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The Trump administration will use the Defense production Act to procure 60,000 coronavirus test kits. China ramped up its production of test kits to 7000 a day in a few days after the crisis hit Wuhan. The U.S. Government is also using the DPA Act for procuring 500 million masks. FEMA is now coordinating the response to the crisis according to this report,

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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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Analysis of its findings in the WSJ story on August 18 shows the FDA unnecessarily delayed private labs from developing and using their own tests from Feb 9 when FDA test for coronavirus failed for its third component. The FDA said it would correct the flaws but repeatedly failed to do so until it finally allowed private labs to go ahead on their own- a costly delay of 3 weeks that made the test and contact trace strategy inoperable, because the time window was lost in those 3 critical weeks. In March through August the pandemic has now taken up about 5 million cases in the U.S. and 170,000 deaths, with no end in sight. During times like these and in a swiftly moving current of a river such as the time of a pandemic, the  teaching hospital labs and labs with resources and scientific reputation with their lightning speed have to have the freedom  to immediately respond. In this case the FDA should have released the private labs of teaching hospitals and the the highly reputable labs of well known medical companies to immediately start developing their own tests and using them, starting  on Feb. 10 the day after it was evident that the FDA test's third component was not working. ...

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Richard Levitan, a physician expert on patient oxygen levels treated patients at a New York Hospital, and found this very important fact about coronavirus and its attack on patient lungs. Early detection and treatment, use of pulse oximeter monitoring, are shown to be critical for coronavirus.  Covid or cornavirus pneumonia is different from normal pneumonia in that it attacks the lungs but patients can be low on oxygen without realizing it through shortness of breath. As it turns out and confirmed by this physician expert who has invented intubation techniques and served at a New York hospital to understand why coronavirus was killing patients, the patient simply breathes faster and deeper without knowing it and is not short of breath even though his oxygen saturation is going down. This delays treatment- use of pulse oximeter is therefore recommended, an easy test placed on a finger that shows the oxygen reading. This kind of fast breathing then suddenly leads to the complete collapse of the patient's lungs, which is why so many end up in hospitals late and end up later on ventilators. British prime minister Boris Johnson received this kind of monitoring and early treatment to be able to return to work.  ...

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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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When the coronavirus spread in China it was expected that Taiwan would be affected badly. Yet Taiwan has managed the situation in a number of ways that has limited cases to 50. Health experts attribute this to quick preparation and early intervention. After the 2002 and 2003 SARS epidemic Taiwan setup the National Health Command Center (NHCC) to combine resources for managing a health crisis. This was to prepare for the next crisis. Taiwan acted early imposing a ban on travel to China, Macau and Hong Kong, and a ban on the exporting of surgical masks to keep a stockpile in Taiwan.  Taiwanese government integrated data from national health insurance with immigration and customs data. A program was developed  that allowed people to report travel histories and symptoms by scanning a QR code when they arrive in Taiwan. Travelers receive a text message with their health status that allows customs officers to focus on the ones requiring attention. The public's willingness to follow government regulation is now much higher after the difficulties caused by the SARS crisis. This makes them willing to follow more readily action taken by the government, as SARS memory is still fresh in their minds. Investments in public health systems and in biomedical research is much further advanced than in other countries. A research team at Academia Sinica has developed antibodies that can identify the protein that causes coronavirus, The aim is to shorten the test time for diagnosis to 20 minutes. The lead researcher Yang says the next step is to validate it before turning out a rapid test kit. ...

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By preventing serious illness in patients two pills for coronavirus from Pfizer and Merck can change the course of this pandemic. Pfizer will give a royalty free license to Medicines Patent Pool, an organization backed by the United Nations for its coronavirus pill. Merck has also given a royalty free license to Medicines Patent Pool for it pill. This organization will then grant a license for the manufacture of the coronavirus pills to poor developing countries. India is included in the list of countries yet China, Russia and Brazil are excluded for the Pfizer license.  Merck has given Indian generics manufacturers approval to make the pill. This will provide supplies of the pill to 105 developing countries, South Africa will also make the pill to provide it at $10 a course in Africa. Pfizer will begin manufacturing of large quantities in 2022 with 50 million planned for 2022 and 21 million in the first half of 2022. Pfizer pill will be made available in 95 countries. The Merck pill is called Molnupiravir. Pfizer pill is called Paxlovid with 30 pills taken over the course of 5 days. Pfizer pill is effective in studies when given to people who had not been vaccinated. It has to be given within 3-4 days of getting coronavirus confirmed through a test which makes testing critical for its use. ...

