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U.S. president Trump admonished GM for delaying the delivery of ventilators with negotiations, and called it  "always a mess." GM offered varying numbers, initially says the president saying it could supply 40,000 ventilators but later saying it could supply 6000 by late April. As a result the president used the Defense Production Act to order GM to make ventilators for the government. The Trump administration then pulled together other companies that could make ventilators for the government. The president has publicly criticized GM in the past for closing factories and laying off workers in midwestern states.   The president said yesterday that the administration was working to sign contracts with other companies including, General Electric, Philips, Hamilton, and Medtronic. In all the administration wants to get 100,000 ventilators in a short time frame to meet the needs of hospitals in states with need. Any surplus ventilators could be sent to UK, France, Italy, and other friendly countries that cannot manufacture on their own. At his daily press briefing Friday Mr. Trump said he called Boris Johnson of the UK and the first thing Boris told him was "we need more ventilators." ...

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International aid arrives from the UK, France, US, and the European Union, as India faces a surge of the coronavirus in April 2021. A flight with oxygen and ventilators arrives from the UK. The EU is pooling resources, France is preparing flights with equipment. The United States Biden administration says it will release some of the 60 million doses of Astra Zeneca vaccine to India that remain unused in the US to address vaccine shortages.

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Mr. Peter Navarro, 70, a key advisor to president Trump on trade and economic policy, is now the DPA policy coordinator.  Mr. Navarro takes on the presidential task force role of coordinating government-business cooperation with wartime powers under the Defense Production Act. Mr. Navarro says in an interview with the WSJ that he will take tough measures if necessary. Saying this is no time for delay, to hoard or price gouge, companies must move quickly or the government will clear the obstacles. "This is war. When there are bumps in the road, President Trump is going to knock them down immediately and unmercifully."  A California Economics professor Mr. Navarro warned about the virus and epidemics of this kind in a 2006 book. He now assumes this role after president Trump said about GM "always a mess," after long negotiations with GM leading to a shrinking supply of ventilators and government frustration. President Trump then used DPA powers to order GM to make ventilators and lined up 5 other manufacturers in 2 days. Navarro says he is following Trump time which he has in his office. This meaning he and the president will use the full arsenal of federal powers to get things done in record time.  ...

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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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US president Biden says efforts are being made to provide emergency assistance to India for vaccine making supplies, as well as therapeutics, ventilators and other equipment. The White House says "The United States has identified sources of specific raw material urgently required for Indian manufacture of the Covishield vaccine that will be immediately be made available for India." Joe Biden said that "Just as India sent assistance to the United States as our hospitals were strained early in the pandemic, we are determined to help India in its time of need." This assistance is now being coordinated at the highest levels and being done round the clock. Chancellor Merkel of Germany - "The fight against the pandemic is our common fight. Germany stands in solidarity with India and is urgently preparing a mission of support."  The European Union's von der Leyen said "The EU is pooling resources to respond rapidly to India's request for assistance via the EU Civil Protection Mechanism. We stand in full solidarity with the Indian people."   ...

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How do you setup a vaccine business. Consider Mr. Adar Poonavalla in the city of Pune in India. His company Serum Institute of India, remains family owned. Founded in 1966 by Cyrus Poonavalla, it produces billions of doses of vaccines for measles, polio and other diseases. It is expected to be one of the key sources of vaccines because of its expertise and the stocks of vials and other supplies that it has in stock for the next 2 years of vaccine production. It is working on a separate facility for coronavirus production that could turn out 800 million doses of vaccine at a price of about $13 a dose over 2 years. Serum Institute is working with 3 companies that are doing the research on the vaccine for coronavirus in the U.S. and Europe, and will play a key role in the manufacturing of vaccines. To respond to the question how do you setup a company to produce vaccines for the people of the world. This is what Mr. Poonavalla says- he will only work with ethical long term funds and sovereign funds because he does not want to be in the situation where he has to charge high prices to give them returns. Unlike most countries in the world, India is unique in making certain that most of the basic pharmaceutical drugs are available to over a billion people at a low cost. Serum's goal is low cost quality vaccine production so that over a billion people in Asia can be "protected from the birth onwards." As the U.S. and Europe and large parts of Asia, Africa and Latin America, face the second vaccine phase of the coronavirus response following difficulties in PPE, Ventilators, and Masks in the first phase, they can have confidence because of companies such as Serum and the research centers in U.S. and Europe like the one at Oxford University. ...

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Ghana, Kenya, South Africa and other countries are using locally developed technology to produce ventilators, vaccine delivery mechanisms, and 3D printed face shields. This local product is made at a tenth or less of the cost of it when imported from Europe or the U.S.

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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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Results at Midland Memorial Hospital in Texas, show that a low cost conversion to electronic medical records by using the VA system's open software and having computer software companies adapt it to Midland's needs. This cost Midland $7 million and has resulted in many benefits. Senator Rockefeller is introducing legislation to promote the use of this open software for conversion to electronic medical records. Medsphere chairman Kenneth Kizer, former undersecretary ohealth care at the VA oversaw the development of VIstA software. He says its enhanced version called Open Vist A, "can be installed in one third the timeand for about one thrid the cost of the big-name proprietary systems." There is alot to be said for open software as this would enable hospitals and clinics acoross the country talk to each other and pull up records and sen them electronically, wich is hard to do when different systems of differnt commerical vendors interact. If Midland Memorial is any guide there are huge savings in the conversion. By enabling access instantly of patient records, lab results and Xray images, there are a huge array of benefits. It helped Midland catch up with a$16.7 million coding and billing backlog for 4,500 patient records in 4 weeks instead of 5-6 months. In the 18 months since the system was made hospital wideinfection rates dropped 88%, because of guidelines in the record system that prompted nurses to follow infection control procedures, such as changing dressing or following procedures when inserting a new IV. That is huge. Bed sores were reduced from electronic prompting to nurses to turn patients.And Midland increased by 77%in staff compliancewith guidelinesfor care for patientson ventilators, which if not followed could lead to pheumonia....

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 This message from Pope Francis is especially relevant today during coronavirus. Francis says of the mistaken priorities of today away from healthcare, education, infrastructure and "coherence" in society and the pain and hardship this is causing in society, there is much that can give people thought to reflect on. Francis  new book, "Let us Dream: The Path To a Better Future" will be out December 1. "If we are to come out of this crisis less selfish than when we went in, we have to let ourselves be touched by others’ pain." He cites a line in Friedrich Hölderlin’s “Hyperion” that speaks to him, about how the danger that threatens in a crisis is never total; there’s always a way out, that where the danger is, also God plants the saving power, a way out. And not simply a way out, God also gives human beings a chance to grasp for and hold onto renewal if only one makes the endeavour. As it says in the Bhagavad Gita God gives man a chance to warm himself near the fire, only those who make the effort to go to the fire can feel the warmth, it is a choice man has to make. And again God says in the Bhagavad Gita that he is not partial to any man. Ever since the global financial crisis hurt working families in the middle and lower classes hard in 2009 because of banks misbehaviour and greed, Pope Francis has called for countries in the western world to heed his warnings about the dangers of greed and corruption to us all. Even George Washington warned of this in his inaugural address, so the warnings are not new. Reminding people once again he says "we cannot return to the false securities of the political and economic systems we had before the pandemic. We need economies that give to all access to the fruits of creation, to the basic needs of life: to land, lodging and labor. We need a politics that can integrate and dialogue with the poor, the excluded and the vulnerable, that gives people a say in the decisions that affect their lives. We need to slow down, take stock and design better ways of living together on this earth." The pandemic has exposed the paradox that while we are more connected, we are also more divided. Francis is never tired of warning that the present political and economic structures and people who staff them have not felt others pain, so he reminds us it is hard to build a culture of encounter in which we meet as people with a shared dignity, within a throwaway culture that regards the well-being of the elderly, the unemployed, the disabled and the unborn as peripheral to our own well-being. Where only self preservation counts. Francis reminds us of the Christian concept that no one is saved alone. This is not just an abstract concept. When Francis was only 18 years and a second year student he was admitted to a Buenos Aires hospital for a severe respiratory disease, so severe that he lost a part of his lungs. He remembers the day August 13, 1957. He understands this pandemic from personal experience. He knows what it is like to be on a ventilator. Surgeons removed the upper right lobe of his lung. Francis struggled to breathe. He was  saved Francis says not even by the doctors, but by a Dominican sister, a senior ward matron, who had been a teacher in Athens before being sent to Buenos Aires. She understood that Francis was dying and after the doctors left asked the nurse to double the prescription dose of penicillin and streptomycin. Sister Cornelia Caraglio, knew better than the doctors from her regular contacts with sick people what they needed, and she had the courage to act on that knowledge.      ...