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China's healthcare system is overburdened and overwhelmed, says this report in the NYT. The changes in living and investment in infrastructure and housing are not matched by similar investments in the health system. Shortages of hospital beds and doctors is making tackling the coronavirus in the Wuhan region more difficult. A new hospital is being built in 6 days in late January 2020 in Wuhan for the coronavirus patients, showing how severe the situation is. 

The lack of strict regulation and lack of enforcement at the local level is leading to the situation where the virus was detected in twice- in 2003 in wild animal meat and again in 2019. Public anger and call for a ban on wild animal meat is happening today.

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The U.S. aid package to tackle the coronavirus includes $425 million for mental health and substance use disorders and $50 million for suicide prevention to ramp up mental health services. A telemedicine program for mental health providers is being expanded and a suicide prevention program at Veteran Affairs Department is being expanded to other Americans. Second lady Mrs Pence is supporting the suicide prevention program. 

Widespread anxiety and post traumatic stress disorder is expected by experts as a profound aftershock from the coronavirus.

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The Oxford second generation vaccine is being developed to handle several strains of the mutating virus at the same time. The Oxford team developing the vaccine is following what the vaccine is doing, in the way it is mutating, to develop the new vaccine.

The Oxford vaccine uses a virus that has been modified to contain a piece of genetic code from the coronavirus. When injected it causes human cells to produce the coronavirus spike protein, which the immune system learns to recognize. A single vaccine would contain different lines of benign virus, each containing the genetic code for the spike protein of a different variant so that the immune system can recognize several mutated coronavirus strains at the same time. This is also how the flu vaccine works. 

Quick regulatory approval is expected with much smaller trials that would be followed by immunization shots given in September 2021 when winter arrives.

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The Indian variant B.1.617.2 is beleived to be 50% more transmisable than the UK variant B.1.1.7 variant of the coronavirus. It is expected to be the dominant strain of coronavirus in the UK. The government has sent out the army to vaccinate populations in UK where this variant is widespread.

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Britain's trains on time record beats Germany's- it is at 98% during the coronavirus time. With about one tenth of the passengers as reopening happens gradually. The Deutsche Bahn German train system is suffering from a lack of investment, neglect of infrastructure. Britain's needs an update too, but the Deutsche Bahn has taken a sharp turn for the worse in recent years. The German government is shifting its attention away from protecting the auto industry to investing in infrastructure in its new $130 billion investment initiative to tackle the upheaval of digitisation, climate change, and decaying infrastructure. 

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Genome sequencing is a way to tell if there are mutations in the virus. This is a very important part of the battle against the virus. About half of the genome sequencing in the world is done in Britain. 
Lessons learned are pointed out by the Science Editor of The Times.

During the first wave with the origins of the coronavirus in Wuhan, China, focus shifted to selected countries without much attention to Europe next door to Britain. Much of the mutated virus strains from Europe, from Italy, Spain and other countries cause the epidemic to get out of control. This is being repeated in the second wave.

When the epidemic surged in Kent British health authorites conducted genome sequencing for the virus to find out that there was a variant, a mutation of the virus that was causing a surge. This has helped Britain prepare to tackle the pandemic as it changes with new strains of the virus.

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The source of a repeat infection is a mutated form of the virus. In one case the viral genome belonged to a different strain of the coronavirus the second time. Mutations are the likely cause of the new infections in Netherlands, Belgium, and Hong Kong.

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This report in WSJ looks at how Toulouse, the aviation capital of Europe, is coping with the aviation crisis after the drop in flying and planes idle from the coronavirus. Toulouse has the expertise for both aviation and fast trains. New designs and technology are being developed in all forms of transportation as Toulouse uses this time to develop new technological advances.

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Women are represented more in lower paid part time jobs and have borne more of child care responsibilities by two thirds than men according to ONS in Britain. Women spend more time than men on nondevelopmental care of children and average about 3 hours 18 minutes each day during the pandemic. The pandemic puts greater strain on working mothers and mothers who lost pay during the coronavirus layoffs.

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China has used the experience gained from an earlier SARS outbreak to tackle the virus outbreak in 2019 which started at a food market in Wuhan. Early detection, strict quarantines, and other measures, were taken. A viral pneumonia outbreak happened in Wuhan, a city of 19 million. 59 people were quarantined and the largest food and seafood market in Wuhan was shut down quickly. Between the first case on December 12 to the detection of the new strain of coronavirus in 1 month, China acted with speed, showing China's strength in public health resources and research labs.

