The Red (Team) Analysis Weekly – 30 April 2020

This is the 30 April 2020 issue of our weekly scan for political and geopolitical risks (open access).

Using horizon scanning, each week, we collect weak – and less weak – signals. These point to new, emerging, escalating or stabilising problems. As a result, they indicate how trends or dynamics evolve.

The 30 April 2020 scan→

Horizon scanning, weak signals and biases

We call signals weak, because it is still difficult to discern them among a vast array of events. However, our biases often alter our capacity to measure the strength of the signal. As a result, the perception of strength will vary according to the awareness of the actor. At worst, biases may be so strong that they completely block the very identification of the signal.

In the field of strategic foresight and warning, risk management and future studies, it is the job of good analysts to scan the horizon. As a result, they can perceive signals. Analysts then evaluate the strength of these signals according to specific risks and dynamics. Finally, they deliver their findings to users. These users can be other analysts, officers or decision-makers.

You can read a more detailed explanation in one of our cornerstone articles: Horizon Scanning and Monitoring for Warning: Definition and Practice.

The sections of the scan

Each section of the scan focuses on signals related to a specific theme:

  • world (international politics and geopolitics);
  • economy;
  • science including AI, QIS, technology and weapons, ;
  • analysis, strategy and futures;
  • the Covid-19 pandemic;
  • energy and environment.

However, in a complex world, categories are merely a convenient way to present information, when facts and events interact across boundaries.

The information collected (crowdsourced) does not mean endorsement.

Featured image: Milky Way above SPECULOOS / The Search for habitable Planets – EClipsing ULtra-cOOl Stars (SPECULOOS) is searching for Earth-like planets around tiny, dim stars in front of a panorama of the Milky Way. Credit: ESO/P. Horálek.

The Strange Case of Sweden in the COVID-19 Pandemic

Many countries hit by the pandemic are now exiting or about to exit the period of most stringent isolation measures. Indeed, they estimate they succeeded in controlling contagion. Meanwhile, they avoided the dreaded break down of their health-care system, which could have taken place if hospitals had been overwhelmed.

In Europe, one country stands apart, Sweden. The oft-heard narrative runs as follows: Sweden appears to have decided for a policy of laissez-faire; it recommended but never imposed; it thus has hardly or no exit policy to design and implement, because there is not so much to exit from. Meanwhile, it does fare much better in its handling of the COVID-19, notably in economic terms, while the toll it pays in terms of casualties is far from terrible.

Is this narrative correct? What are the facts? How can we explain the difference between “Sweden and the rest”? Can we already draw lessons from the Swedish case or is it truly too early in the pandemic to do so? Does that mean that all countries who implemented social distanciation and other measures were wrong to do so? Without falling into a caricatural black and white judgement, are there some lessons we could learn from the way Sweden handled this part of the pandemic outbreak? Is it reproductible in time and elsewhere?

These are crucial questions for policy-makers as they are preparing the exit strategy from lockdown and as they need to provide security to their citizens. It could give them further elements to succeed in protecting citizens both from disease and from economic hardship.

These are keys questions for businesses, corporate and financial actors, as they will lobby political authorities for their interests and as they also need to anticipate for the future of their activity.

These are crucial questions for citizens, who need to be able to assess the way their political authorities succeed in their mission of protection of those who are ruled.

This article addresses the way Sweden handled, so far, the COVID-19 pandemic and the “Swedish model” narrative. The aim is to assess in which way the Swedish strategy can be used as a model by others, not to judge the way Swedish authorities handled the COVID-19.

First, the article focuses on the policies and measures Sweden took to face the COVID-19, the rationale for these measures and their actors. Second, it looks at current impacts of these measures, in terms of health and in economic terms. Finally, it wonders about the reality of the idea of an exceptional Swedish model. It looks first, assuming there is a model, to its replicability. Then it questions the very idea of a Swedish model.

Sweden faces the COVID-19

Since the start of the COVID-19, the Public Health Agency of Sweden (Folkhälsomyndigheten) has had the upper hand on all decisions regarding the Swedish answer to the epidemic (Hans Bergstrom, “The Grim Truth About the “Swedish Model”“, Project Syndicate, 17 April 2020). Anders Tegnell, epidemiologist and head of the Department of Public Health Analysis and Data Development of the agency leads the effort (Ibid.).

According to Hans Bergstrom, professor of political science at the University of Gothenburg, Tegnell’s strong and often erroneous convictions paved the way for Sweden strategies (Ibid.). Tegnell did not believe the Chinese outbreak could spread. Then he thought case tracing was a sufficient measure to control the COVID-19, as there was no sign of community transmission inside Sweden (Ibid.). Bergstrom (Ibid,) argues that “between the lines”, Tegnell seeks to progressively achieve herd immunity. Meanwhile, considering that the COVID-19 was there to last, Tegnell thought that policies that could be sustainable over time economically and psychologically had to be implemented (Ibid.).

Indeed, Tegnell interviewed in Nature, confirms this vision:

“This is not a disease that can be stopped or eradicated, at least until a working vaccine is produced. We have to find long-term solutions that keeps the distribution of infections at a decent level. What every country is trying to do is to keep people apart, using the measures we have and the traditions we have to implement those measures. And that’s why we ended up doing slightly different things.

Marta Paterlini, “‘Closing borders is ridiculous’: the epidemiologist behind Sweden’s controversial coronavirus strategy“, Nature, 21 April 2020

Tegnell also stresses that none of the most severe measures implemented elsewhere, such as isolation, are grounded into scientific evidence, and that epidemiologists produced models that were too pessimistic (Paterlini, Ibid.).

As a result, Sweden advised its citizens to practice social distancing and to work from home, but enforced little. Standing at bars is forbidden but restaurants are opened (Emergency Information from Swedish Authorities, “Ban on crowding in restaurants, cafés and bars“, Bekräftad information om coronaviruset, 25 March 2020).

Entry ban applies primarily to foreign citizens attempting to enter Sweden from all countries, except those in the EEA and Switzerland from 17 March 2020 until 15 May, i.e. 30 days (The Swedish Police, Travel to and from Sweden affected until 15 May 2020).

The exemplary Swedish sense of social responsibility and the unique Swedish values are touted as having allowed the policy to be successful. Sweden would be, deep down,

“A model society based on values of social justice and human rationality, with a high level of trust between people and trustworthy authorities. This has its origins from the Social Democrat-introduced concept of “Folkhemmet,” or people’s home, where a welfare state cares for all with the proviso that everyone complies with a communal order.”

Heba Habib, “With science and shared values, Sweden charts own pandemic course“, The Christian Science Monitor, 27 April 2020.

As a result, people are believed to responsibly follow their government’s suggestions, which translates in successful policies. Hence, early April it was estimated that 50% of people worked from home, that usage of public transports had decreased by 50% and that streets in Stockholm were only 30% as busy as before the COVID-19 (“Sweden’s Outlier Response To COVID-19, And Its Results So Far“, PYMNTS.com 16 April 2020)

Thus, until 24 April 2020, Sweden has had a far less constraining policy to control the COVID-19 than its neighbours or than most of the world, as shown in the table below listing the measures Sweden took compared with its Nordic neighbours.

SwedenDenmarkNorway Finland
All travels
14 March – including to Sweden16 March – all non residents banned to enter Norway16 March
Travels outside EEA17 March until 15 May


Quarantine from high risk regions
9 March27 February -all will be quarantined, save those coming back from Sweden and Finland16 March – all returnees must be residents or citizens only – 14 days quarantine
Stay home for non essential functions
13 March19 March (prohibited to stay in cabins, home quarantine)16 March
Gatherings of peopleGathering limited to 500 people – 30 March: gathering limited to 50 people18 March – No gathering above 10 people
16 March – No gathering above 10 people
Secondary education closed
13 March12 March16 March
Primary education closed
16 March12 March16 March
Retails, restaurants, bars etc. closed 25 March – Standing at bars prohibited. Safety distance maintained elsewhere.18 March12 March -except establishment serving foods)16 March – only decrease of non critical activities
Contaminated inner regions locked down


27 March – 15 April Uusimaa
Measures taken to handle the COVID-19 Pandemic in Nordic Countries – Various official sources, according to countries

In a 21 April’s interview, Tegnell acknowledged that most of the Swedish deaths came from care houses for elder people and that an investigation in the high number of deaths is needed (Ibid.). Yet, according to him, it is not the COVID-19 strategy that potentially failed here, but the social-care system (Jenny Anderson, “Sweden’s very different approach to Covid-19“, Quartz, 27 April 2020).

Tegnell also does not believe much into asymptomatic contagion, or only at the margin, and decries closing borders, as the contagion now exists within European borders (Paterlini, Ibid.). However, he is also forgetting that Sweden is de facto protected by others’ closing borders and by others’ policies.

As a whole, Tegnell is satisfied with the policy he designed and its results.

However other top Swedish scientists contested this approach and 22 of them published an open letter in the Swedish newspaper Dagens Nyheter: “Public health authorities have failed – now politicians must intervene.” There they highlighted a dangerous failure of public-health authorities as deaths topped 1000. They asked political authorities to intervene and change policies.

On April 15, 2020, the Swedish Parliament indeed “extended their agreement on temporary parliamentary procedure during the COVID-19 outbreak to last until at least April 29, 2020” (Library of Congress, Legal Monitor; Sveriges Riksdag, 15 April 2020).

Yet policies did not change, up until 24-27 April 2020.

Impacts… so far

What are the impacts of the policies Sweden implemented regarding the COVID-19?

Health results

A peak?

On 24 April 2020, there has been 17.567 cases identified and 2.152 deaths (John Hopkins CSSE: Tracking the COVID-19 (ex 2019-nCoV) spread in real-time). On 27 and 28 April, 11:30, there has been respectively 18.926 and 19621 cases identified and 2.274 and 2.355 deaths (Official Swedish data updates), but data for the last 7 days still need to be consolidated (Maddy Savage, “Coronavirus: Has Sweden got its science right?“, BBC News, 25 April 2020). So far hospitals have not been overwhelmed: 1.353 for 27 April, 1388 people for 28 April are in intensive care.

