Category Archives: Health

Foreign Policy, Health, International Organizations, Politics

Peak 2020: An Apology to 2017

Readers of The Affiliate Network may recall that three years ago we dubbed 2017 “The Worst, Worst Year”. We were wrong and we owe an apology. 2020 has taken that title and expanded it beyond what most of us considered likely or even possible. The mysterious and terrifying pandemic and the economic tsunami that followed, triggered massive social, political, and economic upheavals around the world. Though the epoch-ending event is not exactly a “black swan” — many credible practitioners regarded it as a certainty — it will still leave a mark lasting decades and may permanently alter the course of human events.

The Worst

The world’s understanding of the novel Coronavirus, nCoV2, is that it emerged out of Wuhan, China in the waning weeks of 2019, and swept across the world like a wildfire. It turned human lungs to concrete, seemingly at random, and left paralysis and ruin in its wake. The contagion quickly spread to Iran before turning up in Italy, Spain, Belgium, France, and eventually New York. The time between the first reported cases in Wuhan to the day the World Health Organization declared Coronavirus 19 Disease (COVID19) a true pandemic: ten and a half weeks. At the time the WHO made the declaration there were 150,000 cases. Nine months later there are nearly 73 million.

A clue to the breathtaking speed of the contagion lies in the WHO declaration which cites “alarming levels of inaction” by the world’s governments. Reflecting a trend among democratic governments with populist tendencies; the leadership of Belarus, Brazil, Hungary, Great Britain, Sweden, the Netherlands, and most notably, the United States, chose to place short-term economic concerns above public health despite the terrifying data and the uncertainties about immunity, transmissibility, treatments, and fatality rates. Though the northern European governments (except Sweden) rapidly reversed course, the most bizarre and damaging response came from the White House itself.

The President of the United States, in a daily Coronavirus briefing, alternated between touting the aggressiveness of his personal response, to dismissing COVID as “just a flu”, a “hoax” perpetuated by his rivals, and even claimed it “would go away like a miracle.” He promoted myths and miracle cures, pushing the untested hydroxychloroquine and speculated that ingesting disinfectants and “powerful light” could be helpful, all while rejecting preventative measures such as masks and social distancing. The effect upon the United States was obvious. It soon led the world in every COVID statistic and has maintained that grim superlative ever since. What is less obvious, is that US leadership in this dubious regard has produced political headwinds for governments around the world struggling to get their populations to make sacrifices in the interest of public health.

The Rest

Though COVID certainly impacted quite literally everything in 2020, only Victor Perez Sañudo and Lino Miani wrote specifically about the disease in The Affiliate Network. While Mr. Miani made an early analysis of the virus’s potential impact on Africa in “The Cloud Over Africa“, Mr. Perez Sañudo explained how to manage COVID risk to business in “Back to Work“. For most of the rest of 2020 our content focused on the foreign policy moves of ascendent states seeking to capitalize on US retrenchment in the hands of an isolationist White House facing the impacts of the virus.

To some degree or another, Turkey, Russia, and China all pressed their advantages in the international arena this year. Dino Mora warned of Russian influence in Central America in “Educating Costa Rica“, while Mike Skillt, in “Why Russia Cannot Win“, introduced us to the Turkish-Russian struggle for dominance in Syria after the Trump Administration ceded the field. Our colleague Wolfgang Pusztai, one of the world’s most respected Libya watchers, pointed out that conflict is an expanding one. In “Libya: From Civil War to Regional Conflict” Mr. Pusztai describes the Turkish struggle for influence against a cast of actors that have interests there. Russia, he says, used the same ineffective strategy of proxy war it applied against the Turks in Syria. As we would soon see, Russia and Turkey would again glare at each other across the field of battle before the end of the year in Nagorno-Karabakh. With Russian proxies in combat on three sides of a NATO member state, Turkish foreign policy is a concern on a global level.

Meanwhile on the other side of the world, both Teoh Jit Khiam and Mr. Miani wrote repeatedly about developments in the South China Sea where Beijing seeks to set the facts on the ground to its advantage. Mr. Teoh’s “Between a ROC and a Hard Place” analyzed the costs and benefits of Taiwanese independence. He later walked us through the history of China’s relationship with the rest of the region in “The Malay Annals.” Lastly, Mr. Teoh capped off his performance with a fun “Alternate Futures” piece that presented a variety of triggers that could spark off a Sino-US conflict. Among the categories of event Mr. Teoh analyzed were “pre-planned actions that take place inside the South China Sea;” similar to the Sino-Indonesian row Mr. Miani wrote about in “Engulfing Natuna.” At the end of the year, Mr. Miani once again turned his pen to the region. In “Strategic Geography of the Internet,” he described efforts by the United States, Australia, Indonesia, and others to safeguard the web from Chinese dominance in the South China Sea. 

The Apology

After living through 2020 and observing its effects with a critical eye, we at the Affiliate Network feel we owe 2017 an apology. The events of 2020, shaped by COVID and made worse by some governments, have changed the game in so many ways. We can only go up from here and we are interested and excited to see what 2021 brings. Among our hopes for the new year are a return to predictability and stability in US foreign policy; a reinvigoration of US alliance relationships both in the North Atlantic and the Pacific; and an embrace of the technology and techniques for remote work that COVID forced upon us. If 2020 had any silver linings, it is up to us to make the most of them.

Lino Miani, CEO Navisio Global LLC

Lino Miani is a retired US Army Special Forces officer, author of The Sulu Arms Market, and CEO of Navisio Global LLC.

Europe, Health

Back to Work: Risk Management in a Time of COVID

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Due to the ongoing COVID-19 pandemic, governments worldwide have opted to confine citizens to their homes. Forcing physical distancing among the population is a strategy of risk avoidance geared towards reducing the likelihood of the virus’ transmission.

In these uncertain times, when so-called “non-essential businesses” are banned from operating, small and medium companies must begin planning now for their eventual return to normal operation once confinement is over. Enterprises with limited resources must become familiar with the concepts of crisis and risk management; otherwise, they risk remaining permanently shut down.

After governments worldwide passed emergency legislation to stop the virus’ spread, companies came face-to-face with the new reality of confinement, which severely restricted operations and displaced employees. One day however, this quarantine will be over and workers will have to return to the workplace. Before this happens, all companies should develop a well-assessed and gradual return to normalcy introduced through phases.

Phase 1 – Observation

After weeks of confinement, citizens and businesses alike might react like a bull charging into the arena once the ban is lifted. Being deprived of simple freedoms like interacting with family and friends drives the desire for returning to normalcy. However, relaxing restrictions and a false sense of security from the viral threat will increase the likelihood of disease transmission. A rise in new cases will follow people as they return to work.

Risk management requires establishing an observation period of the disease’s impact on those wishing to return to work quickly. This observation period is necessary to monitor how the situation evolves as well as to analyze best practices from around the world. This phase should last at least two weeks (the estimated quarantine period for COVID-19) after the end of confinement enforcement.

Phase 2 – Kick-Off

Businesses should not attempt to return to regular operation without a proper mitigation plan in place, especially as staff return to shared workspaces. Companies have a duty to ensure their staff stay healthy and should, therefore, plan additional protective measures.

Evaluate and analyze multiple risks, identifying the most suitable treatment strategies to minimize the existing uncertainty. These strategies should consider (among other things): the number and type of staff physically returning to perform essential tasks; employees in specific risk groups (such as the elderly or those with pre-existing health conditions); and the returning staff’s willingness to share spaces. Managers should plan for shift work for selected staff; know how staff commute to work and develop plans to mitigate the risks of public transportation; and establish protocols for decontamination of public areas and use of personal protection equipment.  Managers should continuously review and draft new processes and operating procedures as the world learns more about this virus.

Phase 3 – Presence Escalation

A business’s most valuable resource is its staff and should avoid putting all of its assets at risk. As companies recover, gradually allowing employees to return while others continue to telework is a valuable strategy.

Additionally, preserving a clean working environment is more vital than ever. Any employee or third-party entering the workplace poses a risk of disease transmission and contamination. New standard operating procedures should include separate decontamination protocols for visitors and be strictly enforced. Social distancing inside the working environment should also be clearly defined and incorporated into these procedures.

Eventually, additional risk mitigation procedures, such as COVID-19 antibody tests that can indicate a person’s immunity to the disease, will be available to the general public. Until then, the above strategies will help prevent a resurgence of the disease as employees gradually return to work. This phase could take weeks or even months but should be completed before any return to full operational capacity.

Phase 4 – Long-Term Treatment

Western countries must enhance preventative measures and modify risk tolerance towards health crises. This means changing our social, cultural, and work habits, especially towards personal hygiene and proximity to others.

Most forecasting at the beginning of this crisis proved to be wrong or imprecise. It is difficult to forecast what may come in the next months, but health specialists believe a second, and even recurrent waves of COVID-19 infections could occur. We can only assume that access to tests and vaccines will be made available in the near term. However, we are not there yet, and other risk avoidance strategies must remain in place for now.

Proper planning for a return to normalcy is necessary as solidarity soars, and we prepare to weather this storm together.