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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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After a sudden surge in the beginning of May the coronavirus wave in India, its second wave, is decreasing. It is 186,000 new coronavirus cases on May 27, down from over 350,000 at the peak. In India's largest state Uttar Pradesh with a population of 210 million the coronavirus cases have dropped sharply to 4000 a day. New coronavirus cases in Delhi and Bombay are around 1000 a day. The Indian government has moved quickly to tackle this wave with decisive action to meet the sudden surge in May 2021. For the rest of 2021 and into 2022 the most important action by the Indian government has been to create a government sponsored effort of India's entire pharmaceutical company sector to reunite in production of over 2 billion vaccine doses by December 2021. After independence in 1947 one of the steps taken by India with great foresight was to create a strong pharmaceutical sector with fair and transparent pricing of basic drugs and vaccines. Something that does not exist in this manner and scale anywhere else in the world. Today this is giving India a tremendous asset in the fight against coronavirus. India is already the largest producer of vaccines in the world, the new effort will make give it a decisive advantage in meeting not only India's but the world's need for new vaccines. ...

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Senay Boztas writes from Amsterdam, Netherlands, that the strict lockdown in the Netherlands is a result of a badly handled coronavirus policy response. The Dutch experience is offered as a lesson other countries can learn from. It too long to form a government after Dutch elections in March, 271 days so that it took too long to have a policy response. When a policy response was made it faltered badly with too relaxed a lifting of restrictions without essential distancing and mask use. Restrictions at super spreader events at night clubs and stadiums were lifted all at once. The government failed to develop a policy of anticipating the next wave from variants by planning early for a booster campaign. (Israel is already into its fourth booster shot as reported in NYT).  The result is that instead of a calibrated response, because infections make up 15% of tests, Netherlands is in a sharp lockdown. A policy of prime minister Rutte that put too much into the idea of freedoms with different meanings in the west calling Holland a "slightly anarchistic country that doesn't need a preachy government," rejected vaccine mandate of any kind as in France and Austria for public transport and restaurants.   ...

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Vietnam has an excellent record in the coronavirus epidemic with zero deaths and 324 cases. No locally originated cases are seen. The country has an astounding 792 tests per confirmed case compared to 144 for Taiwan and 57 for South Korea. Vietnam acted quickly to close its borders, quarantine foreign travelers in camps, close schools, and imposed an early lockdown.  This gives Vietnam an opportunity to restart its economy and maintain its growth. With the reallocation of supply chains away from China underway, Vietnam sets an ambitious growth rate of 5% for 2020, down only slightly from 7% for 2019.  The coronavirus also had some positive effects including the digital transformation that is taking place-  the rate of online transactions in public services increased from 12% to 24% during the 2 month lockdown. The discipline showed in Vietnam for tackling the crisis contrasts with other countries in Europe and America. This report says some small businesses and export industries in clothing and shoes are affected, yet even a 3% growth rate in 2020 makes Vietnam a winner, as the future in 2021 looks good. ...

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Tensions on the India China border as India builds roads and infrastructure in the mountainous Himalayan area close to the border in Ladakh to match the Chinese buildup of roads in the region over the last decade. India has also built up its troop presence in the region to match China's troop presence along the border in Ladakh.

India has supported a call from Australia for an investigation into the early origins of the coronavirus. The call was supported by many countries around the world and by the U.S., Japan and France. The 350,000 deaths from coronavirus and the 5.5 millions confirmed cases, the economic damage, most of them in western nations in North America and Europe, have  led to growing tensions between China and the rest of the world. 

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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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The northern coastal city of Quingdao in China, popular with tourists for beaches and beer, received about 4.4 million tourists during a National day holiday of 8 days in October. A local hospital Quingdao Chest Hospital has now detected 9 cases of coronavirus. Local health officials now plan to test all 9 million residents of the city. The National Health Commission now has a working group in the city for epidemic prevention efforts. The city went ahead with its annual 3 week beer festival in August, with the event getting 1.2 million tourists. An outbreak in Quingdao could affect other cities in China as people travel back to their home cities.