As we monitor the situation after publication of the article, on 4 May 2020, we have 22.721 cases identified and 2.274 and 2.769 deaths (Official Swedish data updates). Interestingly, the figures for 24, 27 and 28 April are now revised and give respectively 18.100, 19.400 and 20.100 cumulative positive cases.

Sweden, 28 April 2020 – Latest updates on the outbreak of coronavirus disease (covid-19). 
The page is updated daily with number of cases at 14:00

The Public Health Agency of Sweden suggested, first, that, in Stockholm, the epidemic peaked on 17 April 2020 (Reuters, “Swedish health agency says virus has peaked in Stockholm, no easing of restrictions yet“, 21 April 2020). Stockholm represents half of the confirmed cases in Sweden (Ibid.).

Yet, by 27 April 2020, the number of daily cases still rises, with a strong increase between 21 and 24 April, then with lower rises. If the trends continues towards lower increases, then a peak may indeed have been reached.

However as the new updated graph for 4 May 2020 (monitoring after publications) depicts, the revised data show an increase rather than a decrease. Furthermore, 29 April is the day with the highest number of positive cases since the start of the epidemic, i.e. 778 cases, followed by 24 April with 769 cases and 28 April with 750 cases. Thus the idea of a peak for Sweden needs to be questioned, and monitored considering also the variations in data.

COVID-19 cases in Sweden – 27 April 2020
COVID-19 cases in Sweden – 28 April 2020
COVID-19 cases in Sweden – 4 May 2020 – Thus giving updated data for 26-29 April

Meanwhile, as shown on the graphs below, and considering the uncertainties on data for the last seven days, the number of deaths reported has strongly fallen and the number of people in intensive care units has also fallen.

COVID-19 fatalities in Sweden – 27 April 2020
COVID-19 ICU in Sweden – 27 April 2020

Thus do we have a peak or not? The reality of a peak is still unclear and only time will tell (John Hopkins data, see also official Swedish data updates). Nonetheless, as we shall see below, the 21 to 24 April period cancelled previous expectations of a peak.

Comparisons

Compared with its neighbours, even considering its larger population, Sweden has fared less well, as shown in the table below. Swedish rates are rather similar to those of the Netherlands, another country that initially had a laissez faire policy.

24 April 2020SwedenDenmarkNorway FinlandNetherlands
Population10 230 0005 806 0005 368 0005 518 00017 280 000
Cases17 5678 4087 4444 39536 727
%0,17172 %0,14482 %0,13867 %0,07965 %0,21254 %
Fatality Rates2 1524031991774 304
% / pop0,0210 %0,0069 %0,0037 %0,0032 %0,0249 %
% / cases12,2502 %4,7931 %2,6733 %4,0273 %11,7189 %
The COVID-19 in Nordic Countries – Data for 24 April 2020 – John Hopkins CSSE: Tracking the COVID-19
Denmark COVID-19 daily cases up until 27 April 2020 (John Hopkins CSSE: Tracking the COVID-19)
Norway COVID-19 daily cases up until 27 April 2020 (John Hopkins CSSE: Tracking the COVID-19)

All the three other Nordic countries, notably Norway, seem to have clearly peaked. The Netherlands has also most probably peaked.

Finland COVID-19 daily cases up until 27 April 2020 (John Hopkins CSSE: Tracking the COVID-19)
Netherlands COVID-19 daily cases up until 27 April 2020 (John Hopkins CSSE: Tracking the COVID-19)

In the case of Sweden, and as we shall further see below, there is ground to worry that Sweden’s peak is not so easy to achieve.

Economic results

Despite rather lax policies compared with most other countries, Sweden also faces economic damages.

Indeed, Sweden also depends on others for its trade and activity. Thus, on 8 April, the economic research unit of BNP Paribas estimated that the country would be hard hit by the major slowdown in global trade, as exports account for 45.6% of Sweden’s GDP.

Yet, some indicators, such as personal spending and unemployment’s increase were also better in Sweden than in Norway (Darren McCaffrey, “Analysis: Is Sweden right in its handling of COVID-19?“, Euronews, 22 April 2020).

Nonetheless, on 24 April 2020, the Swedish finance minister stated that she expected the economy to shrink by 7%, more than she initially thought, and unemployment to reach 11% (Radio Sweden, “More restaurant corona inspections, economy expected to be hit harder, more infections in nursing homes“, 24 April 2020).

So is there really ground for a model? Sweden did not fare as well as its neighbours in terms of protecting the health of its citizens. Yet, it also did not fare worse than, for example, the Netherlands, so far. But again, the Netherlands appears to have peaked. Meanwhile, the economic cost for Sweden is on a par with 14 April IMF forecasts for the Netherlands as the Dutch economy is expected to shrinking by 7.5% in 2020 (DutchNews.nl, “IMF sees Dutch economy shrinking 7.5% this year, unemployment to hit 6.5%” 14 April 2020).

At first glance, and considering that we are still at the start of the pandemic, it is difficult to assess if we have or not a Swedish model. Let us thus now look at a potential replicability of the model, and then at the evolution of the last couple of days.

A Swedish model?

If there is a Swedish model, is it replicable?

First, besides the role the cultural and socio-political values model plays, Sweden was also probably protected from even higher levels of contagion by a low population density, as shown on the comparative graph below, and despite variations according to areas.

Population density (people per sq. km of land area) – Italy, Sweden, France, Spain, Denmark – Food and Agriculture Organization and World Bank population estimates.

Second, Sweden did not have the same global exposure to the world as other nations such as Spain, Italy or France. Indeed, using World Bank statistics, in 2018, Sweden’s main partners, for exports, were Germany, Norway, Finland, Denmark and the United States, and for imports they were Germany, Netherlands, Norway, Denmark and United Kingdom. By comparison, France’s major partners for exports were Germany, the United States, Spain, Italy and Belgium, and for imports they were Germany, China, Italy, Belgium and Spain. Italy’s major partners were for exports Germany, France, the United States, Spain and the United Kingdom and, for imports, Germany, France, China, Netherlands and Spain.

As a whole, Sweden receives far less travellers (tourism includes business trips) than other countries that were more quickly and more intensely hit by the COVID-19, as shown in chart below for Inbound tourism 2018 (UNWTO statistics).

2018 Inbound Tourism for Sweden with comparisons – (UNWTO statistics)

Thus, considering the specificities of Sweden, if there is a model, it can only be replicated in countries that benefit from the same conditions. Meanwhile, these specific factors also point out that rather than only a specifically designed model, we have here particular circumstances, as for every country, or more largely unit of analysis, interacting with a specific strategy.

But is there truly a Swedish model?

Now, we may also wonder if there is truly a Swedish model, considering the 21-24 April 2020 COVID-19 related data.

Towards a change of policies? Not a different model but different dynamics?

The Swedish government also noted the new rise of cases observed between 21 and 24 April (David Nikel, “Sweden Health Chief Admits ‘It’s Not Over’ As Coronavirus Cases Leap“, Forbes, 24 April 2020). The Swedish Public Health Agency acknowledged the increase. As reported by Forbes, Tegnell stated:

“There have been more deaths than expected. It is definitely not over. We see that especially in the small rise in Stockholm again”

David Nikel, “Sweden Health Chief Admits ‘It’s Not Over’ As Coronavirus Cases Leap“, Forbes, 24 April 2020.

The disappointing results would be related to the Easter week-end.

As a result, the Swedish Civil Contingencies Agency warned that people should not relax their responsible approaches (Ibid.). In the meantime the mayor of Stockholm threatened to close restaurants and bars if safe distancing was not respected (ibid.). Some of them were indeed shut by the local food safety board, while Springtime celebrations were cancelled (Radio Sweden, “Stockholm bars shut due to crowding, springtime celebrations cancelled, warning for long-term unemployment“, 27 April 2020).

Thus, when confronted with an unexpected rise of cases, the Swedish authorities have to resort to the same policies as others. They have to reinforce social distanciation rules.

If such rises happen again, then, considering the very recent decisions, it is possible that the authorities will need to continue on the path of more stringent measures.

In that case, Sweden would just follow on the track of other countries. The “model” would actually rather be a longer initial phase, until more stringent measures become necessary.

If the data are improve and then remain good, then Sweden may relax measures again. Thus, if there is a model, it may be one that promotes flexibility.

Timing matters for preparedness

Should COVID-19 cases rise strongly again, Sweden would then risk facing a shortage of intensive care units ICU), as happened elsewhere.

It seems, however, that Sweden is well prepared in terms of ICU capacities. The ICU initial (pre-COVID-19) capacity of Sweden was 526 beds (Joacim Rocklov, “COVID-19 health care demand and mortality in Sweden in response to non-pharmaceutical (NPIs) mitigation and suppression scenarios“, MedRxiv, 7 April 2020).

Rocklov estimated the ICU capacity could be doubled with preparedness, which is what seems to have taken place (Ibid., Anderson, Ibid.).

On 26 and 27 April, COVID-19 patients in ICU would be respectively 558 and 543, thus hovering above the initial number of beds available for all pathologies (Svenska Intensivvårdsregistret). If the capacity has doubled as a result of preparedness, then Sweden is probably able to handle a substantial amount of new cases.

Preparedness in terms of ICU capacities, assuming the doubling of the capacity is correct, could be seen as a successful element of the Swedish model, but it could also have been achieved with less fatalities.

Towards homogenisation?

Now, if the Swedish political authorities were to continue on the path towards more severe restrictions, because they do not succeed in truly achieving a peak, this evolution could take place just when other countries relax their policies.

The countries exiting from severe isolation measures will then fear a return of the epidemic and a second wave. They will most certainly pay a very high attention to the possibility of imported cases, as China does. Thus the Swedish strategy of not believing in travel controls, added to an uncertain peak could threaten to backfire. As a result, the combination of factors could force Sweden to also change its travel policies. This is all the more likely that Sweden did contribute to the general European contagion as early a 7 February 2020, as shown in the fascinating Spanish study tracing the phylogenies of the virus in Europe (Francisco Díez-Fuertes, et al. “Phylodynamics of SARS-CoV-2 transmission in Spain“, bioRxiv, 20 April 2020). True enough, on 7 February most European countries were mocking those fearing a ridiculous small flu-like epidemic. Yet, since then, they appear to have learned.

