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The situation in nursing homes and eldercare is a huge black eye says this report from Canada. The situation is poor also in the U.S. and Britain. All the Anglo-Saxon countries appear to have the same problem of neglect of eldercare and homes for older citizens compared to say Japan, Germany or France with different healthcare systems and more invested in these areas of health and older citizens.Look at the numbers- in Canada 80% of deaths from coronavirus among older people in nursing homes. Next Ireland at 62%, and the U.S. at 40%. This report says these elder care facilities in Canada are run down, poorly equipped and understaffed. Canada's armed forces sent medics to the nursing homes in Quebec and Ontario and their reports are described as distruging and worrisome by prime minister Trudeau. In these countries lawmakers and policymakers have failed, and the culture of investing in areas other than health and public services and infrastructure, has failed the people. A poor scorecard for this generation of politicians, lawmakers, and leaders both in business and the government. ...

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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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The rotting carcasses of the minks that were culled will be dug up to be incinerated. Environmental inspectors found that some water sources might have been contaminated by bacteria. The 17 million minks in Denmark were the target of culling after fears of coronavirus in minks. The whole issue has shown the problems in some of the Nordic countries that were seen as models for healthcare and public services. Sweden's treatment of the elderly in nursing homes was seen all over Europe as shabby and the king of Sweden called it a "failure.

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The crowded sports stadiums for soccer games during early February in the Lombardy region accelerated the spread of coronavirus in Italy by the end of February. The sports stadiums soccer games spread the virus like wildfire in northern Italy. This is why along with nursing homes, sports stadiums pose the greatest threat from coronavirus. The tens of thousands of people from a single game can contaminate as many as 40,000 or 50,000 people as these 10,000 people go on subways, restaurants and other places. This spreads to millions very quickly creating a wildfire effect. Airports and sports stadiums or music venues, theatres have this wildfire spreading effect that is then compounded by the use of public transport and restaurants other close proximity places, spreading it far and wide. These are also not essential activities as work and office, employees working at companies or in manufacturing, which are essential to the economy.  This is why in terms of priority sports and leisure travel can be deferred till a vaccine is developed. Business travel is increasingly being substituted by using videoconferencing and other ways of staying in touch remotely. ...

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Except in Britain where there is concern about the government's handing of the crisis in nursing homes most European leaders have improved their standing with voters with their coronavirus response. Public confidence has increased for Germany's Merkel, Italy's Conte, France's Macron, and Spain's Sanchez. France's Macron enjoys a personal popularity rating of 44% and satisfaction with his government's response has increased to 42%, after a decline in mid-April when there was a jump in cases. In Italy satisfaction with the government response is at 66%, and Conte remains popular. Mr. Sanchez's response to the coronavirus crisis in Spain is approved by 46% of voters. Most European leaders have shown unity and composure in the crisis, strengthening the community spirit in the European Union.

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Poland has a huge shortage of doctors and nurses. The ratio of doctors to every 100,000 of population is the lowest in the European Union. It is twice that in Germany whose relative success in tackling covid pandemic comes from having foreign doctors and nurses treat patients. Consider that the average age of Polish doctors is 53, only a few years from retirement. The situation in terms of immigration reminds pone of East Germany and its depopulation of young people who left for West Germany. Something like this has happened in Poland in health care.  In similar ways other countries in the EU, Hungary, Slovakia, Romania stocked up on ventilators but now have few doctors and nurses left to operate them. It is stretching the limits of human endurance as this report shows in WSJ, with doctors working 36 hour shifts and working 73 hours a week.  Here we see Dr. Rotnicki, who works these long hours at a hospital in western Poland and says that it is like the Second World War, that it is hard times in Poland for health care workers. This report says Italian and British hospitals, not just German ones, are tackling coronavirus with Polish, Hungarian and Romanian doctors and nurses. This report shows that headhunters in Germany drive in to western Poland blanketing windshields with pamphlets promising 5 times more pay, 2 years of free language classes and housing. In Slovakia a third of all nursing graduates leave the coutnry immediately after graduation. In Poland not nursing pay has lagged behind with fewer going into nursing schools. Staff remaining in the region are older and educated under communism when less English was taught, or have returned back home from years overseas. Forcing doctors to give up private practice and work in public hospitals during coronavirus pandemic is not working in Hungary, where surveys find 6 out of ten medical school graduates intending to leave Hungary. These doctors say they are better off working at Aldi and Tesco if needed and making more pay, plus getting weekends off. Poland only recently increased pay for healthcare workers, some even survived on cash given to them by patients. Not a good situation for a country to be in and reflecting the wrong priorities not just in the U.S. and western Europe, but also in eastern Europe, during the last 3 decades. These priorities shifted money away from health care, education and infrastructure priorities. The people simply lost control of their spending allocation to "financial markets" that shifted money in a way that benefited only small group in society neglecting others and national interests. ...