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Risks are increasing in the southeast and midwestern states in the US where vaccination rates are as low as 30%. The Delta variant of coronavirus is now the dominant virus strain in the US. It is highly transmissible, estimated to be about 50% more transmissible than the original virus. The region covering Missouri, Iowa, Kansas and Nebraska, as well as Wyoming is affected, in addition to the southeastern states, as these states have lower rates of vaccination and vaccine skepticism. As communities in the US and UK reduce pandemic restrictions and open for the summer the risks of last year are being brought up by experts. 

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These simulations show the  importance of flattening the curve for coronavirus especially the steep jump in the curve when it grows exponentially as people mingle in crowded environments, on trains and subways, and in public gatherings of more than 10 people. This is shown here in four different simulations in the Washington Post. Social distancing and quarantine worked in China, Taiwan, Singapore and South Korea. Though the attempted quarantine simulation here does not cover the situations in China, Taiwan and Singapore where quarantine has worked and was the only way to tackle the coronavirus in time to do least damage. Additional simulations would show the way it was limited in Singapore through contact tracing and mandated staying at home for all who have come in contact with affected persons. And in South Korea a simulation could show how this worked through containment by testing and limiting spread, or China by an effective quarantine or lockdown of a city or province.  The basic idea is to limit contact and separate so that intermingling is restricted to as few places as possible for a limited period during which health authorites can achieve a controlled situation through systemwide organized efforts.  ...

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DW.com looks at why India is facing a oxygen shortage. Most oxygen manufacturers are in the east of the country and most of the coronavirus infections are in the west and north of the country. India normally produces 7000 tons of oxygen a day, which is being ramped up to 9000 tons a day and airlifted or sent by rail truck express trains to the north and west. German military aircraft are on the way to India on Wednesday May 5 that have on board a oxygen generating plant that can produce 400,000 litres of oxygen a day. Germany's ambassador to India says German aid is making a difference.

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France and Italy are imposing strict rules for their lockdown and tougher enforcement to control spread of coronavirus. India has imposed a quarantine, a total ban on leaving the home with a televised address by prime minister Modi that set a 21 day lockdown period. Modi said "if the pandemic cannot be managed in 21 days it would set India back by 21 years." 

Fines of $3000 euros are imposed in Italy and cars seized by the police. A special form has to filled out in Italy showing where one is going and checked by police if leaving the home. In France one needs an Affidavit of Movement by Special Dispensation is a filled form required for everyone outside the home. All open air markets are closed in France and drones are used to warn people outside.

All domestic and international flights in India are stopped. All domestic passenger trains and bus services in India are also stopped.

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Tory MP's rebels in the southern part of England are opposed to prime minister Boris Johnson's second lockdown for the whole of England. This report in The Times of London looks at how Johnson's conservative government might have to get Labor party support to pass the lockdown measures in parliament. Or Labor may decide to abstain from the vote. Mr. Gove says the NHS risks being overwhelmed if the lockdown does not take place. Responding to the statements that southern England does not have high or has falling rates of coronavirus Mr. Johnson says it has been shown that a low rate catches up in one area when it is next to a high rate area for coronavirus so that the result is the spread of the virus to the point where the NHS cannot cope.  The NHS like the French health system and other health systems in the European Union, U.S.  India, and other countries are strained to the limit. Most healt care workers in hospitals have felt severe strain on themselves and their families during the first wave. Most are exhausted and are in a situation of fatigue with the added factor of some healthcare workers on leave from the virus illness. This puts additional burdens on the system. Without the action taken the health system may be overwhelmed in many countries leading to disaster.   ...

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On May 11, NYT shows the rail network in India opening with the first trains taking 45 million migrants to homes in all parts of the country. Australia calls for an international inquiry into the cause of the coronavirus pandemic and its origins in China. Russia begins a cautious reopening with the governors of provinces having powers for reopening based on local conditions. In Spain restrictions are gradually being lifted but the major cities of Barcelona and Madrid are still in lockdown. And as Germany the first country to reopen opens up its business and schools the crucial R ratio of reproduction of the virus -with 1 being the number at which it grows again and below 1 showing control of spread- moves up to above 1.