In that case, the uncertainty of the epidemic curve could play as a disadvantage for Sweden, or, to the least, would force Sweden towards homogenisation. The great political scientist Fred Halliday has shown the imperatives of homogenisation in international relations (Rethinking International Relations, 1994). Further research would be needed here to evaluate if the case of Sweden could give us indications that such dynamics towards homogenisation will be at work in the months and years to come, which is crucial to properly build scenarios.

The model in this case would be different from what was initially expected. It would show the importance of timing, the possible danger of an uncertain epidemic curve as seen by others and a possible tendency towards homogeneity.

Trial by pandemic

If ever the COVID-19 evolution went wrong, and if Sweden had to abandon its touted “cultural” model, then it would be the very belief-system underpinning its socio-political organisation that would be questioned.

Trust in political authorities could be impaired, which would twice hurt the Swedish polity. First, as for any political system, the legitimacy of political authorities would diminish. Second, because trust in the system is so crucial to Sweden values, these very values could be shaken. To measure the difference, imagine a system where the constructed shared historical values led to diffidence towards central political authorities, as in the U.S..

However, this “trial by pandemic” is not exclusively a threat for Sweden. Each and every polity has to face it. How each will handle it, how each will be able to reinvent its system to overcome the threat will most probably deeply change each society and the international system.

It is probably too early in the pandemic to conclude with certainty about the success of the Swedish measures in handling the pandemic. However, looking at the Swedish case helped us understanding better how societies handle the COVID-19 pandemic. It also highlighted that there is no such a thing as a Swedish model that could be an easy recipe to follow by all in our global struggle against the COVID-19.

Further bibliography

Francisco Díez-Fuertes, María Iglesias Caballero, Sara Monzón, Pilar Jiménez, Sarai Varona, Isabel Cuesta, Ángel Zaballos, Michael M Thomson, Mercedes Jiménez, Javier García Pérez, Francisco Pozo, Mayte Pérez-Olmeda, José Alcamí, Inmaculada Casas, “Phylodynamics of SARS-CoV-2 transmission in Spain” bioRxiv 2020.04.20.050039; doi: https://doi.org/10.1101/2020.04.20.050039

Paul W Franks, “Covid 19 coronavirus: Sweden thinks we’re underestimating how many people have had virus“, The New Zealand Herald, 24 April 2020.

Featured image: Kurious (pixabay.com)

The COVID-19 Shaping the World – The Red (Team) Analysis Weekly – 23 April 2020

This is the 23 April 2020 issue of our weekly scan for political and geopolitical risks (open access).

Editorial: The COVID-19 has already deeply reshaped the world.

Imagine the headlines and the social networks buzz on the oil prices amazing rout, if we were not in a time of pandemic! It would certainly not be as it is now. Of course, both the COVID-19 and the oil quasi irrelevance are linked, but the imagination exercise points out how much our perceptions and interests have changed over the course of less than two months.

Yet, this “shaping the world” by the COVID-19 is likely far from being finished.

Now, we also face a fight back by those who want the world of globalisation – the world of the last 20 years – to return, expressed, among others, through favouring “herd immunity”, hyping a Swedish success in resisting isolation and lockdown, and a return of the narrative according to which “the COVID-19 is hardly more lethal than seasonal flu”.

This is mixed with a serious risk to see the U.S. collapse. But, are we certain this is “just” the U.S.? Or could it be the Western liberal democracy model that could collapse? And is this “just” this model that could end, or are we facing the collapse of the modern state system?

Furthermore, these threats are also mixed with a serious risk to see war coming to the fore. War and pandemic should not fare well together. But then, we are living extraordinary and bizarre times, with cascading and complex impacts. And animosity is running high, notably against China. And China has also to face the very likely end of the bounty that was delocalisation, as countries want to recover their industrial and economic sovereignty.

And these are only some of the major uncertainties we face.

Using horizon scanning, each week, we collect weak – and less weak – signals. These point to new, emerging, escalating or stabilising problems. As a result, they indicate how trends or dynamics evolve.

The Scan

The 23 April 2020 scan→

Horizon scanning, weak signals and biases

We call signals weak, because it is still difficult to discern them among a vast array of events. However, our biases often alter our capacity to measure the strength of the signal. As a result, the perception of strength will vary according to the awareness of the actor. At worst, biases may be so strong that they completely block the very identification of the signal.

In the field of strategic foresight and warning, risk management and future studies, it is the job of good analysts to scan the horizon. As a result, they can perceive signals. Analysts then evaluate the strength of these signals according to specific risks and dynamics. Finally, they deliver their findings to users. These users can be other analysts, officers or decision-makers.

You can read a more detailed explanation in one of our cornerstone articles: Horizon Scanning and Monitoring for Warning: Definition and Practice.

The sections of the scan

Each section of the scan focuses on signals related to a specific theme:

  • world (international politics and geopolitics);
  • economy;
  • science including AI, QIS, technology and weapons, ;
  • analysis, strategy and futures;
  • the Covid-19 pandemic;
  • energy and environment.

However, in a complex world, categories are merely a convenient way to present information, when facts and events interact across boundaries.

The information collected (crowdsourced) does not mean endorsement.

Featured image: Milky Way above SPECULOOS / The Search for habitable Planets – EClipsing ULtra-cOOl Stars (SPECULOOS) is searching for Earth-like planets around tiny, dim stars in front of a panorama of the Milky Way. Credit: ESO/P. Horálek.

The COVID-19 and the U.S.-China competition (1)

What is “great powers competition” in a time of global confinement?

As we write this article, half of the human species is or has been confined in homes or apartments, in cities and slums. In China, for example, confinement is a massive political and social undertaking. All around the world hundreds of millions of people are living “inside”. Since its start, the epidemic spread from the wet market of Wuhan to South Korea and other Asian countries, India, Europe, Africa, Latin America and the U.S. and Canada. In April 2020, more than 3 billion people are confined (Hélène Lavoix, “COVID 19- Worst case baseline scenarios, March 13 2020 and COVID 19 scenarios- Making sense of antiviral treatment”, The Red (Team) Analysis, April 8 2020).

The rapid spread of the virus triggers contrasted answers from the U.S. federal state and from the different levels of political authorities. Consequently, the U.S. economy is on a free fall trajectory, while social cohesion is under tremendous sanitary and financial pressure. In one week, 6.6 million American people filed for unemployment (Catherine Thorbecke, “6.6 million more Americans file for unemployment amid financial crisis”, ABC News, 9 April 2020).

This situation begs a series of questions about the geopolitical and strategic consequences of the Chinese confinement and of the U.S. reactions to the COVID-19 for the China-U.S. relationships. Indeed, their interactions are extremely deep, notably because of the economic interdependence that links these two giants, without uniting them.

Chimerica versus COVID-19

This relation is so dense that Niall Ferguson calls it “Chimerica”. This expression translates the quasi-intimate process of hybridation between these two mammoth national economies (Niall Ferguson, Xiang Xu, “Making Chimerica Great again”, Wiley one line Library, 21 December 2018). This process emerges both from the installation of thousands of U.S. industries and corporations in China and from the mammoth trade relation between the two countries.

This relation is also the driver of the fantastic trade imbalance between China and the U.S. As such, it is at the core of the trade war launched by President Donald Trump against China in 2018 (Jean-Michel Valantin, “The Midwest floods, the trade war and the pandemic swine flu: the agricultural and food super storm is here“, The Red (Team) Analysis Society, September 3, 2019).

In other terms, the present and future of “Chimerica” is fundamentally related to the consequences of the “global confinement” triggered by the global pandemic of COVID-19.

In this new series, we are going to evaluate and anticipate the way the COVID-19 is deeply redefining the U.S.-China interdependency. That is to say, we shall assess the potential types of partnerships or conflicts it could unleash.

In this first article, we shall see how the COVID-19 triggers the equivalent of a geo economic warfare on Chimerica.

From China’s lockdown to global confinement

At the start of 2020, after a few weeks of tragic hesitation, the Chinese political authorities reacted very strongly in the face of the COVID-19 epidemic. They locked down entire cities and provinces, with Wuhan and Hubei province in the first place.

The Chinese Central power cancelled the New Years festivities, and prolonged the official holidays, before confining hundred of millions of Chinese people. This decision intended to decrease the demographic density in working places in Chinese urban areas and especially to stop the dissemination through the travels of massive numbers of people in order to break the contamination chain (Hélène Lavoix, “Why the COVID 19 is NOT a Black Swan event”, The Red (Team) Analysis Society, March 6, 2020).

For example, on 23 January 2020, the Chinese national authorities decided to impose a complete lockdown on the 11 million people city of Wuhan. This drastic measure aimed at containing the spread of the COVID-19 outbreak, probably originating from the wet market of the city, throughout the country. An immediate consequence of China’s urban confinement was a massive decrease in economic activity (Associated Press, “China reports Jan-Feb economic activity worse than expected”, US News, 16 mars 2020).

Three weeks later, the epidemic being a matter of national emergency, measures of partial and total lockdown were vigorously enforced in numerous provinces and cities. This meant that 500 million Chinese citizens were living through confinement measures. This represented almost 7% of the whole of humanity.

From a strictly analytical point of view, this was, so far, a unique feat of social engineering. However, the international spread of the virus started before the confinement.

Towards international confinement

Pandemic

As a result, the pandemic blazed throughout the globalized world, from China to the rest of Asia and Eurasia. The virus expanded everywhere, from South Korea and Asia, to Italy, France, Great Britain and Europe, to Australia and New Zealand, Africa, Latin America, the U.S. and Canada. Thus, during February and March 2020, the COVID-19 became the first global human pandemic of the 21st century.