Victor Perez Sañudo is a Law Enforcement Officer with over two decades of professional experience in security and risk management worldwide, having worked for the EU, NATO, OSCE and the United Nations in the five continents. Victor is certified Risk Management Professional C31000 by ISO 31000:2018 and certified Director of Security by the Spanish Ministry of Interior.

Africa, Health

The Cloud Over Africa: Corona Virus

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As the 2019 Corona Virus Disease ravages the most developed economies of the world, Africans wait for its inevitable arrival on their shores. The prospect of an extremely virulent and deadly respiratory disease like COVID getting loose on the continent causes a great deal of trepidation. Africa has some of the poorest and least developed health infrastructure on the planet. In parts, its societies are ravaged by malaria, polluted environments, war, and poverty stricken cities with some of the highest population densities in the world. Africa lags behind the rest of the globe in nearly every measurable medical statistic. If and when COVID takes hold there, it seems inevitable it will quickly overwhelm health services and attack an unprotected population as it is doing in Bergamo, New York, and Madrid. COVID may seem like a dark cloud hanging over all of us but perhaps it is just a bit darker over Africa.

The reality is, COVID has already arrived on African soil. As of 2 April there were over 6200 confirmed cases in 51 African countries. Though the vast majority are in just three nations: South Africa, Algeria, and Egypt; distribution across the continent is spreading quickly. Hundreds of cases in Africa’s poorest and least stable countries are perhaps cause for even greater concern. In one example of what could lie ahead, 8.9 percent of the total cases in the Democratic Republic of Congo have already died of the disease.

The State of Africa

Africa holds a precarious position when it comes to health infrastructure that matters in the fight against COVID. Last in almost every measure, only three of Africa’s 54 nations (Mauritius, Libya, and Tunisia) have more than one doctor per 1000 citizens. Only twelve have more than one hospital bed per 1000 citizens and none of those are the densely populated countries around the continent’s periphery. By comparison, Italy, scene of one of the world’s worst COVID outbreaks, has 3.4 hospital beds per 1000. The numbers do not favor the sick.

Diseases like COVID spread faster in areas of high population density and Africa’s urban population tends to be very densely packed. Cities in the Sahel and West Africa have around 5000 residents per square kilometer. The large cities on the Mediterranean averaging about 8000. Cairo, Kinshasa, Mogadishu, and Asmara top the list with 15,000-25,000 people per square kilometer. (By contrast, Washington DC has only about 4000 per square kilometer.)

Though sparse population will slow the disease’s progression in the vast rural parts of Africa, those are precisely the areas with the least access to modern sanitation and health care. A 2012 study by the World Health Organization found 17.9% of respondents in all the sites surveyed, depended on traditional healers for their primary health care. Worse, some of these areas feature migratory populations that could continue to spread COVID for years.

Africa is not ready for Corona Virus
Disease tracking technology in a remote part of the Sahel. African states are poorly prepared for the onslaught of Corona Virus Disease.

Corona Virus Cloud

In more developed parts of the world, governments have the capacity to significantly impact the spread of COVID. Aside from health measures that directly prevent spread of the virus, such as issuing personal protective equipment for health workers, and organizing vast testing regimes, strong states can also enforce effective social distancing measures. Most African states however are not so capable and in some cases lack credibility with their own constituents. Most African governments are not even trying at this point.

In an effort to quantify and compare government responses to the pandemic, the Blavatnik School at Oxford University developed a system to combine 11 indicators into a common “stringency index.” As of 31 March, only seven African nations even registered on the index and of those, only two (Rwanda and Zimbabwe) had more stringent responses than the United States whose response is on the low end of the scale.

It is clear a disaster looms in Africa in the coming weeks. The situation leaves little reason to believe African cities will be spared the dramas we see in Bergamo, Guayaquil, and Madrid, but with far less ability to deal effectively with the results. In rural areas the disease may progress more slowly with a significantly flattened curve but with almost no modern health infrastructure in place in some areas, there is little chance the disease will even be tracked let alone treated. With so many countries around the world overwhelmed by the pandemic, hoping for international aid seems forlorn. Africa will be on its own.

On a continent that remembers the responses to Ebola and Middle East Respiratory Syndrome (MERS), COVID hangs like a dark cloud on the horizon. Perhaps the only ray of light is that Africa’s cities, as unprepared as they are, may actually arrive at an equilibrium with the disease — sometimes called “herd immunity” — far sooner than European and American cities will. Reaching that point however will incur a cost in lives and pain that few can foresee and none deserve.

Lino Miani, CEO Navisio Global LLC

Lino Miani is a retired US Army Special Forces officer, author of The Sulu Arms Market, and CEO of Navisio Global LLC.