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This report in the Times says there are divisions in 10 Downing Street, between Mark Sedwill, the top civil servant, and the prime minister, Boris Johnson on implementation of a coronavirus plan, Mr. Sunak the finance minister and Mr. Johnson on reopening of the economy and the spending plans. There are also frustrations among Tory MP's, women, and ministers, who are left out of the centralized decision making where only a few people around Mr. Johnson- Gove, Hancock, Sedwill, Sunak, Cummings - know what is going on.  Mr. Johnson has not rested well says the Times and Mr. Sedwill also had the virus it is reported. Mr. Hancock is not trusted by Tory MP's to execute the plan correctly for testing, tracing and isolation of clusters, crucial to controlling the pandemic and restoring confidence in the economy. Mr. Johnson also face the prospect of an inquiry into nursing homes- he responded to Keir Starmer of the Labor party in parliament that he"bitterly regrets" what happened there. More money is being poured to control this. There is a sentiment of acceptance that Brexit talks are going nowhere and Britain simply walks out with no deal.   ...

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Most people would not guess or recognize that this place where elderly people in society were treated shabbily is a country in northern Europe, and a country where citizens pay high taxes for precisely better healthcare across different age groups. Sweden is where about half of the 6000 people dead from coronavirus were elderly people.  Over the last two decades Sweden has cut hospital capacity and discouraged elderly people from entering hospitals during the early period of the pandemic, says this report in the NYT. The for profit nursing homes in the centre of Stockholm were unable to cope. Having turned the work in these homes to low wage workers, it put these workers and the elderly at risk with lack of staff, lack of adequate PPE oreven  basic masks, says this report in NYT.  One of the lessons of this pandemic is the failure not just in turning over manufacturing of health care equipment and pharmaceuticals to China, but also turning over the basic care of elderly to for profit institutions that were totally unprepared and could not give elderly the dignity and care they deserve. Year of cuts to public services and health services now showed in a glaring way what can happen when this is done. It has lessons for countries from Europe to North America, and to Latin America, India and other Asian countries as they redesign policy and allocate resources to public services in the next 10-20 years. ...

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In an astonishing contrast to other European countries, including neighbors Norway, FInaland and Denmark, the Swedish government decided to not impose a lockdown, keeping bars, restaurants, hairdressers, gyms, primary and middle schools open. Secondary schools, museums were closed, sports gatherings, gatherings of more than 50 people were not allowed. Social distancing was not enforced, and entirely voluntary. Sweden now has 29000 cases according to Statista and its death rate of 358 per million population is higher than in the U.S. which is 267, and Denmark 93, Finland 53.  Critics such as Lena EInhorn, a virologist, say the Swedish government did not set up a broad testing program, and let a problem develop for elder care in nursing homes. She says a 14 day quarantine of household members of a person infected with the virus would have made a difference. Most action we take for granted was not taken in Sweden. Restaurants that were not required to close spread airborne transmission. Einhorn also says that the government officials have denied it but under their breaths they have acknowledged working on a herd immunity strategy. Denmark has opened schools with social distancing and other measures and reopened its economy. Sweden is in reverse with calls for stricter action and an ongoing debate. No reopening as there was no lockdown, yet considerable and nagging uncertainty. The speed of transmission of coronavirus is the biggest danger, as it can let the numbers grow very quickly if the wrong decisions are taken or something is left out. ...