Half of the human species is confined (Hélène Lavoix, “COVID 19-Worst case baseline scenarios”, ibid). The geopolitical consequences of this sanitary initially domestic crisis were developing at a gigantic scale.

From China to Chimerica

This dire sanitary-economic situation begs the question of what the confinement of both China and the U.S. means for Chimerica?

De facto, the Chinese economic reality is inseparable of the U.S.-China relationship. Indeed, if the U.S. industrial output represents “only” 16,6% of the world production, while China’s industrial output weighs 28%, it is the result of the installation of large segments of the U.S. industrial base in China and in Asia since the 1980s (Felix Richer, “China is the world’s manufacturing power”, Statista, Feb 18, 2020).

Chimerica results from the export of China-based products at very low costs to the U.S. consumer base.

Chimerica and China’s growth

Chimerica

From this point of view, Chimerica literally “is” the different dimensions of the fantastic trade imbalance between the two countries. Since 1986, this imbalance went from zero to more than 336 billion dollars in 2017 and 378 billion dollars in 2018 (Office of the United States Trade representative, “The People’s Republic of China – U.S-China Trade facts“).

One notes that, since 2002 when China joined the World Trade Organization, this imbalance has been growing and accelerating. The Chinese GDP follows the same dynamic. As it happens, according to the IMF, in 2001, China’s GDP corresponded to 13% of the U.S. GDP. It represented 25% of the U.S. GDP in 2007 and 60% in 2016. In 2016, the IMF was projecting a growth of the 2023 Chinese GDP that would make it equivalent to 88% of the U.S. GDP.

In other terms, Chimerica is at the core of the Chinese growth, as well as the heart of the U.S. economy (Niall Ferguson, Xiang Xu, ibid).

The COVID-19 slows down China’s economy…

The coercive measures of forcibly enforced urban lockdown and quarantine drastically slowed the Chinese economy down. They did so by diminishing the industrial and trade activity throughout the country. As a result, the import-export global relationship of China with Asia, and the rest of the world also slowed down.

Thus, as China accounts for a mammoth 28% of the world industrial output, its slowing down impacts the global industrial output. The Caixin/Markit China manufacturing PMI, as well as IMF studies, reveal that, in January and February 2020, China’s industrial production suffered a historic contraction. China’s industrial production was 25% lower than during the same period in 2019. In the meantime, retail sales also suffered a massive 35% drop (Huileng Tan, “China’s factory activity slumps in February in weakest reading on record, private survey shows”, in “A private survey shows shows China’s manufacturing activity expanded slightly in March”, CNBC, updated 1 March 2020).

Impacting America

From this point of view, the confinement of China and its industrial and economic consequence literally rippled through and down the China-U.S. production, trade, finance, and logistical arteries. Moreover, the confinement of part of America is rapidly affects the consuming habits of the U.S. population (Lucia Mutikani, “U.S consumer prices post largest drop in five years amid coronavirus disruptions”, Reuters, April 10, 2020).

Confinement as a geo-economic warfare

Oil as indication

However, “Chimerica” is also the core driver of the world economy. The viral crisis is reinforcing the slowing down trade. It is already translating through the fall of oil Chinese imports and on the oil prices, amid the Russia-Saudi Arabia-Mexico initial oil production dispute (Gillian Rich, “Oil prices mixed after OPEC+ surrenders to Mexico on massive deal”, Investors Business Daily, 10 April 2020). As of 12 April 2020, oil prices are at historic lows, between 22$ and 24$. One must remember that, at the worst of the 2008 crisis, oil prices slumped “only” at 40$.

However, oil is the material and energetic driver of the world economy and finance. This dizzying fall of the oil prices is expressing a global deceleration of production and transport activities. It also means a mammoth loss of petro-dollars that thus cannot be injected in international transactions.

Chimerica as an economic battlefield

So, the consequences of the COVID-19 are triggering the equivalent of a geo-economic warfare on the hybrid U.S.-China economy. However, since 2018, this US-China hybrid economy was already under pressure because of the U.S.-China trade war.

The combination of both the pandemic and the trade war turns Chimerica into an inside-out economic battlefield. As the virus and confinement policies spread through the road of globalization, the whole world is decreasing its interactions with China.

Pandemic as a geo-economic warfare

Actually, we may wonder if those safety measures are triggering a situation with consequences similar to a worldwide geo-economic conflict. Theorised since 1990, a “geoeconomic war” is thought as a way to inflict a country the same kind of damages that could be wrought by military means. This approach concerns infrastructures as well as the financial dimensions of life quality. The idea is to use economics as weapon systems (Edward Luttwak, “From Geopolitics to Geoeconomics”, The National Interest, 1990 and Robert D. Blackwill and Jennifer M. Harris, War by other Means, Geoeconomics and Statecraft, 2016)).

Thus, in a very strange and surprising way, the COVID 19 crisis appears as a new kind of economic disruptive force. As it happens,, this unwanted offensive strikes China, and the U.S., thus Chimerica.

However this battlefield deploys itself on numerous fronts. First, let us see what happens on the savage American front.

Featured image: Image par Gerd Altmann de Pixabay [Public Domain]

The Red (Team) Analysis Weekly – 16 April 2020

This is the 16 April 2020 issue of our weekly scan for political and geopolitical risks (open access). Again, a very large part is devoted to the COVID-19, as the pandemic is reshaping the world.

Using horizon scanning, each week, we collect weak – and less weak – signals. These point to new, emerging, escalating or stabilising problems. As a result, they indicate how trends or dynamics evolve.

The Scan

The 16 April 2020 scan→

Horizon scanning, weak signals and biases

We call signals weak, because it is still difficult to discern them among a vast array of events. However, our biases often alter our capacity to measure the strength of the signal. As a result, the perception of strength will vary according to the awareness of the actor. At worst, biases may be so strong that they completely block the very identification of the signal.

In the field of strategic foresight and warning, risk management and future studies, it is the job of good analysts to scan the horizon. As a result, they can perceive signals. Analysts then evaluate the strength of these signals according to specific risks and dynamics. Finally, they deliver their findings to users. These users can be other analysts, officers or decision-makers.

You can read a more detailed explanation in one of our cornerstone articles: Horizon Scanning and Monitoring for Warning: Definition and Practice.

The sections of the scan

Each section of the scan focuses on signals related to a specific theme:

  • world (international politics and geopolitics);
  • economy;
  • science including AI, QIS, technology and weapons, ;
  • analysis, strategy and futures;
  • the Covid-19 pandemic;
  • energy and environment.

However, in a complex world, categories are merely a convenient way to present information, when facts and events interact across boundaries.

The information collected (crowdsourced) does not mean endorsement.

Featured image: Milky Way above SPECULOOS / The Search for habitable Planets – EClipsing ULtra-cOOl Stars (SPECULOOS) is searching for Earth-like planets around tiny, dim stars in front of a panorama of the Milky Way. Credit: ESO/P. Horálek.

The Red (Team) Analysis Weekly – 9 April 2020 – COVID-19 Cognitive Overload?

This is the 9 April 2020 issue of our weekly scan for political and geopolitical risks (open access). Again, a very large part is devoted to the COVID-19. Read the scan below, after the editorial, quite long this week.

Editorial

First, this week’s scan features the excellent article “Stretching the International Order to Its Breaking Point” by Thomas Wright, Senior fellow at the Brookings Institution in The Atlantic. The highlight for the article reads:

“The greatest error that geopolitical analysts can make may be believing that the crisis will be over in three to four months.”

It is not only geopolitical analysts that are making this error, but, apparently, an increasingly large majority of people, whatever their position and role in the system.

As we progress here, at The Red (Team) Analysis Society, with the building of scenarios for the COVID-19, the idea of a crisis with a rapid end looks more and more improbable, not to say impossible. The COVID-19 is a pandemic, caused by a highly contagious, dangerous virus about which we know extremely little. It is highly improbable it disappears as if by magic, because it is inconvenient to human beings.

The sketch Wright paints for the future is highly interesting and is definitely a must read.

The second point I would like to make for this scan, considering the signals collected, is the incredible sheer mass of texts, articles, posts, etc. produced on the COVID-19. It is not only the COVID-19 cases that grow exponentially, but also publications about it. Thus, we are also faced with the dangers of a huge information overload. It is impossible to keep track of all the articles. It is impossible to even skim through them to sort out quality articles from rubbish, serious articles from fake news, scientific analysis from mere opinion. We certainly cannot rely on Google or search engines, as their algorithms rarely privileges quality and relevance. Google, for example, in its ranking, puts a high premium on page-speed and commercial stuff. But are these truly important criteria to find truly crucial articles on key uncertainties regarding the COVID-19?

The COVID-19 information overload will accelerate the need for closure, which is already enhanced by the stress and the crisis. The need for closure is the imperious need to get answers, any answer, immediately. It rises notably with time-pressure, critical when going through duress and crisis, and with environmental noise, which includes information overload (for more on the need for closure, cognitive biases in general and strategies to mitigate them, see our online course 1 – Geopolitical Risks and Crisis Anticipation: Analytical Model – module 2). Of course, when faced with a pandemic, jumping to decisions and responses is not a very good idea. On the contrary, one needs to think peacefully and to use evidenced-based analysis, and to wait, when necessary, until proper analysis and science-based findings become available. Thus one needs to have a low need for closure.

Now, the very means we have to obtain analysis and scientific articles, the web, because of the massive amount of texts on the COVID-19, creates an information and cognitive overload that, in turn, generates need for closure thus stops the capacity to think. Thus, to be able to know, we impair our ability to think.

Disaster looms.

Actors will probably fall back on classical means to obtain information: the system as it exists (which includes also the pre-COVID-19 Google, Bing and others algorithms). But, this directs us to ask a very inconvenient question.What led us all to first an outbreak of a completely unknown disease, then to an epidemic then to a pandemic, with all the unpreparedness that is everywhere increasingly documented is this very system. Hence, is that system the best to select the relevant and reliable information we need to face and overcome the pandemic?

If not the system then what? Could part of the system be salvaged and should other parts be abandoned? Here our topic is selection of quality and relevant analysis, but should these questions be also extended to the whole system?


