November says the prime minister. No one expected this to be this severe, he says.  About 40,000 patients are hospitalized for coronavirus in the U.S. During the last week the case are increasing by over 40% in the U.S. and increase in hospitalizations are expected. Recovery rate is improving from the first wave. At NYU Langone hospital system in New York with 5000 coronavirus patients hospitalized recovery rate is improving from 25% in March to 7% in October. Better handling of cases and knowledge gained by doctors is a big part of this. ...

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German chancellor Merkel imposes a partial lockdown in Germany starting November 2. This is followed by an announcement of a lockdown across France by president Macron. On October 28 German daily cases went above 14,000. Only 25% of intensive care beds are now available, creating a very serious situation. Meetings in public will be restricted to just two households of up to 10 people total. No crowds at sports events. Restaurants and bars will close except for take away. Schools and kindergartens will remain open. Church services and protests will be allowed to continue. Shops will remain open with one customer for every 10 square meters or 108 square feet. Merkel called it a "very serious situation," and said "we must act now to avoid an acute national health emergency." She told Germans the number of people in intensive care units has doubled in last 10 days, and in many areas it was no longer possible to track and trace infection chains. In 75% of the cases the source of infection is unknown. People are encouraged to work from home and companies encouraged to make this happen. Companies with less than 50 employees and self-employed will get support from the government with  about 75%% of the income. Companies, institutions and clubs will also get federal aid. About $10 billion euros are set aside for this aid. ...

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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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About half of people in Britain in a recent poll taken during the second wave of coronavirus say they see a negative impact on mental health. Depression is affecting a fifth of the population in Britain. It has never been more important to be kind to each other and ourselves as the second wave hits a weary and fatigue stricken society.  People found many activities and hobbies to do during the 6 week lockdown period and there was an expectation that spring would bring better conditions. During the second wave of coronavirus there is a sense of a dreary period that goes on through Christmas. The uncertainty from the U.S. elections, Brexit in Britain, the reopening in countries such as India, the loss of jobs and income in countries that range from severe in Brazil, Mexico and Argentina to moderate in China, adds to the anxiety of daily life with surging cases. Creating what amounts to a low grade depressive effect during the second wave that needs to be addressed by the authorites, by health agencies, and in other ways, says this report in The Times. ...

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Efforts by the Physiology Society and Centre for Ageing Better (CAB), Make Movement Your Mission, and other groups in Britain to launch a national public health campaign. This effort is designed to get older people to exercize and form the contact with others that helps physical and mental health during the coronavirus restrictions and lockdown. It is a campaign for public health resilience.

Medical experts warn that lack of activity even for a few days can build up into negative effects on muscle mass. Three "snack sized" breaks of exercize for 20 minutes each day are suggested as well as super bubbles of 4 people, and guidance on nutrition, mental well being.

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The lessons from Italy, the epicenter now of the coronavirus pandemic, are clear- act early and decisively, impose quarantines and lockdown quickly to prevent intermingling. These steps need to be put early, with absolute clarity, and strictly enforced. This report in the NYT shows how decisive action early is the only way to prevent the crisis from becoming a large one that threatens the health system and millions. German states such as Bavaria and others now have a $25,000 euro and some have jail time. Singapore has jail time and fines for violating the stay home quarantine orders which it imposes after contact tracing. Taiwan has similar measures. Enforcement and strict control are part of the tools that have worked in these places and in China, South Korea.  Britain has still to close flights from Iran, Italy, which The Times reports on March 20 are still landing at Heathrow. This is after the U.S. weeks earlier banned flights from China, Iran, Italy, and last week from Europe after EU nations failed to take action early.  ...

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The second lockdown in France that begins October 29 for 4 weeks is very different from the first. It incorporates many of the lessons learned during the first lockdown.  The construction industry will remain open after this made a large dent in the French economy during the first lockdown. Schools K-12 will now remain open, with children required to wear masks at age six, and stricter rules for masks and visiting parents. The universities will remain open with classes online, but physically closed. Buses metro and other transport will remain open. Churches will remain open but be limited to very small gatherings. Parks forests, gardens and beaches will remain open this time but one has to live within 1 kilometre to access them and limited to 1 hour. People are prohibited from travelling outside the region in which they are registered. People can exercize for 1 hour within 1 kilometre of their home. All are required to carry a signed form for any type of activity, including shopping, work, accessing essential services, or for their one hour exercize. Not having the signed form would lead to a fine of 135 euros. Because bars, restaurants will be closed people in these hard hit industries will get 100% of their pay from the government. In other industries companies will contribute 15% and the government 85% so that these people are covered. ...