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The southern U.S. which was early to reopen the economy after the lockdown with some states having only partial lockdowns, is emerging from the coronavirus in much better shape than the rest of the U.S. The unemployment rate fell to 6.9% in August, the lowest of any region. The number of people employed was only 6% lower in August than in February, when most of the U.S. went into lockdown, compared with declines of 10.6% in the Northeast, 8.2% in the West, and 7% in the Midwest. Some of this was a result of aggressive reopening in Texas and other southern states. Overall deaths in the south were 60 per 100,000 people compared to 132 in the Northeast including New York and New Jersey, Midwest at 52, and West at 40. The Northeast numbers are high because of the elderly in nursing homes hit hard in New York and New Jersey.  In the southern states by comparison the deaths came later and among young people taking risks. The virus hit the northeast early and parts of the midwest, southern states had the advantage of some of the work already being initiated in March to fight the virus nationwide. Many of these states are also Republican and residents feared the virus much less. Republican Governors followed their instincts and aggressively reopened putting the economy first. The numbers tell the story. In South Carolina 44% of Republicans say they aren't afraid of the virus outbreak in the local area, compared to just 2% of Democrats, according to Civiqs poll. Georgia and Florida have similar numbers, all with Republican Governors. One factor favoring southerners is that cities in the south are much less dense and less populated than in the North and West. Smaller cities than Los Angeles and New York. ...

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The coronavirus pandemic and the disaster in nursing homes, the chaotic conditions in the first wave, the lack of staff and poor attention to residents during the pandemic, has exposed the major weakness of nursing home care in western countries. Much of this sector is in the hands of private operators seeking a profit.  The staff is paid low wages and lacks the experience and empathy needed for care of older people. During a virus all these factors turn deadly. With some staff sick the other staff is overburdened. If the sick turn up for work they are likely to risk the safety of other staff and the residents. With the incubation period lack of testing there is no way to know. When deaths occur and the nursing homes are sealed from the outside world the deaths happen with no goodbyes as happened in U.S., Britain and Sweden. This has exposed the scandalous and shocking way in which the elderly are treated in today's environment where ridiculous amounts of money are being spent on other things and the the most basic "one's parents" are neglected and allowed to die in horrific manner in a pandemic. The new trend for home care for the elderly is a welcome trend and long overdue as one of the worst aspects of the system in the west is the treatment of elderly parents in nursing homes run for profit. The new technology tools available for monitoring a elderly person at home, and the help of stores such as Best Buy which are serving elderly at home, is making this more and more a choice for the elderly. Even older patients and ones needing significant care can recover and spend time at home in a better environment, a less costly one, as hospital managers and families have learned in 2020. Some hospitals in the U.S. say they never want to go back. That the drive to get every patient home who can be home is the right one for patients and families and for the government paying for the care so that dollars are well spent in quality of care. Home health care companies are working on providing new services for sicker patients recovering at home. Technology helps do better monitoring. Medicare now pays for digital doctor visits and intense hospital type care at home after coronavirus showed this as vitally needed.  Both the Biden and Trump administrations are firmly focused on this issue. Seema Verma as head of Medicare is clear about the need for a national conversation on how we take care of the elderly, of our parents. And Mr. Biden wants to spend $450 billon to make certain that people who need long term care can get the support they need in the home and the community. This report looks at the home health care companies and how they are improving their services. This and telemedicine are two of the major constructive changes coming out of the pandemic, clearing out some of the worst aspects of the old system of living the older years in the western world.  Nothing speaks more about humanity and a human world than the story here of Savanna Hollar, 90 years old and almost blind. She broke her shoulder in August, Her sons decided not to send her to a the rehab facility she went to after a broken hip 3 years earlier. The sons brought her home to recover in the farmhouse near Yadkinville, N.C., where she has lived since 1951. One of her sons himself 63 years says that at a nursing home she would be lonely, scared and afraid to move. The sons hired two people to help her during the day and a rotating system was used for having people help her. At home Mrs. Hollar could enjoy her gray cat, Buddy, her favorite recliner and tomato sandwiches made with produce from her garden. Really, if we can't do this much what good is the U.S.A.? or Britain? or Sweden? or India? ...