The Scan

Using horizon scanning, each week, we collect weak – and less weak – signals. These point to new, emerging, escalating or stabilising problems. As a result, they indicate how trends or dynamics evolve.

The 9 April 2020 scan→

Horizon scanning, weak signals and biases

We call signals weak, because it is still difficult to discern them among a vast array of events. However, our biases often alter our capacity to measure the strength of the signal. As a result, the perception of strength will vary according to the awareness of the actor. At worst, biases may be so strong that they completely block the very identification of the signal.

In the field of strategic foresight and warning, risk management and future studies, it is the job of good analysts to scan the horizon. As a result, they can perceive signals. Analysts then evaluate the strength of these signals according to specific risks and dynamics. Finally, they deliver their findings to users. These users can be other analysts, officers or decision-makers.

You can read a more detailed explanation in one of our cornerstone articles: Horizon Scanning and Monitoring for Warning: Definition and Practice.

The sections of the scan

Each section of the scan focuses on signals related to a specific theme:

  • world (international politics and geopolitics);
  • economy;
  • science including AI, QIS, technology and weapons, ;
  • analysis, strategy and futures;
  • the Covid-19 pandemic;
  • energy and environment.

However, in a complex world, categories are merely a convenient way to present information, when facts and events interact across boundaries.

The information collected (crowdsourced) does not mean endorsement.

Featured image: Milky Way above SPECULOOS / The Search for habitable Planets – EClipsing ULtra-cOOl Stars (SPECULOOS) is searching for Earth-like planets around tiny, dim stars in front of a panorama of the Milky Way. Credit: ESO/P. Horálek.

The COVID-19, Immunity and Isolation Exit Strategy

One of the critical and key uncertainty about the COVID-19, among so many, is the immunity a patient may have after recovery from the COVID-19. In other words, can someone who recovered from the COVID-19 catch the disease again and infect other people again?

As long as we have neither vaccine nor fully efficient antiviral treatment, specific acquired immunity, i.e. the immunity developed as the body fights then recovers from the disease, is one of the key variables at the center of the few solutions we have to handle the pandemic. Because, as we saw, we shall not be able to use vaccination for immunisation before at the very best winter 2022, and considering the uncertainty considering treatments against the SARS-CoV-2, specific acquired immunity becomes even more important.

This immunity is also key to determine exit strategies to isolation and lockdown. Indeed, one of the components of the exit strategy that may be designed is to allow people who have developed an acquired immunity to return to normal life (e.g. Ran Balicer, “Coronavirus: Two Things Must Happen Before Initiating Exit Strategy“, Haaretz, 2 April 2020).

Thus what do we know or not, so far, about this immunity? How can we handle the uncertainty? Finally, what does that imply for an exit strategy? This is what we shall see in this article.

Many questions and few answers, yet.

In a nutshell and schematically, when a pathogen such as the SARS-CoV-2 enters the body, the immune system develops a range of reactions to fight against the intruder and attacker (for a very interesting clear, detailed biological and medical explanation see, for example, “Features of an Immune Response“, in Immune System Research, National Institute of Allergy and Infectious Diseases). The creation of antibodies is one of these responses. Antibodies will attack the intruder. If the immune system is victorious against the SARS-CoV-2, then the patient recovers. His or her body keeps traces of war that took place. The patient will now also have an acquired immunity (e.g. Encyclopaedia Britannica, “Immune System“).

However, as Morgane Bomsel, virologist and immunologist underlines:

“The question is to know if it [the acquired immunity] will be protective of nor, and how long it will last” (La question est de savoir si elle va être protectrice ou pas, et combien de temps elle va durer) .

in Camille Gaubert, Interview with Morgane Bomsel, “Covid-19 : l’immunisation pourrait, chez certains, ne pas protéger d’une deuxième infection“, Sciences et Avenir, 1 April 2020)

Protective acquired immunity after recovery from the COVID-19?

First, thus, one needs to find the various components of the acquired immunity in the body. For example, antibodies need to be present in such a quantity that they are sufficient to prevent infection again (Wu, IBId., Callow, K A et al., ibid.). Such antibodies were detected in a patient with mild-to-moderate symptoms “before symptomatic recovery. These immunological changes persisted for at least 7 d following full resolution of symptoms” (Thevarajan, I., Nguyen, T.H.O., Koutsakos, M. et al., “Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe COVID-19“, Nat Med; 2020).

Then, Linlin Bao, et al., in a not yet peer-reviewed article, showed on rhesus macaques that those could not be reinfected, “after the symptoms were alleviated and the specific antibody tested positively”, at 5 days post-infection (“Reinfection could not occur in SARS-CoV-2 infected rhesus macaques“, bioRxiv, 14, March 2020.

On 27 March 2020, the Helmholtz Centre for Infection Research (HZI) in Germany announced the start of a much larger study, on 100.000 individuals. The donors’ “blood will be regularly tested for antibodies against the Covid-19 pathogen. The study will provide a more accurate picture of immunity and pandemic development.” The center goes on highlighting that following this study, one may imagine giving a kind of immunity certificate to people who developed an immunity, which would allow them to return to normal life (Ibid.). The tests should start in April 2020 and first results should be available at the end of the same month (Veronika Hackenbroch, “Large Antibody Study to Determine Germans’ Immunity to Covid-19“, der Spiegel, 27 March 2020). Improvements in the test procedure – thus reliability of the study – should take place between end of May 2020 and end of June 2020 (Ibid,).

Thus, it would seem, according to what we now know, that we indeed obtain a protective acquired immunity. Utmost caution, however, must still be exerted waiting for other studies’ results, such as the German study.

Furthermore, we must also account for the possibility, that, for some individuals, a different immune response develops. In two other coronaviruses, the SARS and the MERS, for some people, the antibodies facilitated infection rather than preventing it Camille Gaubert, Interview with Morgane Bomsel, “Covid-19 : l’immunisation pourrait, chez certains, ne pas protéger d’une deuxième infection“, Sciences et Avenir, 1 April 2020). Favourable results for experiments in vitro gave opposite, negative results in vivo experiments (ibid.). If such were the case for the SARS-CoV-2, however, possible negative impacts of antibodies could then be blocked with adequate treatment (ibid.). However, this would be again more pharmaceutical efforts to endeavour.

The possible existence of such individuals that would then possibly be more fragile after infection needs to be thoroughly deepen and then checked before general measures are applied to the population.

Length of the protective acquired immunity

However, antibodies remain in the body, for a while (e.g. interviews with virologists and immunologists in Katherine J. Wu, “What Scientists Know About Immunity to the Novel Coronavirus“, Smithsonian Magazine, 30 march 2020; Callow, K A et al. “The time course of the immune response to experimental coronavirus infection of man.” Epidemiology and infection vol. 105,2 1990; Gaubert, Ibid.).

But how long is this while? This is the first unknown we face. Antibodies usually diminish with time then disappear (Wu, ibid.). Thus, how long do we keep these antibodies? For how long will the acquired immunity be protective?

Then, another related question is about the immune memory: will antibodies be able to remember the attacker well enough to generate the proper response (Wu, Ibid.)?

Thus, to summarise, for our purpose the key question is: for how long will the acquired immunity be protective?

Currently, although we do not know with certainty, most scientists seem to consider as likely hypothesis that, in general, patients who have recovered from the COVID-19 will be sufficiently immunised, for a while.

The possible length of the naturally acquired immunity considered varies.

Indeed, our knowledge of the SARS-CoV-2 is extremely recent. It started with recorded data mainly in January 2020. Thus at the beginning of April 2020, we cannot know with certainty the possible length of the immunity beyond 2 to 3 months. This is one more reason why monitoring what is happening in China, where the first patients recovered, is so important.

Various hypotheses are considered.

If the SARS-CoV-2 is similar to the coronavirus giving the common cold, then some scientists state that the immunity could last “years” (Interview with Angela Rasmussen, a virologist at Columbia University in Brian Resnick, “The 9 most important unanswered questions about Covid-19“, Vox, 20 March 2020). However, other results, obtained with the coronavirus 229E, show a more complex picture, as some individuals could also, in experiment, become reinfected a year later (Callow, K A et al. “The time course of the immune response to experimental coronavirus infection of man”, Epidemiology and infection, vol. 105,2, 1990).

If the coronavirus behaves as the seasonal flu, the hypothesis the Imperial College COVID-19 Response Team used, then re-infection is considered as “highly unlikely in the same or following season” (Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand, 16 March 2020, p. 4). However, the seasonal flu is not a coronavirus.

Other uncertainties

The condition and age of the patient, as well as genetics, may also impact the response of the immune system (Wu, Ibid.).

Finally, mutations may occur as the virus duplicates itself, leading to new strains the body cannot recognise, as with the seasonal flu (Wu, Ibid.). This is however less likely for coronaviruses than for flu viruses (Ibid.). But coronaviruses can also “trade segments of their genetic code with each other”, which allows them to trick the immune system. (Ibid.). In that case, the acquired immunity would be useless. Note that this would also be true for a vaccine.

Virologists and immunologists most probably have other much more specific questions to which they need to find answers.

Thus, with such a new disease, we are still faced with many uncertainties. How can we handle them?

Impacts on the architecture of scenarios

Again, scenarios are a crucial tool to handle these uncertainties.

Our scenario structure is currently as follows. The main scenario we consider as most likely is that we shall have to wait for a vaccine until winter 2022 (at best) (see Hélène Lavoix, The COVID-19 Pandemic – Surviving and Reconstructing, The Red (Team) Analysis Society, 24 March 2020, last updated 3 April 2020). Then we need to account for the possibility to see the emergence of treatments impacting the disease (see Hélène Lavoix, Covid-19 – Scenarios – Making Sense of Antiviral Treatment, The Red (Team) Analysis Society, 30 March 2020).

Now, ideally, we would need to have another epidemiological layer of models and scenarios that vary to include various possibilities for the acquired immune response. We would build the next layer of our scenarios out of these.

