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US health officials remain on high alert for one unfinished task of the fight against coronavirus- the unvaccinated people who could be a breeding ground for new variants of coronavirus. There is the danger that a new mutation of the virus in unvaccinated people could be more resistant to vaccines. This means everyone needs to get vaccinated, and one dose should be followed quickly with the second dose. One dose only has limited protection with strong level of antibodies resulting only after the second dose. In the US southern states such as Arkansas and Oklahoma lag behind in vaccination, and are seeing a large increase in cases.

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Already vaccination experts at the Baylor College of Medicine cited here say they foresee another wave of the coronavirus in the Southern US because of vaccine skepticism barriers to vaccination, and much of the population not being vaccinated. The percentage of the population in the Carolinas, Georgia, Georgia and Louisiana, that has both doses of vaccine is low. About 50% have had just one dose. In southern states Mississippi and Alabama the vaccination rates are much lower leaving large parts of the population unvaccinated. The widespread presence of the Delta variant in the UK and the R rate being between 1.00 and 1.2 in UK shows that the UK even with higher vaccination rates than the US is still facing a danger of another wave as it reopens.  The ominous aspect of this is that from just over 400,000 the vaccinations per day dropped to 316,000i n the US. This means there will be a period when vaccination drive is stalled while the reopening is fully underway with a new contagious variant twice as contagious as the original coronavirus. This leaves the US at risk of another wave, with the south and western US, younger people who are out more and unvaccinated, more at risk.  ...

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France is tightening up on vaccine passes making them mandatory and imposing bigger penalties for fake passes. Fine of 5 years in jail or 75,000 euros for use of fake vaccine passes and stricter penalties for stores not checking the pass. Vaccine passes are mandatory in stores, public transport and venues in France. The goal is to get the remaining unvaccinated to get vaccines as omicron variant of the virus reaches 200,000 new cases a day in France. 

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Households and businesses have built up trillions of dollars in extra savings and the economic recovery looks strong says this report in the WSJ. Experts expect the economy to pass pre-pandemic levels in the second quarter of 2021. From this point the economy can recover the pre-pandemic trajectory of growth for 2022. There is a bit of caution about another wave of the coronavirus with new more contagious variants considering that about half the population still remains unvaccinated. The US has enough vaccine supplies, it is the anti-vax sentiment that could be the problem. Even with this bit of caution the economy appears resilient.

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China faces risk of a surge inthe coronavirus in June 2021. The area in and around Guangzhou appears to be seriously affected. The city tested almost its entire population of 18.7 million between June 6 Sunday and June 8 Tuesday. This report shows pictures of a deserted Beijing airport, strict restrictions on foreign travel. The SinoPharm vaccine effectiveness against the Delta variant in India and UK is unknown. The government is locking down entire neighborhoods rather than entire cities or provinces.  As the risks of the Delta variant and other new variants increases most of the population even in the US and Europe have either no dose or one dose. Researchers at the University of New South Wales in Australia show the Astra Zeneca vaccine effectiveness with one dose at only 30%, only after two weeks following the second dose does the vaccine effectiveness reach about 70%. The population of China and India are so large that much larger parts of the population remain unvaccinated. In China with 1.3 billion people and even if the figure of 800 million doses stated by the government is accepted- it could be an overestimate as the US has only managed 300 million doses with many vaccines- most of the population is unprotected. Vaccine skepticism is high in China making vaccination an uphill task. SinoPharmvaccine is not as effective as Pfizer, Moderna, Astra Zeneca, or Covaxin vaccines, making the task even more of an uphill kind. ...