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This article in The Lancet published in February 2018 throws much light on how the ban on gain of function research on virus was lifted -research that carries with it the danger of increasing transmission of virus if something unexpected happens in the manipulation of a virus. It was lifted in 2018 in the US by officials in the US Health Ministry, NIH and HHS. The Cambridge group of scientists and experts opposed lifting the ban on such dangerous research that could make the virus more contagious through manipulation. Epidemiologist Marc Lipsitch of Harvard School of Public Health wrote at the time that the lab research to create a more lethal strain of virus could lead to "an accidental pandemic" yet he was ignored. The public in America and in the world is unaware of how this created serious risks for public health in the world through the coronavirus.  Did US health officials lift the ban on such research without consulting other countries such as India, Brazil, France, Germany, Italy, and the EU on its ramifications. Were public health experts and the publics themselves in the US and around the world not drawn into the discussion of public health and the dangers that existed. Not only did officials in HHS and NIH restart the research by lifting the ban but also sent funds overseas for such research- was this a proper or thoughtful action considering the risks involved.  Is enhanced surveillance of virus- a dubious benefit from manipulation of a virus- something a few health officials can decide for the whole world in addition to the US. How are health officials in one or two countries responsible to the people in India, Brazil, Europe and the poorest populations in the world in the world in Africa, Latin America, and Asia, people who have suffered devastating consequences from transmissibility of the virus, including children and older people with health problems. India, Brazil, Italy, Spain, France, UK, and other countries worst hit by the coronavirus must ask serious questions about how they can protect their people if institutions in the US and international institutions are seen as failing to protect world public health. ...

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With U.S. crossing the 300,000 mark in infections on April 5 the country enters a new and critical phase in the fight against the global pandemic. Globally cases of infections jumped by 100,000 for the first time to 1.2 million. Health experts say the next 2 weeks are critical for winning the war against the global pandemic. White House coronavirus response coordinator Deborah Birx urges people to isolate themselves, avoiding even the trips to the grocery store or the pharmacy. Models show the infections peaking in New York, Detroit, and New Orleans in the next 6-7 days Birx says. In Europe the pandemic may be reaching a peak in Paris area and eastern France. High speed trains transferred patients from eastern France to western France as the fight continues. In Italy and Spain strict containment measures are now bringing in results with rate of infections increasing by less than 5% from the previous day. Daily deaths are less and pressure on hospitals is beginning to ease, with number of patients in intensive care decreasing. Queen Elizabeth II will address the British nation in a prerecorded address, the fourth one in seven decades of her reign, to thank health care workers. ...

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The Biden vaccination target of 70% of American adults at least partially vaccinated with one dose by July 4, 2021 remains elusive as vaccination rates have dropped. From a high of 2 million a day vaccinations have dropped to 400,000 a day during the first week of June 2021. Vaccination skepticism particularly in the south and western part of the US is making it harder to vaccinate the rest of the US population. This poses increasing risks as the new variants of the virus such as the Delta variant found in India, and now the most widely prevalent strain of virus in the UK, remain a serious problem. The unvaccinated population in the US is too large for any degree of safety in numbers vaccinated. Consider that at the press briefing given by the White House on June 3, 2021, only 28 states out of 51 states have fully vaccinated 50% or more of their population. There is a large variation between different states with states in the south such as Mississippi as low as 34% at least one dose and a similar situation in Alabama. In Arkansas, Georgia, Carolinas, and Louisiana  it is higher at about 50% with at least one dose. Even these figures are deceiving as in some parishes in Louisiana only 20% have even one dose. Studies show that only after the second dose are enough antibodies released to protect well against coronavirus. This is why vaccine experts at Baylor College of Medicine cited in NYT foresee a second wave in the southern US because of the South so underachieving in the case of vaccination.  ...