Until such detailed epidemiological models are available, if ever, we need to handle the variable “immunity” as correctly as possible, through different sub-scenarios useful for our purpose. The best way at this stage is to consider a first batch of sub-scenarios where a fully protective immunity is developed upon recovery and to have this immunity vary according to time.

Considering that the detailed epidemiological model that many governments use is the model the Imperial College COVID-19 response team developed (Ibid.), it is interesting for our purpose to look at a scenario that is less optimistic than the “same season and next one” immunity they used, for example less than one year, one that is the Imperial College scenario and one that is more optimistic, for example, an immunity that lasts from one and a half to two years.

That said, the Imperial College’s model shows that “temporary suppression” (with social distancing of the entire population, case isolation, household quarantine and school and university closure) is the only way forward not to overwhelm the health system and to prevent massive fatalities. It also shows that because this suppression is successful, then only a small number of individuals will develop immunity. Hence, for a collective approach focused necessarily on health, fatalities and not overwhelming the health system, variations on the acquired immunity, because they play on small numbers, may not be a key variable.

Things are, however, more challenging for the second objective all polities must fulfil, i.e. ensuring the fundamental security a society needs to survive as well as not to break down (see The COVID-19 Pandemic – Surviving and Reconstructing, and Summary of previous findings in Covid-19 – Scenarios – Making Sense of Antiviral Treatment). Indeed, critical functions must continue, and, as much as possible, a new economy must start emerging. As a reminder, the first objective is to reduce as much as possible the fatalities resulting from the disease (see Summary of previous findings, ibid.).

Hence the need for sub-scenarios that consider acquired immunity and its length.

Finally, to make sure we cover the whole range of possible futures, we may create a “complex immunity” scenario that would actually cover all other cases. This scenario would, for example, include a situation where the acquired immunity varies so much according to diverse criteria that it becomes difficult, rapidly, to create adequate understanding and thus policies. It could also be used if our knowledge is so uncertain and the involved risks are so high that similarly, no policy can be created easily. With time, or according to the decision-makers for whom the actionable scenarios are created, this “cluster scenario” would need to be developed adequately.

This “complex scenario” would be the least favourable.

Immunity and exit strategy

We must highlight first that the theories and models created to handle the exit of the “suppression/isolation” period need to account for the immunity uncertainty.

Thus, considering the high cost in lives and sufferings, as well as the impacts across domains, we must consider all scenarios. We cannot consider only the most likely and most preferable scenario. Actually, we need either to make sure that policies will be correct across scenarios or that they are flexible enough to switch in a timely way from one scenario to another. In that case, this demands precise monitoring and warning that will allow to steer policies, again in a timely manner. This flexibility should also allow to fully integrate new understanding and new results on the length and protection of the acquired immunity, as they become known.

Policies also need to be correct at both individual and collective level, considering the high stakes in terms of legitimacy for political authorities. For example, the policies should try to consider the possibility of individual variations in terms of acquired immunity.

In terms of exit strategy, for example, the current assumption, considering the early results (see above) is that people who were positive to the COVID-19 and recovered, now have a protective immunity to the SARS-CoV-2. However, it does not seem that the length of the immunity is, so far, taken into account.

The challenge thus becomes, in terms of handling of the pandemic and exit of the isolation/suppression phase to identify who has antibodies. If we wanted to also make sure the length of the immunity is considered, then we would need to make sure that a possible fading of the immunity can be identified.

The answer to this need will be in the serological tests, which are currently developed worldwide (Chad Terhune, Allison Martell, Julie Steenhuysen, “U.S. companies, labs rush to produce blood test for coronavirus immunity“, Reuters, 25 March 2020; Gretchen Vogel, “New blood tests for antibodies could show true scale of coronavirus pandemic“, Science, 19 March 2020; Hugo Jalinière, “Les tests de sérologie, clé du déconfinement“, Sciences et Avenir, 30 mars 2020; Lauren Chadwick, “Coronavirus: Antibody tests ‘will be crucial’ in determining when to lift lockdowns“, Euronews, 6 April 2020; for a list of commercially developed tests all categories, not only serological, see Find, Covid-19 Diagnostics resource centre).

Assuming that the tests are reliable, we nonetheless find again the familiar problem of quantities. The ongoing “war for face masks” is very likely to be again reproduced, this time, with tests. Masks as well as serological tests become crucial stakes to fulfil the two objectives of societies faced with the COVID-19 pandemic. Those who will be able to develop and secure for their populations as much and as many of the necessary tools – including smart strategies – to both survive and ensure the fundamentals of security, will survive best. Furthermore, they are also likely to be earlier and better able to interact again with each other.

To account for the length of the immunity, if the tests which are developed cannot detect early enough a fading of immunity, then testing many times subjects may become necessary. However, here the problem of test quantity – and test operationalisation – increases. Continuing imperatively protective gestures as well as a generalisation of face masks is thus likely to be necessary to compensate for insufficient serological testing.

With the next articles we shall continue exploring the factors which are key to build the general architecture of our scenarios.


Some detailed references and bibliography

Callow, K A et al. “The time course of the immune response to experimental coronavirus infection of man.” Epidemiology and infection vol. 105,2 (1990): 435-46. doi:10.1017/s0950268800048019

Linlin Bao, Wei Deng, Hong Gao, Chong Xiao, Jiayi Liu, Jing Xue, Qi Lv, Jiangning Liu, Pin Yu, Yanfeng Xu, Feifei Qi, Yajin Qu, Fengdi Li, Zhiguang Xiang, Haisheng Yu, Shuran Gong, Mingya Liu, Guanpeng Wang, Shunyi Wang, Zhiqi Song, Wenjie Zhao, Yunlin Han, Linna Zhao, Xing Liu, Qiang Wei, Chuan Qin, “Reinfection could not occur in SARS-CoV-2 infected rhesus macaques“, bioRxiv, 14, March 2020, 2020.03.13.990226; doi: https://doi.org/10.1101/2020.03.13.990226

Thevarajan, I., Nguyen, T.H.O., Koutsakos, M. et al. Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe COVID-19. Nat Med (2020).https://doi.org/10.1038/s41591-020-0819-2

Shi, Y., Wang, Y., Shao, C. et al. COVID-19 infection: the perspectives on immune responses. Cell Death Differ (2020). https://doi.org/10.1038/s41418-020-0530-3


Featured image: Image par Gerd Altmann de Pixabay


The Red (Team) Analysis Weekly – 2 April 2020

This is the 2 April 2020 issue of our weekly scan for political and geopolitical risks (open access). Again, a very large part is devoted to the COVID-19. Read the scan below.

Using horizon scanning, each week, we collect weak – and less weak – signals. These point to new, emerging, escalating or stabilising problems. As a result, they indicate how trends or dynamics evolve.

The 2 April 2020 scan→

Horizon scanning, weak signals and biases

We call signals weak, because it is still difficult to discern them among a vast array of events. However, our biases often alter our capacity to measure the strength of the signal. As a result, the perception of strength will vary according to the awareness of the actor. At worst, biases may be so strong that they completely block the very identification of the signal.

In the field of strategic foresight and warning, risk management and future studies, it is the job of good analysts to scan the horizon. As a result, they can perceive signals. Analysts then evaluate the strength of these signals according to specific risks and dynamics. Finally, they deliver their findings to users. These users can be other analysts, officers or decision-makers.

You can read a more detailed explanation in one of our cornerstone articles: Horizon Scanning and Monitoring for Warning: Definition and Practice.

The sections of the scan

Each section of the scan focuses on signals related to a specific theme:

  • world (international politics and geopolitics);
  • economy;
  • science including AI, QIS, technology and weapons, ;
  • analysis, strategy and futures;
  • the Covid-19 pandemic;
  • energy and environment.

However, in a complex world, categories are merely a convenient way to present information, when facts and events interact across boundaries.

The information collected (crowdsourced) does not mean endorsement.

Featured image: Milky Way above SPECULOOS / The Search for habitable Planets – EClipsing ULtra-cOOl Stars (SPECULOOS) is searching for Earth-like planets around tiny, dim stars in front of a panorama of the Milky Way. Credit: ESO/P. Horálek.

COVID-19 Antiviral Treatments and Scenarios

The world is now struggling to know how to face the COVID-19 pandemic. We want to know how long the pandemic will last. Actually, what we want to know is when the pandemic will end and when life will be able to resume normally.

As we explained in the opening article for this series, to be able to answer these questions, considering the very high number of uncertainties involved, we need to use scenarios. Our aim is to contribute to the creation of robust scenarios in our field, political science and international relations. We are thus concerned with the future of polities, i.e. the futures of organised societies. Nonetheless, to be able to do so, we obviously have to take into account what other sciences, those primarily concerned with diseases and pandemics, find out.

For now we are trying to establish both the general structure for our scenario tree and the timeframe. Thus we study main critical factors that will allow us to articulate our scenarios.

In this article, we first briefly summarise the points made in previous articles. We then turn to the antiviral prophylaxis and treatment as a second key critical factor.

Summary of previous findings

Objectives of societies faced with a pandemic

Because we have collectively and individually “chosen” not to accept the baseline worst case scenario, then our main aim is now survival for each individual, and for each polity, society or country. Fundamentally, as long as the pandemic continues, thus as long as the baseline worst case scenario could become a reality, each polity will need to fulfil simultaneously two objectives.

First objective

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The first objective is to reduce as much as possible the fatalities resulting from the disease. This implies reducing the number of infected people and caring for those who are ill. This means, in turn, not overwhelming the care system.

Should we fail, then, not only the dreaded scenario we seek to avoid would take place, but, at worst, all other fatalities and deaths we succeeded to prevent over centuries could come back. The excess deaths (compared with the pre-pandemic time) would be dramatic. It would also seriously impaire the capacity of a society to ensure its security and, at term its survival.

Second objective

The second objective is to continue having a society that ensures fundamental security.

Simultaneous objectives

The two aims must be fulfilled at the same time.