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European Union countries, Britain and the US face the risk of a resurgence of coronavirus through the Delta variant and other variants. The Delta variant detected in India is 40% to 80% more transmissible than the Alpha variant detected in the UK, with the Alpha variant 50% more transmissible than the original coronavirus that originated in Wuhan.    Virologists in Italy feel they are flying blind at this time because of the lack of genetic sequencing in Italy, Spain, France and across most European Union countries. The UK has done genetic sequencing on 27% of recent covid positive tests. The figure drops to 1% for Italy and is tiny for most of the EU countries including Spain and France. Without genetic sequencing it is hard to predict and take steps. Another problem in the EU is that the southern economies Spain, Portugal, Greece, Italy, Croatia are dependent on summer tourism for the economy. The UK economy can handle a delay to a full opening for 6 weeks without serious impact to the economy, says WSJ. Southern European economies can afford only short delays to full reopening. Croatia acted as a door to spread of coronavirus into central Europe when Germans and Austrians went to vacation spots in Croatia in summer 2020. This situation could be happening again in 2020 with British and other tourists visiting vacation areas in Portugal, and Germans visiting Greece and other summer tourism spots. Portugal's national health institute says the Delta variant represents 60% of new cases in the area around Lisbon based on early data. The government of Portugal is facing criticism for letting a Champions League soccer final to take place in Porto, Portugal between two English teams. Thousands of English fans watched the game at the stadium. Other problems are in relaxing of mask rules in France and Italy, last week in France and in the coming week in Italy. French nightclubs open July 9 without mask requirement. Germany is maintaining some social distancing measures and this includes mandating medical masks in closed public spaces and on public transport. Half of French, Italians, Germans are vaccinated and quarter fully vaccinated. Yet the gaps of unvaccinated people is large enough to cause serious concern of another wave. The relaxation of mask rules- the entire stadium in Budapest was packed for a recent game between Hungary and Italy for a soccer Euro 2021 game with no masks to be seen. Stadiums played a key role for the spread of the original coronavirus in Italy with a game in Bergamo, Italy, in the area near Milan. All this makes health officials concerned about the risks of still another wave of the coronavirus.   ...

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After stalling in summer 2021 US vaccination picks up in August to 865,000 on August 4, 2021. At one point vaccinations reached 3 million a day and stalled with younger people hesitating to get vaccinated. Some southern states Tennessee, Oklahoma and Georgia see a surge in vaccinations. This happens as US daily cases exceed 100,000 for the first time on August 4. Of this 50% are in 8 southern states including Florida, Texas, and Louisiana. Florida is the worst affected state. Hospitals are again being overwhelmed with new cases of delta variant among the unvaccinated in August. Southern states have lagged behind in vaccination.

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About 60% of Swiss voters in this Sunday's referendum on keeping Covid passes and restrictions in place favor keeping them. The referendum vote is likely to provide $6 billion for increasing nurses pay and benefits, which is a good thing as nurses are exhausted after 2 years of non stop work.  Vaccination rate is 65% of people vaccinated in Switzerland. In the US state of Michigan the vaccination rate is 58%, resulting in a surge in cases. Vaccination rates had stalled in Germany and Switzerland resulting in a surge in cases. New variant from South Africa adds to the problem of the unvaccinated in Europe and the US.

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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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The rule requiring health pass showing one is fully vaccinated goes into effect in France starting July 28 at restaurants, coffee shops, trains, and other public places. For the first week restaurants will not be fined. After this they can be fined 1500 euros for a single violation. The passe sanitaire in France is now required  for all public places where more than 50 people gather, such as events and museums including the Louvre in Paris. It will be extended to restaurants, cafes and shopping centres in August.

French premier Castex says 97% of the 18000  daily average new cases in France, up by 150% since the prior week, are from the unvaccinated. This has made health authorites and the government concerned about the delta variant high transmission rates and the high proportion of people still not vaccinated. For France this poses risk of a new kind of fourth wave, causing the government to take strong action to accelerate vaccinations.

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This report in NYT suggests that coronavirus in New York is becoming endemic. Endemic means chronic instead of the acute crisis situation in 2020. This is because hospitalizations are not filling up ICU's the way they did in 2020. The burden of the coronavirus pandemic is now on people who are unvaccinated and people under 45 years.  New York has a higher rate of vaccination than the rest of the country. About 76% of people ages 12 and over in New York are vaccinated. Yet the 24% of younger people who remain unvaccinated is a part of the population that has fears about getting vaccinated which are harder to overcome. As many of these younger people also spend more time outdoors, and are part of the community, more likely to be in contact with families, relatives and friends indoors in winter, and less likely to wear masks and follow social distancing the pandemic, one could see another surge in the winter of 2021.  Another problem could be that some portion of the population of vaccinated has not taken booster shots by the middle of winter which would create a population of a third of the people even in cities such as New York that remain unprotected. The emergence of another difficult variant could also be a complicating factor. In this way chronic or endemic may still be elusive where masking, social distancing and other preventive actions are not taken. For the community as a whole there will be the risk to upward mobility from the people who risk losing jobs because of fears of the vaccine.     ...