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The chaotic nature of the national lockdown announcement in Britain with Health Secretary Hancock pushing for a national lockdown and prime minister Boris Johnson's hesitation for 2 weeks. The Chief Medical Officer Mr. Chris Whitty told a top level meeting of ministers that the NHS could be overwhelmed by the first week of December and warned of 4000 deaths a day, if a lockdown did not take place. Tory backbenchers continued to resist but the prime minister had no other option but to call for the lockdown. The fact that Germany and France decided on a national lockdown gives Boris Johnson the cover he needed in his own party.

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On October 28 France reported 36,000 daily coronavirus cases. French president Macron announced a new lockdown starting October 30 that last till December 1.  Under this second lockdown people can leave home only to go to work, to go to school, to give assistance to loved ones, for essential shopping and for 1 hour of physical exercize. People will have to show documentation when leaving home. Travel between regions is banned. Bars and restaurants and nonessential businesses will be closed. Universities and higher education will be done online. Schools will remain open, essential businesses will remain open. Most public services will be open. Factories, farms and construction sites can continue to operate. There will be extensive economic support for business and people. Small businesses will have access to 10,000 euros per month of assistance, employees get short term work assistance, and people having trouble with rent receive assistance. About half of intensive care beds are now taken in France. And Macron said transferring patients to other regions will not be possible as the virus is everywhere. ...

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French president Macron in a televised address with frankness and humility, the fourth for coronavirus, says the national lockdown will extend till May 11. As infected cases and deaths gradually level they are still very high. His main point- "There is new hope but nothing is won at the moment... the epidemic is not under control." "Were we prepared? No. Clearly not enough. There were failings, there was a lack of material." "These are difficult days and we are now feeling afraid and anxious for our parents and ourselves." In many ways he reflected the feeling in France, Britain and Spain, a sense of humility after the virus.  "We have to reinvent ourselves, and me first of all... We are vulnerable. When can we hope for an end to this? I understand you have many questions and I would like to answer all of them. But I say in all humility, I don't have definitive answers today."   ...

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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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This report in WSJ shows how European countries are maintaining salaries of employees who would otherwise be laid off. Governments have setup programs in France, Britain, Germany and other countries to provide employers with the money for 80-84% of salaries up to 2500 pounds ($3165) in Britain and 5330 euros a month in France. As a result 1 worker out of three in the private sector in France for subsidy applications for 6.9 million workers are already received. For the German program 2.4 million workers will get this benefit. About 1 million companies in Europe retain employees with this program of governments simply sending out the salaries with funds directly to households. This helps to keep out the stress for families, particularly families with children. It is as if the employees are not really laid off but asked to stay at home for manufacturing facilities and work from home in shorter hours where work can be done remotely.  Money is quickly deposited into the bank account of employees in these countries, though it is slower in Italy and Spain. It is as if the European approach is put the whole economy on pause for 2 months and restart it almost like before with only a small dent in employment once the coronavirus is pushed out with lockdowns and strict control actions. This will cap German unemployment at 5.9% compared with 5% last year, only a modest increase. The cost is not that much considering what it accomplishes. 10 billion euros is the cost in Germany where the state fund for this has 26 billion euros. 10 billion pounds in Britain. And 20 billion euros in France.  The U.S. adopts a similar approach also through its $349 billion program which provides loans to companies with less than 500 employees to meet payroll for 8 weeks and pay some overhead. Loans are forgiven based on job retention and employees on the payroll and only if the employees are retained. Another program is for companies larger than this. And a third program targets entire industries such as airlines, aerospace, and companies in other industries so that they do not have to layoff employees. U.S. unemployment insurance is modified to work along similar lines maintaining incomes of employees laid off because of the pandemic. Another program sends checks directly of $1200 to households with lower incomes to help them and to help people at poverty level or without jobs. The thrust of both the European and American efforts is the same, lose as few jobs as possible, keep people's incomes steady, and do this in a way that the economy can pick up quickly to the former level in as short a time as possible. Compared to Europe U.S. unemployment will be higher predicted at 9.8% with the expected rebound lowering the unemployment in 2021. ...

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Prof. David Spiegelhalter of Cambridge University is critical of the British government for not finding out how many people may be infected by coronavirus. He says he is not telling how anybody should feel or what they should be worried about, but at least the people's anxiety should be proportional to the risks they actually face. His estimate is that based on the death rate of 1% its possible that there could be 3.5 million people in Britain who are infected with coronavirus or higher. Sir Spiegelhalter is professor at Cambridge University for the public understanding of science. He says this "basic information" is essential in making the decision such as how far and when to go out of lockdown, and that the British government has failed to do this in a timely manner required for tackling coronavirus without risking more lives.

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Germany has shown that low tech contact tracing efforts work- no apps needed, a phone, a desktop computer with a centralized database, and most important the human relations skills of the person doing the calls. The  sensitivity to the situation facing each person being called, being able to talk to the person in the language they speak in a multilingual environment such as California, is shown here. A 40 person team operates in San Francisco consisting of public health officials, clinicians, medical students and librarians. They call the contacts of people with coronavirus, arrange tests, and as needed send packages of food and medicines to hotel rooms or homes. Every call is expected to last 15 minutes but all sorts of questions are handled.  English and Spanish are used. Here one of the persons doing the contact tracing says she does not use apps, just an open source software used in the fight against Ebola. Definitely low tech, no waiting, get going is the message to every city in the world. She says apps software such as what Google and Apple are putting out can tell you whether the person went to some place, but cannot tell you more about that person, cannot tell you about problems the person is having being tested, and how they are having difficulty providing for families. One of the big lessons from Germany and efforts such as this one in San Francisco, and in other places such as Paris, Singapore, Taiwan, is that there is a complex nature to contact tracing that cannot be solved by tech. In fact the best thing to do is to get started immediately, with a phone and a database on a computer, as long as you have a person who has the motivation and skills, empathy with people, a lot can be done. Waiting for apps is a dangerous waste of time is shown by the low tech German experience, and the experience in other places. Most important is starting immediately. The example shown here of working with migrant workers in contact tracing shows in the most vulnerable places it is these human relations skills that count, that no tech app can do. It requires detective skills to find out and get people to share their history of movements and contacts for 14 days . In Singapore crowded dormitories house 300,000 of 1.4 million migrant workers. Singapore using an app also but its use is secondary. Apps don't work in many situations but fail in the most critical situations such as these dormitories and other eccentric or atypical situations such as faced by South Korea with religious groups and gay communities, elderly people in Europe, that generate the worst dangers of spread and need to be cluster isolated quickly. Human contact tracing has a history of being an effective method and was used in China and South Korea during the 2003 SARS epidemic. More countries need to adopt the method used in Asia and in Germany, particularly Britain, the U.S., France and India. It is OK that Britain's NHS and India's national government with Aarogya Setu app have put out their own apps which balance privacy concerns with the need to act immediately and cover the entire country, but the hard slog of human contact tracing teams in each district is indispensable. This is why the former Health minister in Britain calls it Britain's national mission to do this. Speed is key- putting together teams across the country in every district from skilled volunteers or government workers, and pulling together the phone and a centralized database on a computer as basic equipment. The fact that this is easily doable and people with human skills needed can always be recruited as they have been in Germany- from public officials in local government who are less busy in lockdowns, medical students, clinicians, volunteers, people from different professions- makes it inexcusable not to learn from others experience and get going. Just Do It. You want to reopen business, professions, offices and public services- Just Do It, it makes this possible. You want to prevent spread of the virus- Just Do It, it makes this possible. You want to limit damage to the economy and get the recovery going- Just Do It, it makes this possible. People of all shades of opinion can agree on this- its the only thing that works, even when there is a lack of enough proper accurate testing. ...