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Addressing the UN General Assembly in a virtual setting Mr. Trump tells delegates that China should be held accountable for certain actions in letting the coronavirus pandemic spread. He included the denial by China of human to human transmission very early before Feb-March, and its allowing Chinese flights to go overseas when it had completely banned flights domestically. He said flights were allowed to leave China after the virus spread from Wuhan even after Mr. Trump banned flights from China to the U.S. This spread the virus from China to Europe and to America.  Mr. Trump says the WHO is controlled by China. And this happened after foundations such as the Bill and Melinda Gates foundation and other foundations partly replaced the strong role played by the U.S. government at the world health agency during the post war period maintaining strong U.S. and European oversight in the earlier period. The lack of cooperation by China to let American experts into Wuhan immediately in January played a role in delaying the U.S. getting a first hand look at the coronavirus at the epicentre. Instead a 2-3 week delay left the U.S. Europe and India unprepared for the speed and havoc caused.  The only way to tackle the coronavirus was with speed and that speedy response was doubly needed because Europe and the U.S. had no recent experience with epidemics. Even India and rest of Asia, Latin America, Africa have no experience with this type of transmission and spread making time absolutely critical.  This speed was affected because China and the WHO acted as stumbling blocks in this view of what happened. The result was that in past pandemics were fought together, this pandemic was fought on a country by country basis, a bad precedent. ...

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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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EU Commission president Leyen announces Pfizer will supply EU with 1.8 billion doses of Pfizer vaccine to 2023. The increased supplies will include booster shorts to increase immunity. Another change is the new date for 70% of European Union population to be vaccinated, which is now advanced to end of July instead of end of September. With new waves of the coronavirus affecting Europe, and criticism of the EU's earlier effort in securing vaccine supplies, more urgency has gone into the new effort in 2021. Leyen told Pfizer CEO Albert Bouria- "If I may say so, engineer the mRNA in a way that it can adapt to potential escape vaccines," at a joint press conference. Leyen thanked Pfizer for its enormous effort in boosting vaccine manufacture and delivery. This will help accelerate the vaccination effort in Europe after the slow start in March and April of 2021. Bringing much needed optimism and new hope of a lasting recovery both in economic activity, health and in the mood in Europe, which can then spread from the US and Europe to the rest of the world. ...

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Public health experts warn that it is essential that countries reopening their economy have a reproduction ratio of much less than 1.0 so that the rate of increase is under control. Germany's Robert Koch Institute which advises the German government says the reproduction ratio which was 0.70 in mid April is now up to 0.96 after creeping back up. This is based on a mathematical model and extrapolated from infection numbers several weeks back.  It doesn't reflect the change by recent easing of lockdown measures starting with reopening smaller stores. This validates the careful approach adopted by France which was put forward by prime minister Edouard Philippe in his address to the National Assembly. The Assembly approved the plan 368 to 100. More legislation will back up the French government's authority to ban non essential travel between French departments and the creation of a large brigade to perform contract tracing. That involves finding testing and isolating everyone potentially infected, using dedicated locations. Detailed restrictions on travel, work and gatherings will take effect when France reopens partially on May 11.  France is also putting resources behind its testing program to test every person having coronavirus symptoms, and all they are in contact with. That means about 700,000 tests a week. Officials will generate a color coded map from this with red areas facing more restrictions than green areas. Student size is capped at 115 per class. Cafes, restaurants, movie theatres and large museums will remain closed. Gatherings of more than 10 banned. Those who can work from home asked to do so. Public transit users will be required to use masks, and marks on platforms will indicate the social distance required. Only essential travel is allowed more than 62 miles from home. These rules remain till June 2, when new ones will be set. Large music festivals and sporting events are canceled till the fall. Mr. Philippe says "these efforts will not be in vain and should allow us to arrange for a better summer season." ...