Indeed, if fundamental security is not ensured, then the system will rapidly collapse. Neither caring for diseased people, nor containment measures will be possible anymore. The pandemic will run its course as with the worst case scenario, but the situation will be even worse. If we do not stop the pandemic, then death and disease will take their toll and damage the capacity of society to ensure its security. Society will be fragilised, and in turn will less be able to handle the pandemic, increasing fatalities. We risk here to fall into a vicious circle.

Immunisation and vaccine as a first key critical factor

We explained in the previous article, that immunisation through vaccination is a first critical factor around which we can organise the architecture of our scenarios. We also assessed – with many uncertainties remaining – that we could not expect such immunisation to take place before winter 2022-2023. This gives us a first broad likely scenario upon which we can concentrate. Within this scenario that we shall use as framework, we need to understand the futures of our systems as they face the COVID-19 over the next two to three years.

Actually, another implicit scenario at the same level of analysis should also be made explicit. This scenario is, however, uncontrollable, according to the current and expected stage of knowledge. The virus, could lose either its infectious power or its lethality or a strong immunity could also develop naturally among human beings. In that case, the pandemic would end much earlier. This scenario being less likely and also obviously less threatening, considering limited resources, we shall not, right now, examine it. Nonetheless the factors influencing the probability of this scenario must be monitored.

Antiviral prophylaxis and treatment – a second key critical factor

Antiviral prophylaxis and treatment are a second critical factor for our scenarios architecture. Indeed, we try to reduce fatality. Thus, if we have a cure for the disease, the possibility of the worst case baseline scenario disappears.

To date, 30 March 2020, there is no known antiviral treatment against the SARS-CoV-2, i.e. certain and having gone through all the usual testing process.

Thus, some of the key questions we must ask are as follows. Is it possible to see a treatment discovered and developed? Which types of effects this treatment could have on the disease and on the pandemic? When could this treatment become available?

Here, we face a supplementary challenge as controversies, debates, power and ego-struggles have entered the field. Meanwhile, notably out of fear, panic, or lack of trust in governments, these debates and struggles have been transformed and relayed as rumours, fake news, and conspiracy theories.

As far as we are concerned, we shall rely on scientific papers and focus on looking for elements which are key for our aim, contributing to establish valid scenarios. We shall also keep the issue of the timeframe in mind.

Possible candidate antiviral treatments from existing and known drugs

The Chloroquine hope and debate

Since mid-February and increasingly so as the pandemic spread, the efficiency of chloroquine, either as Chloroquine phosphate or as one of Chloroquine’s derivate, hydroxychloroquine, to treat patients infected with the SARS-CoV-2, has become a hot topic in scientific and lay publications (see a non-exhaustive bibliography below). Some promote it as the Graal that will save us all from the disease. Others just underline that the necessary clinical tests allowing to assert and measure its efficiency – as well as the ideal posology according to the stage of the disease – have not yet been completed. Meanwhile, conspiracy theories abound.

Hope from a Chinese publication

In a nutshell, the issue is relatively simple. On 19 February 2020, as an e-publication, Gao J, Tian Z, Yang X, published a letter for advanced publication titled “Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in
clinical studies” in the journal BioScience Trends. There, they notably stated that

“The drug is recommended to be included in the next version of the Guidelines for the Prevention, Diagnosis, and Treatment of Pneumonia Caused by COVID-19 issued by the National Health Commission of the People’s Republic of China for treatment of COVID-19 infection in larger populations in the future.”

They also underlined that

“results from more than 100 patients have demonstrated that chloroquine phosphate is superior to the control treatment in inhibiting the exacerbation of pneumonia, improving lung imaging findings, promoting a virus negative conversion, and shortening the disease course according to the news briefing”.

The need for further trials

Now, those who urge caution do so because they would like to have access to all these trials and to be able to replicate and enlarge them.

Consequently, up to 30 March 2020, at least 17 studies (out of 22 trials) have started, or are planned, to carry out further testing of the efficiency of hydroxychloroquine on patients with COVID-19. They are taking place from South Korea to the U.S. through Thailand, Brazil and the EU. They address various stages of the clinical trials studying a drug. One of these studies only has been completed, in Shanghai. Its results have been published in the Journal of Zhejiang University (Medical Sciences, 3 March 2020). It was carried out only on 30 patients.

Disappointing results on a small sample

We should note that the results of the Shanghai’s trial show no impact of hydroxychloroquine on patients, compared with the control group. Even worse, although on such a small group conclusions are only tentative, one patient under hydroxychloroquine developed to a severe condition (ibid).

A French microbiologist promotes the treatment

Meanwhile, some French immunologists and specialists in microbiology headed by the Director of the State Institut Hospitalo-Universitaire Méditerranée (IHM) Infection Didier Raoult promoted the early use of Chloroquine (Philippe Colson , et al., “Chloroquine and hydroxychloroquine as available weapons to fight COVID-19”, International Journal of Antimicrobial Agents, 26 February 2020). Furthermore, the same team tested Chloroquine with Azythromycine on 26 patients, 16 others being used as control group (Gautret et al. (2020) Hydroxychloroquine and azithromycin as a treatment of COVID‐19: results of an open‐label non‐randomized clinical trial). On 22 March 2020, they decided to start applying hydroxychloroquine massively to infected people in Marseille, adding furthermore Azythromycine.

Out of the 17 studies mentioned earlier, three of them test the combination of Hydroxychloroquine and Azythromycin.

Further need to be careful

Meanwhile, scientists, including from the IHM, have warned about the difference between in vitro successful experiments and in vivo ones. For example, Franck Touret et Xavier de Lamballerie in “Of chloroquine and COVID-19” (Antiviral Research 177 (2020) 104762) pointed out various negative possible impacts in previous attempts at using Chloroquine on other types of viruses. Notably, “in a nonhuman primate model of CHIKV infection”, the use of Chloroquine was shown to delay the cellular immune response (Ibid.). Even though every virus is different, these earlier trials on other viruses highlight the need for caution.

An indication from outside the medical world

To this, we should add an indication coming from outside the world of clinical tests. If China considers “the apparent efficacy” of Chloroquine since 19 February, it has nonetheless continued its lockdown, travel bans and quarantine policy on the country. Indeed, for example, lockdown on Wuhan will be partially lifted only on 8 April 2020 (BBC News, “Coronavirus: Wuhan to ease lockdown as world battles pandemic“, 24 March 2020). Furthermore, China is rightly being extra careful with not allowing new imported cases to spread (BBC News, “Coronavirus travel: China bars foreign visitors as imported cases rise“, 27 March 2020). It is paying particular attention to all cases, in case a new wave of COVID-19 would hit the country (Ibid).

Should Chloroquine – possibly added to Azythromycine – be such a miracle drug, then China would not be so afraid of seeing a new epidemic outbreak. Thus, if we take Chinese policies and behaviour as indication, Chloroquine could hopefully alleviate sufferings, but not critically change the disease behaviour.

The results of the clinical trials will tell.

Other candidate treatments

Meanwhile, China and other countries are testing other drugs and molecules, such as arbidol, remdesivir, favipiravir, lopinavir and ritonavir, also with immunomodulator interferon beta-1b and others (Liying Dong, Shasha Hu, Jianjun Gao, Discovering drugs to treat coronavirus disease 2019 (COVID-19), Drug Discov Ther. 2020;14(1):58-60. doi: 10.5582/ddt.2020.01012; Lindsey R. Baden, M.D., and Eric J. Rubin, M.D., Ph.D., Covid-19 — The Search for Effective Therapy, NEJM, 18 March 2020; Camille Gaubert, “Coronavirus : lancement d’un essai clinique sur 3.200 patients atteints de Covid-19“, Sciences et Avenir, 12 March 2020; John Cahill, “Potential COVID-19 therapeutics currently in development“, European Pharmaceutical Review, 26 March).

Major ongoing trials

Among all these candidates the WHO has selected four treatments as most promising for a very large trial: the “experimental antiviral compound called remdesivir; the malaria medications chloroquine and hydroxychloroquine; a combination of two HIV drugs, lopinavir and ritonavir; and that same combination plus interferon-beta” (Kai KupferschmidtJon Cohen, “WHO launches global megatrial of the four most promising coronavirus treatments“, Science, 22 March 2020). The WHO solidarity trial is expected to run from March 2020 to March 2021 (ISRCTN registry).

The French INSERM coordinates a European corresponding trial called DISCOVERY on 3200 patients. It started on 22 March. Fifteen days after the inclusion of each patient, the analysis of treatment efficacy and safety will be evaluated.

We should also count the Institut Hospitalo-Universitaire Méditerranée 22 March beginning of treatment of patients with Chloroquine and Azythromycine also as a trial. Indeed, it differs from SOLIDARITY and DISCOVERY because it adds Azithromycine. This point could be important if we consider the pre-test done, as Azythromycine seemed to have a critical role to play (Ibid.).

As highlighted above, according to the database Clinicaltrials.gov of the U.S. government, 22 trials are currently taking place on various drugs.

Discovering new treatments or uncovering less common treatments

This type of scenario is quite similar, in terms of process, to what we saw with vaccines. We must first discover or unearth one or more molecules that may positively impact the development of the disease, yet without adverse effects.

Artificial Intelligence, Automation, and supercomputers against the SARS-CoV-2

As existing and known drugs and treatments are tried, researchers are also also busy trying to unearth or discover molecules that could help fight the SARS-CoV-2.

For example the Institut Pasteur of Lille – France (EN version) tests molecules on the virus thanks to robots in a specially confined laboratory. As a result, researchers can greatly speed the rhythm of tests. Thousands are carried out daily. Meanwhile, the combination of molecules by pairs for testing is also automated (website).

DeepMind, or rather DeepMind Technologies Limited, the famous artificial intelligence / deep learning lab. Alphabet Inc. (Google) bought, joined the efforts to fight the SARS-CoV-2 ( Computational predictions of protein structures associated with COVID-19, 5 March 2020 – for more on artificial intelligence and deep learning see our related series). It used the latest version of their AlphaFold system to “release structure predictions of several under-studied proteins associated with SARS-CoV-2”. Should these deep learning predictions then be confirmed through experiments, then they will have contributed to a better knowledge of the virus and possibly to the development of new drugs.

Researchers at the U.S. Oak Ridge National Lab (Department of Energy) use Summit, the most powerful supercomputer to date, “to run through a database of existing drug compounds to see which combinations might prevent cell infection of COVID-19” (Brandi Vincent, “Researchers at Oak Ridge National Lab Tap into Supercomputing to Help Combat Coronavirus“, Nextgov.com, 11 March 2020). Researchers could simulate 8,000 compounds and select 77 that have “the potential to impair COVID-19’s ability to dock with and infect host cells” (Dave Turek, “US Dept of Energy Brings the World’s Most Powerful Supercomputer, the IBM POWER9-based Summit, Into the Fight Against COVID-19“, IBM News Room, nd). It took them a couple of days instead of “months on a normal computer” (Ibid.).

As we pointed out in our series on supercomputers and computing power, these are increasingly key factors for the present and the future. In this case, supercomputers could be critical in the fight against this pandemic.

Other efforts using supercomputing power, such as a NSF programme or the European program Exscalate4CoV are at work (Oliver Peckham, “Global Supercomputing Is Mobilizing Against COVID-19“, 12 March 2020, HPC Wire). For example,

“E4C is operating through Exscalate, a supercomputing platform that uses a chemical library of over 500 billion molecules to conduct pathogen research. Specifically, E4C is aiming to identify candidate molecules for drugs, help design a biochemical and cellular screening test, identify key genomic regions in COVID-19 and more”. 

Oliver Peckham, “Global Supercomputing Is Mobilizing Against COVID-19“, 12 March 2020, HPC Wire

We could also imagine that companies and start-ups in the quantum information science field, who highlighted the importance of quantum computing and simulation in the field of chemistry, for example, or material science, would be actively contributing to the fight against the COVID-19 (e.g. Foreseeing the Future Quantum-Artificial Intelligence World and Geopolitics; Quantum Optimization and the Future of Government). A similar point could be made regarding logistics necessary to survive the pandemics, working from the Volkswagen Group research with D-Wave (Quantum Optimization, Ibid.). Yet, up to 30 March 2020, no open source information regarding the participation of the “quantum world” in the fight against the COVID-19 seems to be available.

When could such a new treatment become available?

There is no way to know how close we are to the discovery of the right molecule or combination of molecules.

Once it is discovered, the new potential drug will have to go through the whole process of trial and development, including clinical trials (e.g. EU Drug Discovery and Development, U.S. Biopharmaceutical Research & Development).

Classically – i.e. when we are not in an emergency mode – this process takes 10 to 15 years (Drug discovery, Ibid.) as shown in the picture below.

Then, even if we are lucky and manage to shorten the process – to how long? – we shall still need to manufacture the drug and then deliver it.

First, this explains why the current focus is on known drugs. Second, this highlights that totally new drugs may not help us on the short and even medium term.

This reminds us that major world pandemics, in the past, lasted not months, but years. Meanwhile, outbreaks happened across centuries. If ever, for antiviral treatments, hope is only in the discovery of a totally new medicine, then then waiting (actively) for a vaccine moved from being a pessimistic scenario to being an optimistic scenario.

Key elements to look for in an anti SARS-CoV-2 treatment and to inject in scenarios

Because an antiviral treatment can mix different drugs, posologies and approaches, sub-scenarios will need to include main elements impacting epidemiological models. To identify them, we used the model of the Imperial College COVID-19 Response Team in Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand, 16 March 2020. As a result, we shall also get the indicators we need to monitor candidate treatments.

We assume that, once a treatment is found, epidemiologists will relatively rapidly run their models and publish results. In turn, this will allow us updating our scenarios as well as their likelihoods.

The key elements to which we need to pay attention are as follows.

Impact on infectiousness

For example, the treatment could be given prophylactically to everyone, or to the contact cases of an infected person. In turn, the treatment could also lower the cases of asymptomatic or very mild symptomatic infections.

Impact on immunity

The impact of treatment on immunity after recovery from infection, on the short term and on the long-term needs to be evaluated.

Impact on severity of disease

If the treatment is given to symptomatic cases, we shall monitor if the treatment lowers the amount of patients developing severe, critical and fatal disease. This could twice decrease the pressure on the health system. Indeed, we would have less patients needing stays in hospitals. Furthermore, the duration of the stay in hospital could also diminish. Currently, the Imperial College COVID-19 Response Team estimates that we have:

“A total duration of stay in hospital of 8 days if critical care is not required and 16 days (with 10 days in ICU) if critical care is required. With 30% of hospitalised cases requiring critical care, we obtain an overall mean duration of hospitalisation of 10.4 days…”

Imperial College COVID-19 Response Team, Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand, 16 March 2020

Manufacturing and supply

Again, as for vaccine, the manufacturing of doses and their availability per country will need to be envisioned in detailed scenarios. Supply tensions are likely to emerge. As a result, we may possibly face international tensions. Should the quantity of the new drug be insufficient per country, then it would be interesting if epidemiological models were run according to possible supply.

New treatment(s) against the SARS-CoV-2 could offer any combination of the proprieties above. Ideally, epidemiological models or those built on them would also account for the feedbacks between non-pharmaceutical interventions, new treatments beneficial impacts and drug availability.

With the next articles, we shall continue to explore the factors that determine the architecture of our scenarios.


Bibliography

Tara Haelle, “Chloroquine Use For COVID-19 Shows No Benefit In First Small—But Limited—Controlled Trial“, Forbes, 25 marche 2020.

Tony Y. Hu, Matthew Frieman & Joy Wolfram, “Insights from nanomedicine into chloroquine efficacy against COVID-19“, Nature, 23 March 2020.

Xueting Yao, Fei Ye, Miao Zhang, Cheng Cui, Baoying Huang, Peihua Niu, Xu Liu, Li Zhao, Erdan Dong, Chunli Song, Siyan Zhan, Roujian Lu, Haiyan Li, Wenjie Tan, Dongyang Liu, In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Clinical Infectious Diseases, , ciaa237, https://doi.org/10.1093/cid/ciaa237

Adam Rogers, Chloroquine May Fight Covid-19—and Silicon Valley’s Into It, Wire, 19 March 2020.

Liu, J., Cao, R., Xu, M. et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitroNature, Cell Discov 6, 16 (2020), 18 March 2020. https://doi.org/10.1038/s41421-020-0156-0

Philippe Colson, Jean-Marc Rolain, Jean-Christophe Lagier, Philippe Brouqui, Didier Raoult, “Chloroquine and hydroxychloroquine as available weapons to fight COVID-19“, International Journal of Antimicrobial Agents (2020), doi: https://doi.org/10.1016/j.ijantimicag.2020.105932

Gautret et al. (2020) Hydroxychloroquine and azithromycin as a treatment of COVID‐19: results of an open‐label non‐randomized clinical trial. International Journal of Antimicrobial Agents – In Press 17 March 2020 – DOI : 10.1016/j.ijantimicag.2020.105949.

Guangdong Provincial Department of Science and Technology and Guangdong Provincial Health Committee Multi-center Collaborative Group on Chloroquine Phosphate for New Coronavirus Pneumonia, “Expert Consensus on Chloroquine Phosphate for New Coronavirus Pneumonia” [J]. Chinese Journal of Tuberculosis and Respiratory Medicine, 2020,43 (03 ): 185-188. DOI: 10.3760 / cma.j.issn.1001-0939.2020.03.009


Featured image: Image by Darko Stojanovic from Pixabay 


The Red (Team) Analysis Weekly – 26 March 2020

(Credit Image: ESO/P. Horálek)

As the Covid-19 spreads, it also invades all thoughts and permeates most issues and actions.

As a result, we kept the section on the COVID-19 pandemic for articles truly specific to the pandemic, such as confinement or possible second wave of outbreak, as well as for the struggle against related rumours.

Then we spread the signals according to usual categories. Thus, for example we have many signals related to the COVID-19 and economy, and as many to COVID-19 and international relations. For example, the pandemic is also now instrumental in the tension between the U.S. and China. It is also testing the EU, the sanction regime against Iran, could be used by Jihadists for new attacks or lead to new unrest, etc.

The COVD-19 has become – obviously – an issue in itself, an intensifying factor and probably a revealer.

Help us continue offering open access/free articles on the COVID-19
Donation – Fund Analysis for the War against COVID-19

The 26 March 2020 scan→

This is the 26 March 2020 issue of our weekly scan for geopolitical risks (open access). Read it below.

Using horizon scanning, each week, we collect weak – and less weak – signals. These point to new, emerging, escalating or stabilising problems. As a result, they indicate how trends or dynamics evolve.

Horizon scanning, weak signals and biases

We call signals weak, because it is still difficult to discern them among a vast array of events. However, our biases often alter our capacity to measure the strength of the signal. As a result, the perception of strength will vary according to the awareness of the actor. At worst, biases may be so strong that they completely block the very identification of the signal.

In the field of strategic foresight and warning, risk management and future studies, it is the job of good analysts to scan the horizon. As a result, they can perceive signals. Analysts then evaluate the strength of these signals according to specific risks and dynamics. Finally, they deliver their findings to users. These users can be other analysts, officers or decision-makers.

You can read a more detailed explanation in one of our cornerstone articles: Horizon Scanning and Monitoring for Warning: Definition and Practice.

The sections of the scan

Each section of the scan focuses on signals related to a specific theme:

  • world (international politics and geopolitics);
  • economy;
  • science including AI, QIS, technology and weapons, ;
  • analysis, strategy and futures;
  • the Covid-19 pandemic;
  • energy and environment.

However, in a complex world, categories are merely a convenient way to present information, when facts and events interact across boundaries.

The information collected (crowdsourced) does not mean endorsement.

Featured image: Milky Way above SPECULOOS / The Search for habitable Planets – EClipsing ULtra-cOOl Stars (SPECULOOS) is searching for Earth-like planets around tiny, dim stars in front of a panorama of the Milky Way. Credit: ESO/P. Horálek.