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By dropping most coronavirus restrictions including masks, social distancing and size of gatherings, and opening night clubs, England is risking the same sudden rise in new cases from variants that hit the Netherlands last week. Analysis of what happened in the Netherlands shows nightclubs and bars as the origins of 40% of the new cases in the Netherlands. Prime minister Rutte of the Netherlands apologized for this kind of reopening after a big jump in cases in Netherlands.Seven day average in the UK is at 46,000 for the last week. With 40% of the UK population not fully vaccinated, the new variants can spread faster and mutate in the unvaccinated population.  There is a basic difference in priority- getting to work and doing essential shopping compared to going to nightclubs. The Dutch government shut its nightclubs after reopening them in June. At this point England is split in how to reopen. The Mayor of London says masks will be compulsory in all public transit in London. And 55% of the UK public in a recent survey from YouGov think reopening in this way is the wrong thing to do. Another poll by Ipsos shows 70% of people surveyed saying they wanted mask wearing to be compulsory indoors for another month. One bar club owner says that he thinks what they are doing is wrong. Some students think that this is a recipe for transmission to happen quickly. ...

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Vaccine mandates are becoming a favored action as companies and governments see the dangers of rapid spread of highly transmissible delta variant. Following the action by the French government to make vaccinations mandatory for all healthcare workers, and require health pass passe sanitaire showing one is fully vaccinated at restaurants, cafes, and trains, more governments are taking up this action. This is supported by French premier Castex showing that 97% of the 18000 average daily cases in France this week, up 150% from prior week, are from unvaccinated people. Similar situation prevails in the US making it critical that governments take action early, and not miss the right time for such action.

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Germany faces the possibility of a pandemic surge of the unvaccinated, something that is happening today in the southern United States.  For days the percentage of people that are fully vaccinated remains at 62%. Some vaccination centers are closed. A vaccination center outside the train station in Cologne offers passersby free vaccinations. Berlin's Social Democrat mayor Michael Muller is very frustrated. He says "I am now coming to a point where I think we have exhausted what we can do in politics."  At 62% the rate of fully vaccinated people in Germany is too low to prevent a surge of the Delta variant in the way that it has hit the southern US, and California. Vaccination rates of close to 85% are needed to tackle the risk of another surge in highly contagious delta variant. Not everyone remaining is die hard opposed to vaccines. The Robert Koch Institute estimate is that 5 to 10% of people are in that die hard category. The remaining 20-30 % are people who have various other concerns and fears, hesitancy, that may be changed.  The chairman of the World Medical Association Frank Ulrich Montgomery favors a vaccine mandate, what he calls a 2G rule, that should be introduced in Germany requiring vaccination to attend events, sports, restaurant visits, adopted nationwide. German government has rejected idea of mandatory vaccination of health personnel, that was adopted in France. Vaccination drives are regionally based. Some are ineffective such as the Deutsche Bahn train system vaccination drive for commuters that only had a few hundred doses of J&J vaccine and ran out quickly in Berlin. One prick J&J some say is better for vaccine skeptics. Vaccine skeptics think they may get away without getting covid infection. How does one get over this misconception? Others including members of the Greens party say vaccine needs to be delivered where people are- transit points, bus stops, doses offered in evening and early morning hours, trying new ways to reach people and inspire confidence. Germany now ranks behind France but ahead of Bulgaria in terms of vaccination percentage in September 2021, not a good situation. ...

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Lessons can be learned about careful reopening in fighting the coronavirus from other countries. Here the Netherlands experienced a rise of cases by 500% within two weeks of reopening after some poor decisions. The Mark Rutte government decided to open all bars and nightclubs resulting in a twelve fold surge in these locations in one week. Most of the new coronavirus cases were in people 18-29. Data from Dutch public health institute shows 4 out of 10 new cases linked to bars and nightclubs with 262% surge in cases for young people 18-24 years. This goes to show that with the vaccination drive what we see is the cases shifting to younger people, the unvaccinated, and to activities like nightlife. People going to work, or doing hybrid remote work with trips to the office, workers in factories, people doing essential shopping, are not causing the rise in cases. Much can be learned from these examples in working out reopening that does not lead to new crises with surging cases in new waves of coronavirus. Earlier in 2020 summer tourists who ignored mask and social distancing restrictions in Croatia brought on a post summer coronavirus wave to Germany and Austria. This time Greece and Portugal are introducing restrictions. Greece plans to make vaccine health pass required effective July 21 to go into restaurants. Another lesson from Netherlands this week is that a 20,000 person music event of 2 days in Utrecht where QR codes were required showing vaccination or PCR tests failed. About 1000 cases were attributed to the Utrecht event alone. Reasons given are that people faked the QR codes, or that the covid testing system produced too many false results as much as 20%. The same QR code system was followed at nightclubs resulting in big problems. One can never be sure that things work as expected and the risks are great as this adds up. Even vaccines offer limited protection and only if fully vaccinated depending on the type of vaccine. One dose of the vaccine is simply inadequate, and obesity, other morbidities can lead to problems. Withdrawing the mandatory use of face masks in most situations is also a risky decision of the Dutch government. Face masks offer the added protection at a time of variants that spread quckly, and when large parts of the population have only one dose of the vaccine, some elderly are still not vaccinated, and young people have not been vaccinated in large numbers. ...