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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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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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A 35 year old Engineering professor from Texas who studies how transportation systems propagate infectious diseases and her 2 graduate students from China started and since January maintain the database of coronavirus confirmed cases and deaths. This is one of the widely used databases, also used by public health officials in the U.S. The database was started with a hunch from one of Lauren Gardner's students from China Ensheng Dong who comes from Shanxi province, north of Wuhan. A geography and mapping specialist he had studied in the U.S. since 2012, and spent many hours inputting data by hand following his classes. This WSJ report says the website was built in 1 day and was launched on January 22, when the coronavirus cases were practically nonexistent in the rest of the world and were concentrated in the Wuhan area. This report says behind the data reported in the media everyday is a complicated supply chain filled with challenges that come with data, what is reported, underreported and with what assumptions it is reported. Dr. Gardner says she is dealing with so much data on her dashboard, 4000 points of data, that its hard enough to pull all the data scraped together from different sources, its impossible for her to check the assumptions behind the data for consistency and trying to figure out facts underlying the data.  One of the ways the virus developed in the rest of the world is the surprise with which it caught western countries and then the rest of the world. As a result something that the government authorites would do such as the Centres of Disease Control is being done in a totally ad hoc manner. The U.S. government uses the University of Washington Health Metrics database, and in turn the University of Washington Health Metrics database takes some of the data from the John Hopkins database. Because a complacent population in the western countries were relying on numbers counted as cases to know how serious this epidemic was or whether there was an epidemic, the significance of data count from China assumed a signifcance far out of proportion to what it might normally be. This was because the western countries in Europe and America never encountered an epidemic of this kind in living memory, the last one forgotten from 1917 hundred years ago. Researchers in Gottingen University study in Germany conducted analysis of data in studies of cases published in Lancet Journal and found that only 6% of cases were being shown- that a much larger part of the population was infected. A researcher at Princeton University Ramanan Laxminarayan says countries tend to delay reporting until a problem becomes certain, because telling others comes with economic costs such as a rapid drop in trade and travel. Yet he says early warning systems are key to prevention. Early warning from the different publicly available data bases was not possible for many reasons. Relying on such ad hoc data was hazardous considering that as the NYT reported recently when there was the first confirmed detected case reported in New York there were already 10,000 persons estimated to be undetected. James Glanz and Benedict Carey, say in the NYT.com on May 7, that hidden outbreaks spread through U.S. cities far earlier than Americans knew, estimates show, which makes the publicly available databases giving a false sense of security, and not acting as an early warning because of the inadequacy of the resources for this task for individual researchers to handle. Not depending on  hurriedly put together databases with inadequate resources and having an independent sense of what the danger was as German chancellor Merkel described it in her first coronavirus address in March, was a better early warning signal than the databases in retrospect. And this too had come late. The reason is that the response had to be fast, very fast, and public perceptions had to be shaped quickly about the magnitude and speed of enormous proportions of the coronavirus, so that actions could be shaped quickly and executed quickly to stop it in its tracks.    ...

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California's economy is going through tough times during the coronavirus. Unemployment is up to over 20% which compares to 14.7% for the U.S., closer to that of New York. The state depends on the tourism industry, agriculture in the San Joaquin Valley, and entertainment industry around Los Angeles for jobs. Tech in the San Jose area does not account for as many jobs. The state also has a public university system and foreign students mostly from China bringing in $7 billion.   Its port system around Long Beach and Los Angeles connects with the Asian economies and China, for goods mainly transported to the rest of the U.S.  All these sectors are the ones most badly hit during the coronavirus.  California now has a deficit of $54 billion and was the first state to borrow from the federal government to pay $13 billion in unemployment claims. Undocumented Californians are not able to collect unemployment because of their immigration status, creating an American version of the informal economy that is found in India and Italy or Spain. California has 83 million people taking plane trips to the state for a tourism industry that normally brings in $145 billion. 600,000 travel industry jobs were lost in the state. Taxes related to travel are a significant source of revenue for cities in California bringing in $12 billion. The only sector that is less affected is the tech industry, yet this makes up only about 10% of the jobs or 1.7 million higher paid but fewer jobs. This tech sector at about just 15% of the California economy GDP, is of a precarious nature with a boom bust pattern, the last boom one that happened since the 2009 financial crisis. It in no way forms a significant support for employment or income for people in California or the U.S., and may even be responsible for distortions in the allocation of capital away from infrastructure and public services, through its disproportionate influence on how the nation's capital is allocated. The broader changes underway during coronavirus are likely to affect the state over many years, as supply chains shift away from China, and as infrastructure and public services investment assume their rightful role again in the nation rebuilding effort, agriculture and rural America become a part of the American renewal story.   ...

