Why It's Too Early to Tell If Remdesivir Cures Coronavirus We have only gotten results from the preliminary study. by Nial Wheate and Andrew Bartlett

The race is on to find a drug that is both effective and safe for treating COVID-19, which has spread to 3.1 million infections and caused 220,000 deaths worldwide. 

This week, the US National Institute of Allergy and Infectious Diseases released findings of a clinical trial of the experimental antiviral drug remdesivir. This showed COVID-19 patients recovered more quickly and had an improved survival rate when taking the drug, compared with those given a placebo and standard care.

But these are just the preliminary results of one study. Other human trials have not shown similar results. Further trials are under way and will more definitively show whether remdesivir is a suitable and effective treatment for COVID-19.

What is remdesivir?

Remdesivir is an experimental antiviral drug being developed by Gilead Sciences. Originally it was being developed as a treatment for Ebola, a viral infection that causes severe internal bleeding. But researchers are now interested in its potential to treat patients with COVID-19.

Remdesivir mimics a natural ingredient called adenosine of DNA and RNA, the latter being a molecule similar to DNA that is used to carry the genetic information of viruses. After the drug is activated in the body, it works by blocking a type of enzyme called a polymerase, which is needed to make DNA and RNA.

When you block the enzyme, the virus can’t make copies of itself, limiting the development of symptoms and spread of the disease.

It should be noted that no drug is perfectly safe, and remdesivir is no different. Studies undertaken so far suggest the drug may damage the liver and cause other short-term side effects such as nausea and vomiting.

These side effects need to be taken into consideration when treating COVID-19 patients who have other underlying conditions.

Clinical trials in US positive but only preliminary

This week the National Institute of Allergy and Infectious Diseases (NIAID) released the results of its trial using remdesivir for COVID-19 patients. They studied the effects of the drug on patients who were already infected with COVID-19 to see whether it helped them recover faster and improve their survival rate.

Adult patients hospitalised with COVID-19 were given daily injections of remdesivir. They were found to recover four days faster, an improvement of 31%, when compared with other patients who only received standard care and placebo.

The results also indicated that more patients survived the infection with remdesivir treatment, with the death rate dropping from 11.6% to 8%.

The results are significant enough that director of NIAID Anthony Fauci said it was an “ethical responsibility” for the remaining trial patients who were taking the placebo to be switched to the active drug.

But we need to treat the results of this trial with caution; for the moment they are only preliminary.

A data and safety panel has looked at the initial results, but they haven’t been peer-reviewed. During peer review, independent experts from the scientific community scrutinise the study design, methods, data produced, and the conclusions before the study is published in a medical journal.

How does it compare with other studies?

The results of other trials, such as one undertaken in China, have not shown the same promising results.

The Chinese study was published in the Lancet, considered one of the most influential medical journals in the world. This trial was a randomised, double-blind, placebo-controlled study which means that neither the researchers nor the patients knew if they’d been given the active drug or a placebo.

These types of studies can reduce some biases that can influence studies, but also help quantify the effectiveness of the drug.

But the study also had limitations that need to be recognised. The patients were not as seriously ill as those in the NIAID trial, and the study was terminated early because the outbreak in China was easing.

In the end, the study only collected data on 237 patients, compared with 1,063 patients in the NIAID trial. The authors acknowledge further study is needed in more seriously ill patients and with a larger sample size.

Currently there are more than a dozen other clinical trials of remdesivir and COVID-19 being undertaken throughout the world. We need to await the data to know for sure whether the drug is as effective as we need it to be.

How Can Your Phone Tell You If You've Been Exposed to the Coronavirus? Apple and Google have created an exposure notification system. by Johannes Becker and David Starobinski

On April 10, Apple and Google announced a coronavirus exposure notification system that will be built into their smartphone operating systems, iOS and Android. The system uses the ubiquitous Bluetooth short-range wireless communication technology. 

There are dozens of apps being developed around the world that alert people if they’ve been exposed to a person who has tested positive for COVID-19. Many of them also report the identities of the exposed people to public health authorities, which has raised privacy concerns. Several other exposure notification projects, including PACT, BlueTrace and the Covid Watch project, take a similar privacy-protecting approach to Apple’s and Google’s initiative.

So how will the Apple-Google exposure notification system work? As researchers who study security and privacy of wireless communication, we have examined the companies’ plan and have assessed its effectiveness and privacy implications.

Recently, a study found that contact tracing can be effective in containing diseases such as COVID-19, if large parts of the population participate. Exposure notification schemes like the Apple-Google system aren’t true contact tracing systems because they don’t allow public health authorities to identify people who have been exposed to infected individuals. But digital exposure notification systems have a big advantage: They can be used by millions of people and rapidly warn those who have been exposed to quarantine themselves.

Because Bluetooth is supported on billions of devices, it seems like an obvious choice of technology for these systems. The protocol used for this is Bluetooth Low Energy, or Bluetooth LE for short. This variant is optimized for energy-efficient communication between small devices, which makes it a popular protocol for smartphones and wearables such as smartwatches.

Bluetooth LE communicates in two main ways. Two devices can communicate over the data channel with each other, such as a smartwatch synchronizing with a phone. Devices can also broadcast useful information to nearby devices over the advertising channel. For example, some devices regularly announce their presence to facilitate automatic connection.

To build an exposure notification app using Bluetooth LE, developers could assign everyone a permanent ID and make every phone broadcast it on an advertising channel. Then, they could build an app that receives the IDs so every phone would be able to keep a record of close encounters with other phones. But that would be a clear violation of privacy. Broadcasting any personally identifiable information via Bluetooth LE is a bad idea, because messages can be read by anyone in range.

Anonymous exchanges

To get around this problem, every phone broadcasts a long random number, which is changed frequently. Other devices receive these numbers and store them if they were sent from close proximity. By using long, unique, random numbers, no personal information is sent via Bluetooth LE.

Apple and Google follow this principle in their specification, but add some cryptography. First, every phone generates a unique tracing key that is kept confidentially on the phone. Every day, the tracing key generates a new daily tracing key. Though the tracing key could be used to identify the phone, the daily tracing key can’t be used to figure out the phone’s permanent tracing key. Then, every 10 to 20 minutes, the daily tracing key generates a new rolling proximity identifier, which looks just like a long random number. This is what gets broadcast to other devices via the Bluetooth advertising channel.

When someone tests positive for COVID-19, they can disclose a list of their daily tracing keys, usually from the previous 14 days. Everyone else’s phones use the disclosed keys to recreate the infected person’s rolling proximity identifiers. The phones then compare the COVID-19-positive identifiers with their own records of the identifiers they received from nearby phones. A match reveals a potential exposure to the virus, but it doesn’t identify the patient.

Most of the competing proposals use a similar approach. The principal difference is that Apple’s and Google’s operating system updates reach far more phones automatically than a single app can. Additionally, by proposing a cross-platform standard, Apple and Google allow existing apps to piggyback and use a common, compatible communication approach that could work across many apps.

No plan is perfect

The Apple-Google exposure notification system is very secure, but it’s no guarantee of either accuracy or privacy. The system could produce a large number of false positives because being within Bluetooth range of an infected person doesn’t necessarily mean the virus has been transmitted. And even if an app records only very strong signals as a proxy for close contact, it cannot know whether there was a wall, a window or a floor between the phones.

However unlikely, there are ways governments or hackers could track or identify people using the system. Bluetooth LE devices use an advertising address when broadcasting on an advertising channel. Though these addresses can be randomized to protect the identity of the sender, we demonstrated last year that it is theoretically possible to track devices for extended periods of time if the advertising message and advertising address are not changed in sync. To Apple’s and Google’s credit, they call for these to be changed synchronously.

But even if the advertising address and a coronavirus app’s rolling identifier are changed in sync, it may still be possible to track someone’s phone. If there isn’t a sufficiently large number of other devices nearby that also change their advertising addresses and rolling identifiers in sync – a process known as mixing – someone could still track individual devices. For example, if there is a single phone in a room, someone could keep track of it because it’s the only phone that could be broadcasting the random identifiers.

Another potential attack involves logging additional information along with the rolling identifiers. Even though the protocol does not send personal information or location data, receiving apps could record when and where they received keys from other phones. If this was done on a large scale – such as an app that systematically collects this extra information – it could be used to identify and track individuals. For example, if a supermarket recorded the exact date and time of incoming rolling proximity identifiers at its checkout lanes and combined that data with credit card swipes, store staff would have a reasonable chance of identifying which customers were COVID-19 positive.

And because Bluetooth LE advertising beacons use plain-text messages, it’s possible to send faked messages. This could be used to troll others by repeating known COVID-19-positive rolling proximity identifiers to many people, resulting in deliberate false positives.

Nevertheless, the Apple-Google system could be the key to alerting thousands of people who have been exposed to the coronavirus while protecting their identities, unlike contact tracing apps that report identifying information to central government or corporate databases.

America's Coronavirus Nightmare: Debt, Deflation and Mass Unemployment And the fed alone can't mitigate it. by Desmond Lachman

If before today’s grim unemployment numbers Federal Reserve Chair Jerome Powell had reason to worry about engineering a post-coronavirus U.S. economic recovery, he now has even more reason for concern.  

Today’s unemployment numbers have to remind him that the U.S. economy has entered waters unchartered in the post-war period. It also has to be worrying him that we could soon be revisiting economic challenges similar to those last faced by the United States in the 1930s.

Not even during the Great Depression did unemployment increase at nearly as rapid a pace as it is now doing. Over the past six weeks, as the country has been locked down, a staggering 30 million or around one in five American workers has been forced to file for unemployment benefits. It is all too likely that before the lockdown is lifted, the U.S. unemployment rate will peak at well above 20 percent of the labor force. 

Equally troubling is the likelihood that U.S. unemployment will remain unusually high for a prolonged period of time as the economy stages only a gradual recovery as it did after the 2008 Great Economic Recession. According to the Congressional Budget Office, by the end of 2021 U.S. unemployment is likely only to have declined to 10 percent.

There would never have been a good time for the U.S. to experience very high unemployment. However, it is particularly not a good time to have unemployment rising sharply when as today inflation is stubbornly low, when the country’s debt level is high, and when the country is running a large budget deficit.

With unemployment and excess capacity likely to remain unusually high for a prolonged period of time, we must now expect considerable downward pressure on wages and prices. Starting from a very low inflation rate, such downward pressure makes it all too likely that we will revisit the debt-deflation problems of the 1930s. 

Deflation would be the last thing that Jerome Powell now needs as he tries to kick start the economy with lower after-inflation interest rates. Indeed, he will very likely find that his efforts at cutting interest rates will largely be negated by falling prices. He will also likely find, as Japan has found over the past two decades, that in a world of falling prices, consumers and corporations tend to delay spending in the hope that they will acquire their purchases at even lower prices in the future. 

Deflation could constitute yet another headache for Mr. Powell in that it would exacerbate the country’s debt problem. If prices and incomes were to fall, both households and corporations would find it all the more difficult to meet their debt service obligations. That, in turn, would heighten the chances that we will soon see a wave of household and corporate bankruptcies that will put considerable strain on the U.S. financial system.

Needless to add, deflation will also make it difficult for the government to dig itself out of its deficit and debt problem. This is all the more to be regretted considering how parlous is the state of the country’s public finances. According to the Congressional Budget Office, the U.S. budget deficit is likely to reach a record 17 ½ percent of GDP in 2020 before receding to around 10 percent of GDP in 2021. That, in turn, will cause the public debt to rise to a troubling 108 percent of GDP by end-2021.  

Hopefully, the Trump Administration and Congress will recognize the limits that the Federal Reserve faces today to get the U.S. economy moving again. In a world of falling prices and with interest rates already at their zero bounds, the Fed’s interest rate instrument has lost much of its potency. Meanwhile, if the Fed finds that companies and households are facing solvency as opposed to liquidity problems, there is not much that the Federal Reserve can do to prevent them from falling by increasing its lending.

All of this suggests that if in the months ahead a faltering U.S. economic recovery finds that it needs more policy support, such support must necessarily come from budget policy rather than from the Federal Reserve.

Life After Kim Jong Un: What are the Next Steps for North Koreans? The totalitarian dictatorship of North Korea does not disappear with the death of Kim Il-sung, Kim Jong-il, or Kim Jong-un, just like totalitarianism or the fall of Nazi Germany. by Jihyun Park

Joseph Stalin’s communism, the Nazi’s extreme form of totalitarianism, or the totalitarianism aspects of the killing fields seem to have ended, but totalitarianism remains a prominent part of the North Korean people’s lives.  

This is because totalitarianism is not a system but rather a movement conveyed by propaganda. 

As soon as a dictatorship is welcomed, those who represent the interests of a particular class or group, oppress the people with a strong dictatorship, seize the power with dictatorship totalitarianism and as a result the people lose their freedom.

North Korea’s totalitarian rule is a very different rule from other kinds of dictatorships that history has experienced so far. 

The most repressive totalitarianism known to mankind is Stalin's dictatorship of Bolshevism and Hitler’s Nazi regime, which systematically slaughtered six million Jews to ultimately solve “Jewish problems.”

The Stalinist Bolshevik regime suppressed people thoroughly by oppressing them as a political means to firmly solidify the Soviet state system and operate the forced labor camp, Gulag. 

According to Soviet records, about one million people died from 1934 to 1953, but it is estimated that six to fifteen million people actually died.

With the fall of the two regimes, the totalitarian system should have also disappeared, but, still, it remained. 

North Korea is the only remaining totalitarian dictatorship on Earth that completely controls the public and private lives of citizens through a totalitarian dictatorship.

Kim Il-sung, who entered the Joseon Dynasty with the Soviet power in 1945, began a Stalinist dictatorship. In 1956, he erased the Stalinist totalitarianism and started the Kim Il-sungsik dictatorship.   

Kim Il-sung is the father of Juche. Juche verges on being the opposite of Marxism and its ideology is the system of slavery.   

Kim’s totalitarian “democratic centralist” people became his machine for enforcing collectivism.  

Kim Il-sung instilled the entire society into a society with Kim Il-sung’s ideology and instilled excessive political ambitions and actions into society so that people have faith in his ideology, as in the Soviet Gulag. 

People lived and worked under harsh conditions with a high death rate and spent their free time memorizing Kim Il-sung. 

On July 8, 1994, when Kim Il-sung died, North Koreans were saddened by the death of “the God” and many thought the country of North Korea would collapse in a few years.

However, Kim Jong-il’s brutal totalitarian dictatorship continued, and thousands of people starved, froze to death, and even crossed the third country to end up dying in an unknown place.

Meanwhile, Dictator Kim is making nukes and missiles, committing cyber-terrorism and making chemical weapons that threaten the world, regardless of people’s deaths. 

In the present, the world is paying attention to what will happen to North Korea as Kim Jong-un’s health theory begins, but North Korea is a terrorist nation that has existed on the planet, maintaining seventy years of dictatorship through totalitarian propaganda. 

The totalitarian dictatorship of North Korea does not disappear with the death of Kim Il-sung, Kim Jong-il, or Kim Jong-un, just like totalitarianism or the fall of Nazi Germany. 

History remembers Mao Zedong’s cultural revolution, the Cambodian Khmer Rouge regime, and Rwandan terrorism, while still forgetting the brutal totalitarian genocide of North Korea in the twenty-first century. 

The death of Kim Jong-un should abandon the expectation that North Korea’s dictatorship will collapse in a day; the collapse of North Korea can only be achieved by North Koreans. 

Enlightening North Koreans who live under the same sky but look at different skies after being brainwashed through the country’s education system for over seventy years is the most beneficial and quick way to ensure the safety of the world and the collapse of the North Korean regime. 

The Invisible, the people who are not socially aware and who do not belong to those who are on Earth, were in the Universal Declaration of Human Rights. 

The stories we tell, the actions we are doing, are invisible to them. 

Since they were born in North Korea, into a country with no religion, color, or language, they became people who were no longer interested in anyone other than their warmongering and murderous leaders.

Remembering North Koreans and liberating the country’s slaves is the answer to the collapse of its regime, and it is also a way to root out the only totalitarian dictatorship left on the planet. 

I Was On the Front Lines Of Ebola, And I Know What Coronavirus Nurses Need If nurses don’t take care of themselves, how will they be able to care for others? by Cheedy Jaja

Since the beginning of the profession, nurses have played pivotal roles during outbreaks of disease, delivering care throughout even the bleakest of public health emergencies.

Here’s my story: In 2014, the world was slowly recognizing that the Ebola outbreak in West Africa was monumental in scale and getting worse. More than 30,000 were infected, and 11,000 would die. Transmitted from person to person, the disease was mostly in Sierra Leone, Guinea and Liberia. As local health care systems struggled to respond to the large cases of infected patients, nurses from around the world came to help; I was among them. I am an associate professor of nursing at the University of South Carolina College of Nursing and a board certified psychiatry and mental health advance nurse practitioner.

When our team arrived in Sierra Leone in December, 2014, there were 450 cases being recorded weekly. The health care infrastructure had been devastated by a decade of civil war, and it lacked trained health care workers, medical supplies and hospital beds for the surging Ebola cases.

I was drawn to serve in Sierra Leone at the height of the epidemic because of the duty to care that we nurses believe is part of our profession. I felt a calling even though I had no idea what I could offer. But I would do whatever was asked of me.

Protective equipment that felt like body armor

I remember vividly the first day I donned my personal protective equipment (PPE) – hooded Tyvek bodysuit, N-95 face mask, boot, theater cap, three pairs of gloves, face shield and apron – to enter the Ebola isolation unit at Port Loko Hospital early Christmas Day 2014, only to encounter a young patient who had died overnight, lying on the cold concrete floor. The cacophony of emotions I felt – panic, fear and dread were palpable. I thought to myself, “God, I am no hero. Please get me out of here.”

As my initial fears subsided, I put my clinical skills to work. For two months, our team worked round the clock providing palliative care and psychosocial support to patients with dwindling clinical resources, constantly evolving treatment protocols, in a frighteningly dire work environment. In that sense, Ebola was also a disease of the caregiver. As health care workers, we knew we were more likely to be infected with Ebola than adults in the general population. There was no vaccine.

A constant existential feeling of unsafety and heightened sense of doom enveloped the Ebola hospital. Yet each day, we went through the meticulous process of donning and doffing PPE to assess confirmed Ebola patients, perform physical exams, provide medication, keep them hydrated and cajole them to eat. We would repeat this process three to four times each 12 hours shift.

Performing these tasks required careful deliberation. PPE are difficult to walk and to bend in. With daily temperature in the region reaching 100 degrees Fahrenheit, we were instantly drenched with our sweat. Our goggles fogged up, hampering visibility; double gloving interfered with our dexterity, and our hoods made use of stethoscope impossible. Patient assessment was sub-par and care was limited. Our patients could not see our faces, limiting ability to show empathy and establish human connections. We were terrified about safety, about getting infected. But no one saw our fear; it was our job to conceal it.

And on we worked. It was only years later that I realized the toll that the Ebola epidemic had taken on me. At the peak of the epidemic, we had an average census of 70 confirmed cases daily. Ebola was ruthless on children. For every 10 infected kids under 12 months of age, nine died. For every 10 kids under five years, seven were likely to die.

A look back, in wonder

In retrospect, I wondered: Was I truly prepared for the mental pressure and anguish health care workers faced in an epidemic? While cognizant of the “duty to care,” was I oblivious to the “duty to self-care”?

Nurses have an ethical obligation to care for themselves. If nurses don’t take care of themselves, how will they be able to care for others? I did not ask the crucial question before heading to Sierra Leone: Did I have the appropriate “nursing preparedness” required in a disease epidemic?

I did not ask this question because I did not anticipate how the media hysteria over Ebola would affect my mental well-being. I did not anticipate the stigma, simmering anger and deep sense of betrayal surrounding monitoring and quarantining of returning volunteer health care workers from West Africa. I did not anticipate the psychological trauma, confusion, anger and sadness I would experience during state-mandated isolation.

As hospitals across the U.S. have ramped up diagnostic and treatment capacity for the coronavirus pandemic, it is imperative that our society also focuses on nurses’ preparedness. During disease outbreaks, nurses’ levels of preparedness and experience help them decide adroitly how much care they can provide to patients while also taking care of themselves. Nursing preparedness is a set of skills, abilities and knowledge that enables nurses to respond and prepare for varying public health emergency roles.

Preparedness training is supposedly integrated into nursing curriculum with a focus on principles of disaster management. However, studies have shown that nurses remain inadequately prepared to respond to infectious disease outbreaks. Lack of a formal institutional preparedness plan may result in delays in initiation of treatment by nurses.

The misdiagnosis of the first Ebola patient in a hospital in Dallas, Texas in 2014, combined with two nurses contracting the disease while caring for the patient, is a classic example of lack of institutional preparedness in responding to a novel disease.

Education and training are critical to preparedness during disease outbreaks. Evidence‐based recommendations to enhance nurses’ preparedness include opportunities to engage in emergency preparedness planning, mock drills and actual events when possible to increase competence in disaster management, confidence in abilities, and familiarity with disaster preparedness protocols.

Given the increase in prevalence in recent years of natural and human-induced emergency events, it is imperative that nurses understand their roles in the planning, mitigation, response and management aspects of disease outbreaks at the community, national and global levels. Studies have shown that nurses feel ill-prepared to respond effectively to disease epidemic and disaster situations.

Institutional support

During an epidemic, nurses are likely to acquire new roles and perform unaccustomed tasks, often extending themselves beyond their expertise, scope and comfort level. Nurses could encounter unanticipated challenges like a shortage of needed resources, such as personal protective equipment, infection control material resource and inadequate facilities that could adversely hamper the quality of health care service delivery.

This was our reality fighting Ebola in Sierra Leone. To prevent the same thing happening here, local hospitals and health care centers should include nurses in resource triaging to ensure accurate identification of front-line priorities in maintaining core nursing services.

Nurse should not work in uncertain, unsafe and morally distressing conditions with limited resources. The adverse consequences on nurses’ short- and long-term mental health could be significant. Establishing a supportive atmosphere at the front-line is of paramount importance. Specific interventions to promote psychological well-being should be implemented as part of ongoing support from health care institutions.

Nurses more than any other health care workers, constitute the major taskforce in responding to the disease outbreaks. For their sake and society, they need institutional support to ensure that they are trained, well prepare and ready to step into an epidemic response role.

The Looming Crises in North Korea: Coronavirus, Starvation and a Nuclear Test “We will know soon enough what is going on with Kim Jong-un. However, for now, one thing is very clear. North Korea is on the precipice of crisis—from wide-spread illness and starvation or from a nuclear provocation that escalates into a disastrous miscalculation. We can choose to ignore past lessons when perhaps millions died before in North Korea, but I cannot.” by Philip W. Yun

In the midst of a world engulfed in pandemic, economic meltdown and distracting speculation over Kim Jong-un’s health, we are in danger of missing two new crises to come: (1) an overwhelming cycle of disease and famine in North Korea; as well as (2) a seventh North Korean nuclear weapons test.  Both possibilities ominously signal what we don’t need more of — major instability in Northeast Asia which risks miscalculation and possibly war. 

As a former State Department official, I bore witness through cables and media reports to the North’s 1990’s famine, and during official trips to Pyongyang, I saw the heavy toll of mass starvation on the faces of Pyongyang’s residents. Reportedly millions died. As a second-generation Korean-American, I promised myself then that I would not let another similar tragedy unfold without sounding the alarm. 

Pyongyang has proudly declared that it has no COVID-19 cases. Few believe this is true. Even with comprehensive social distancing and draconian quarantine measures, we know that viruses respect no borders. So even taking the regime’s assertions at face value, it is only a matter of time before the disease mounts its own kind of invasion.  

In the case of COVID-19, North Korea’s citizenry is particularly susceptible to a devastating outbreak. Decades of malnutrition have left the population’s health and immunity compromised. North Korea’s persistently high rates of respiratory diseases like tuberculosis show the country is not capable of dealing with these types of sicknesses at any scale. Where international sanctions are stringent and the economy sputtering, domestic shortages are chronic -- the country will have few personal protective equipment (PPE), ventilators and other medical basics. Rather than request international assistance, its mistaken priority to keep the country under control will likely delay an effective response until it is too late.  

To make matters worse, North Korea may soon be facing more food shortages. The challenge is daunting even in normal times. But during a pandemic, who will plant, harvest and process badly needed grains if all are sheltering or ill?

When faced with a crushing combination of large-scale malnutrition and COVID-19, the regime will do what it always does when it doesn’t have proper tools — it will triage. North Korea will devote precious resources to its privileged and not to everyday North Koreans, leaving them to simply die either from disease or lack of food. Regardless, the loss in human life could be shocking and threatening to the regime’s very existence.

Adding to this morass is the high likelihood that North Korea will test another nuclear device.  Here’s why:

First, Kim Jong-un was embarrassed by last year’s summit in Hanoi because the North’s leaders had high expectations for concrete gains (like sanctions relief); yet nothing came. Relations with the U.S. are dead. Kim’s highly publicized remarks in December 2019 have arguably rejected diplomacy while simultaneously bracing the country for greater hardship and possible provocations. With a population under pressure, Kim will do what many political leaders do when stressed, internally rally his country by touting an outside threat. 

Second, the North’s leaders are skilled at making the country’s weakness an asset, usually by resorting to nuclear extortion to draw international benefits. We can expect more of this. More troubling, however, is North Korea’s tendency to double down and show “strength” during unusual internal turmoil – usually in the form of a deliberate warning to adversaries to back off and leave the country alone. If Kim Jong-un is ailing or dead, then this incentive becomes even greater for those in charge and a nuclear test more certain.

Third, there is a technical imperative. To produce a truly operational nuclear device, North Korea must test again. Undoubtedly, its military is aggressively lobbying for another test because it sees a nuclear weapon as the best guarantee against invasion and attack.  

Finally, there is perhaps a no better time to conduct a test than this year. Governments around the globe are mired in and distracted by a pandemic and the prospect of world-wide depression. Ever opportunistic, the North could very well calculate the international political costs of a nuclear test as minimal. 

So what do we do?

Having contained COVID-19, South Korea has the means and know-how to help the North; its President Moon Jae-in, the will. The U.S. needs to set aside differences with the South over security costs and fully support upcoming peace and humanitarian initiatives that are sure to come. The U.S. must then work with the WHO and others, like Japan, Russia, and China, to put together a comprehensive approach that will augment South Korean efforts. While a decision to conduct a nuclear weapons test or some other provocation is solely up to North Korea, there is a small chance, and one worth taking, that American willingness to help the North during a time of dire need may create an opening to somehow persuade the North to forego a test. Lastly and perhaps most importantly, the U.S. must lead. We can’t do everything, nor should we, but our role in the world, I believe, remains essential.

We will know soon enough what is going on with Kim Jong-un. However, for now, one thing is very clear.  North Korea is on the precipice of crisis -- from wide-spread illness and starvation or from a nuclear provocation that escalates into a disastrous miscalculation. We can choose to ignore past lessons when perhaps millions died before in North Korea, but I cannot. 

Is the Coronavirus Ushering in an Era of Eurosceptic Leaders? The pandemic could very well be a watershed moment in European politics. by Spencer Wong

Euroscepticism’s a brewin’…or at least it seems that way. 

The European Union (EU) in the era of coronavirus appears to be facing challenges to its existence not experienced since the fallout of the 2008–09 financial crisis. Indeed, the coronavirus pandemic could very well be a watershed moment in European politics. 

Why is this the case? Well, one can only look at how the European Union and its member states have responded to the pandemic. Unlike what would be expected in a union, Brussels and member states’ capitals have largely gone their own way, pursuing ad hoc, national approaches. Politico reporters David M. Herszenhorn and Sarah Wheaton note “EU nations, despite their pledge to an ever-closer union, reacted selfishly and chaotically once the threat became evident.” 

During the early stages of the pandemic in Europe, EU leaders and heads of government did not take the virus seriously, even as it was spreading beyond China. The European Commission, led by Ursula von der Leyen, was slow to respond to the unfolding health crisis and belatedly expressed solidarity with and provided assistance to Italy. In President von der Leyen’s March 9 press conference on her first one hundred days in office, the coronavirus was barely discussed. Understandably, however, the EU was simultaneously focused on coronavirus and the recent migrant crisis along the Turkey-Greece border. 

Nevertheless, the actions of both the EU and its member states have brought into question whether aspirations of unity and solidarity can truly bind together the twenty-seven countries. While the pandemic has necessitated that countries develop their own solutions, appropriate for their specific national and local conditions, the EU-27 could have done more to coordinate their efforts. 

Today, