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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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The Trump administration suspended all flights from Europe on March 13, about one month after suspending all flights from China. This report in the NYT says there were about 10,000 estimated undetected infections in New York on March 1 when only 1 case of coronavirus was confirmed. It also says that researchers have tracked the mutations of the virus in all American states and found that most of it came from New York. Could the Trump administration have acted earlier than March 13 to stop flights from Europe? The state and city authorites in New York did not take the threat seriously by March 13, making it not clear that they would have acted earlier.   In places like Michigan which has Italian Fiat owned Chrysler operations, and automotive connections with Munich, Germany, reports show the virus coming from Europe. Munich based auto companies have extensive operations in China. In Louisiana the Mardi Gras celebrations around Feb. 25, received large numbers of visitors from New York, with research showing the virus mutations in Louisiana originated in New York. There was little awareness of the seriousness of the virus because of lack of past experience as happened in Asian countries. So that these kinds of public events bringing huge numbers of people in close contact were allowed to happen, and people who were cautious were likely to be ridiculed or shoved aside. New York continued to hold public gatherings at Madison Square Gardens and sports stadiums well into March, with complete disregard of the dangers, a decision made by local authorites.   ...

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Researchers at Gottingen University in Germany analyzing data from a study published in the Lancet Infectious Diseases monthly journal say countries around the world have only discovered on average about 6% of all coronavirus infection cases. The true total of infections could be tens of millions worldwide. Why this is important- the recurrence of the virus is a real danger even after it appears that it is under control, making relaxation of essential guidelines for prevention very risky.

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The deep deterioration in U.S. China relations as the U.S. sees itself in a disadvantage in trade with China and the Trump administration imposes tariffs, calls for changing existing supply chains and trade to safeguard U.S. interests. The lack of transparency from China about the coronavirus and the underreporting that led to the U.S. and Europe not taking the threat seriously enough or taking defensive steps is also seen as a part of the deeper problem as the U.S. and Europe bear the brunt of the coronavirus in terms of deaths and cases.  This presents a deeper problem than the trade issue by itself as the U.S. had a trade issue with Japan which was later resolved. The way the Trump administration sees itself as the only protector of U.S. interests in trade, security and international cooperation creates a new level of tensions. Other countries such as Australia, India, Japan, and countries in South East Asia are seen as having similar concerns as supply chains are being remade to reflect the new trading conditions and economic structures. ...

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As this report in WSJ shows underreporting of coronavirus cases is a serious problem for Africa, and the figures from Africa's CDC, part of the African Union, do not show the magnitude of the problem. It shows that health workers in places from Yaounde in Cameroon to Dar es Salaam in Tanzania, to cities in Somalia, are reporting a situation quite different from what the CDC shows, with hotspots emerging in some places with little in the way of resources.

Only 1 million tests have been done and half are in SOuth Africa and Ghana. WIthout the testing it is hard to know how many cases there are. Capetown area in South Africa is emerging as a hotspot and hospitals are expected to be overwhelmed within weeks. Officially Tanzania a country with 56 million has 509 cases and 21 deaths, yet this contrasts with reports from health experts. Cameroon and South Sudan are also possible emerging hotspots in addition to Tanzania says this report in WSJ.

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Underreporting of coronavirus cases in China poses risks for other nations in not giving them a sense of the magnitude and severity of coronavirus. This leads to a false sense of security- in Japan, Sweden and other countries, much delayed action and a sense of exceptionalism that we can ride this thing through like an ordinary virus, In the U.S. and Italy, Spain, UK and Germany, loss of crucial weeks before taking action. Looking to the future this poses new risks as it still leaves people without a sense of how long to continue lockdowns.  The pandemic poses huge risks for Asia and Latin America because of poverty, crowded conditions and sanitation levels. The early action by prime minister Modi was a huge step in the right direction before coronavirus spread could damage the economy and people- as Mr. Modi said if not done right such as with a 21 day lockdown this could set India back by 21 years. It had value in that it alerted other countries such as Philippines, Indonesia, Malaysia, Bangladesh, Pakistan to take strong action early. As the WSJ says here in this essay by what is important for China and all other countries reporting on coronavirus is that this reporting is vital only because it can save many other countries from making costly mistakes. Which is why the direct doctor to doctor contact between Chinese doctors and American doctors is an encouraging right step, says WSJ.  ...

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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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France was exceptionally well prepared says France 24, citing a report in Le Monde, for the SARS crisis in 2002 and the H1N1 influenza in 2009. A billion masks were stockpiled by 2009. Following the H1N1 influenza not appearing in any significant way the media, political parties and the public shifted their attention away from public health crises preparation. For H1N1 the government spent 1 billion dollars some of it going to pharmaceutical labs. The eurozone financial crisis that followed the global financial crisis shifted policy to austerity measures. The entire preparation effort for influenza type health crises was abandoned as too costly.  The same pattern repeated in Britain which was also well prepared before 2010. Austerity budgets after 2010 had little room for public health investment.  One could say a similar pattern was seen in the U.S. Today the worst hit countries are U.S., Britain, France and other European countries. France which had 1 billion masks in 2009 to tackle a possible H1N1 epidemic finds itself with 150 million masks in March 2020 and scrambling to find masks. Some masks which were usable were even destroyed as expired, ministers and experts who had built up the prevention effort in 2009 were even demoted and forgotten, as was much of the preparation in these years. It wasn't just medical supplies pubic awareness had practically disappeared. In the U.S., in Europe, the same situation of a lack of public awareness so that experts, government, and the public could work together quickly, was clear to see. In countries such as Taiwan the preparation led to speedy response at all levels, making contact tracing, isolation of clusters effective. In the U.S. and Europe this early, early, period was lost leading to makeup mitigation measures and the growing sense of a loss of control over the virus. ...