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With better control over the coronavirus than U.S. and Europe, South Korea is not rushing to buy the vaccines developed by Pfizer or Moderna. It is waiting to see how the vaccine rollouts work in other countries before buying the vaccine. South Korea is also looking at getting better price from manufacturers after the rollouts in the U.S. and Europe. South Korea is moving cautiously and has said it wants to get 10 million doses through the Covax initiative the main global effort to provide broad access to vaccines. Another 20 million doses would be secured from private companies. This is in contrast to the approach in Japan where the government has signed deals for purchase of 290 million doses for 145 million people for its population of 126 million. The money allocated is $6.5 billion and the goal is to vaccinate everyone by first half of 2021.  If it works this would prepare Japan for the Tokyo Summer Olympics to open in July, after 1 year delay. South Korea has the freedom to do this and wait to see what vaccine works best with least long term effects because their are relatively fewer cases there. A total of 313 new daily cases on November 18, lower than daily cases in a single county in the state of Michigan in the U.S. Moderna and Pfizer vaccines use anew kind of gene based technology that has never been approved to prevent infectious diseases. Other competition is the vaccine from Oxford and Astra Zeneca which uses an existing technology that is used in existing vaccines modified for use in coronavirus. The Oxford vaccine and a vaccine from Johnson and Johnson are expected to have a lower price. Because life is functioning very close to normal South Korea is in the unusual position of saying that its people have no reason to be anxious for vaccine procurement, as indicated by its deputy director of Korea Disease Control and Prevention Agency. Only three fifths of the population is the target for vaccination by fall of 2021. ...

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The full text of the letter is given here. In this letter the U.S. sets out some important facts about events that happened during the coronavirus crisis during the crucial 4 month period from December 2019 to March 2020. Every week lost in this time due to reasons of a lack of transparency, openness meant hundreds of thousands of people more infected and tens of thousands of deaths worldwide. There are questions of transparency, of openness and this raises questions about the manner in which the World Health Assembly operates with hundreds of small countries in Africa and Asia having votes equal to that of the U.S., India, Brazil, Mexico with votes taken of over 200 countries. The entire election process can now be seen as questionable, when over a billion people in one country alone such as India or hundreds of millions in Brazil and Mexico would have to bear the consequences of poor decisions made by small countries that can be swayed in one direction or another based on political bias and other considerations that have nothing to do with global health.  At the conclusion of the letter by the U.S. to the current WHO shaped by a controversial election in 2017 the following is stated about the standards set by Gro Harlem Brundtland and which helped the world prevent the SARS crisis which originated in China in 2003 from spreading to the large countries of the world India, Brazil, Mexico, and other such countries in Asia and Africa, Latin America, and the U.S. European Union. "In 2003, in response to the outbreak of the Severe Acute Respiratory Syndrome (SARS) in China, Director-General Harlem Brundtland boldly declared the World Health Organization’s first emergency travel advisory in 55 years, recommending against travel to and from the disease epicenter in southern China. She also did not hesitate to criticize China for endangering global health by attempting to cover up the outbreak through its usual playbook of arresting whistleblowers and censoring media. Many lives could have been saved had you followed Dr. Brundtland’s example." Even this does not come to grips with the flawed way in which the election of WHO head is done. It can no longer be relied on when there is the danger that lack of transparency can emerge in the WHO leadership itself because of a flawed process. It risks endangering the lives and livelihoods of hundreds of millions in countries such as India, Brazil, Mexico, as well as in the relatively small countries of Africa and Latin America where even basic water supplies are at risk but which could tilt elections at the World Health Assembly. Consider that a cyclone just hit the Indian state of West Bengal and Bangladesh on May 20 just as the coronavirus pandemic is spreading. That this region of 1.5 billion people had just 2 votes out of over 200 cast at the World Health Assembly in 2017 shocking. And even these votes cast based on old geopolitical considerations not how good the candidate is, and how good the country he is coming from is in terms of its record  on public health. The irony here is that private foundations in the advanced countries in the U.S. and Europe some of whom are major donors to WHO did not think that more experienced candidates in their own countries with a better record of public health such as in France or Germany are better qualified, in a flawed NGO support mentality left from the Clinton years. Basically the people in these large countries such as India, Brazil, Mexico were disenfranchised, when the austerity policies were consuming the European Union, and the U.S. had just elected a new administration itself groping for ways to reverse years of neglect of public services and infrastructure priorities. They would trust good leaders no matter where they come from, who have a record of transparency, leadership, and all the values we cherish together no matter where we come from. ...