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Kerala state of 35 million people who speak the language Malayalam, is one of the rare places today that has only 4 deaths from coronavirus, 524 cases confirmed and no community transmission. Here the Guardian looks at the reasons why. The Health minister KK Shailaja started very early on January 23, with a meeting of her rapid response team when the virus was still in China.  She setup a control room and instructed Kerala's 14 districts to do this on Jan. 24. When the first case arrived on Jan. 27 on a plane from Wuhan, Kerala had already adopted the WHO  protocol of test, trace, isolate and support. These passengers were checked for temperature, tested and quarantined. With some at a nearby hospital and others in home isolation. This is all the more amazing considering that Kerala is a state in southern India on the west coast that has a large number of people living and working overseas. Many are in the Gulf countries and the arrival of these refugees could have triggered a second outbreak. This was prevented by careful testing, and contact tracing of clusters.  When one group was evasive and concealed information from an airport surveillance team -arriving from Venice, Italy,  in late Feb- a case was detected back to them.  Contact tracers tracked down all of the hundreds whom they had been in contact with and quarantined them.  By 23 March all flights to 4 Kerala airports from overseas were stopped, including Cochin and Trivandrum. On March 25 India went into lockdown.  Some of the achievements in Kerala include quarantining 170,000 people early. with strict surveillance, which is now down to 21,000. Accomodating and feeding 150,000 migrant workers from other states, before returning them on charter trains to their home areas. A big reason for the success is the high literacy rate in the state. A big emphasis on education and healthcare is a part of the Kerala model. Shailaja is a secondary school teacher, and Health minister. From the days since independence of India in 1947 the state has a strong socialist tradition of taking care of the basics- health, education and public services. It also generates a part of its GDP with income from workers who are overseas.  Another reason for the success in dealing with coronavirus is experience. The state had a virus epidemic called Nipah in 2018 which has become the story for a movie called Virus in Malayalam. There is decentralized public health system in the state and people value their health care facilities, understand and trust the health care authorites. There are hospitals at every level of administration and 10 medical colleges. But trust and education, experience tackling the virus before, are key. Kerala is showing that poor countries can deal effectively with the virus, and create a better life by adopting the right model of creating good societies that value education, healthcare services, better economic structures and distribution of wealth, and  a degree of trust and responsibility found in a state that values public spiritedness. ...

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Two US carrier strike groups and 17 naval ships prepare for joint exercizes with Japan's Self-Defense Forces off Okinawa in the first week of October 2021. In late September a British aircraft carrier group goes through the Taiwan Straits. China has flown aircraft near Taiwan's airspace before. On October 1-5 over a period of 4 days China sends 150 fighter, bombers and other aircraft near Taiwanese airspace. This situation is reminiscent of the situation in 1950-53 during the period of the Korean War when US president Harry Truman sent the Seventh Fleet to the Straits of Taiwan. In 1954 Chinese artillery started the shelling of offshore islands Quemoy and Matsu. This happened again in 1958 under president Eisenhower. At that point the US sent a naval contingent to the Taiwan Straits. The crisis was resolved through talks with China. Eisenhower then setup a joint defense agreement with Taiwan.  Here the Taiwan Defense Minister says China is capable of an invasion of Taiwan in 2021 but "it has to calculate what it would cost and what kind of outcome it would achieve." He also says that after 2025 "it would have lowered the costs and losses to a minimum." As US companies seek expansion in China the situation is changing rapidly in 2021 in the other areas.The US under president Biden sees the wars under previous presidents and the economic policies of not investing in American industrial strength have created risks for America in its role in the world. Biden seeks to restore American industrial strength through massive investments. It has been reported that Taiwan even considers the concentration of world semiconductor industry in Taiwan a way to assure the US dependence on Taiwan for semiconductors would lead to allied economic commitment to Taiwan in addition to defense commitments already given. In a sign of awareness of the distorted situation in semiconductor manufacturing that American companies such as Intel have allowed to happen, including ceding essential technologies in manufacturing semiconductors to other nations, the Biden administration has pushed to reverse these policies giving $52 billion in state aid. President Biden talked to president Xi of China in early September in a 90 minute call. This was aimed at easing hostility between the two countries. During that call the two leaders had agreed to abide by the Taiwan Relations Act, that states Taiwan's status should be resolved through peaceful means. It was passed in the US Congress in 1979 during the period when the US restored diplomatic relations with China. The situation today resembles that in the period after the Korean War into the late 1950's when China under Mao continued shelling of islands under Taiwan from the mainland. This makes the existing supply chains that make the US, Europe and India overly dependent on China,Taiwan, Singapore, for manufactured goods look antiquated and out of place. American companies such as Apple, GM, Black Rock and American financial companies are caught in a bind as they operate as if nothing is happening, when a lot has changed during the coronavirus pandemic. The Biden administration is pursuing its own long term policy for restructuring the supply chain for American industry. ...