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The US vaccination drive appears to be stalling when it comes to getting younger people vaccinated. On a recent day 1.13 million persons were vaccinated. About 150 million Americans are fully vaccinated or about 47% of the population. About 53% of the population have one dose. This still leaves the rest of the population close to one half unvaccinated as the US is opening up fully and removing the social distancing and mask mandates that existed before. The problem is that the coronavirus delta variant is about twice as transmissible than the original coronavirus of March 2020. Vaccination is uneven across the US. Large parts of the southern states and the western states lag behind. In these areas as well as areas with large urban concentrations of population, the densely populated cities where social distancing and mask mandates are being lifted as if the coronavirus crisis is over, are at risk of seeing a more powerful virus spread quickly before gene sequencing catches up with new variants- making the response lag behind in terms of weeks. That lag in response could lead to another wave in the US. Consider also that tourism is opening up in Europe with removal of mask mandates, that gene sequencing to track variants is tiny in even countries such as Italy and France. A WSJ report on June 22 shows gene sequencing to track variants at 1% of positive tests in Italy, and virologists in Italy saying they feel as if they are flying blind. This report in the Washington Post says surveys show as many as one third of Americans have no immediate plans to get vaccinated. This is showing up in the low numbers for the vaccination drive, of around 1 million a day at this time in June 2021. In April this was 3 million vaccine doses adminstered on a single day on average. India where the new delta variant has had the most serious impact has stepped up its response with the federal government taking complete responsibility for vaccine supplies and vaccination drives. It is now vaccinating aggressively in the range of 6 million to 8 million doses a day during the last 7 days with a plan to ensure enough vaccine supplies for 1.2 billion people to get vaccinated by December 31.  The European Union and the US have  vaccinated just over 50% of their population for a variant that is more than twice as transmissible than the original virus. This leaves the unvaccinated at real risk because all the social distancing and mask mandates that existed earlier are being removed- in the US, in France, in Italy, and other countries. Soccer stadiums are filling up in Europe, the kind of sports events that later hit Bergamo, Italy, in March 2020. Summer tourism is back in Portugal and Greece. The best intentions will not be enough. Are mask and social distancing protocols being lifted too quickly especially in tourist locations reminiscent of last summer in Europe and elsewhere. Germany and Britain are holding on to them a bit longer. Will this be enough to tackle a new variant. ...

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Most American large companies support president Biden's decision to mandate vaccinations for all employers with more than 100 employees. Smaller business also supports the decision as it makes this decision for them. The US Business Roundtable of the largest US companies issued a statement saying it "welcomes the Biden Administration's continued vigilance in the fight against Covid." It went on to applaud the decision of some companies to implement a vaccine mandate before the president's decision. Companies would like to see a rapid ramp up in testing capacity as they see testing capacity levels not the vaccine mandate as the real problem today with the surge in Delta variant. These companies such as Target, Nike, and retailers see testing capacity as "stressed" and say "testing capacity must be scaled immensely to meet the new requirements." Labor unions clearly support president Biden's decision including teachers associations, and the AFL-CIO. Some companies including Delta Airlines are imposed health surcharges for unvaccinated employees, and United Airlines has brought in its own vaccine mandate. The president's vaccine mandate has broad and deep support of the American people and business, according to this WSJ report, with recognition of the huge risks posed by the transmission rates of the Delta variant in the surge of coronavirus in September 2021. However companies say the Biden Administration has to scale up testing capacity quickly to make it work. ...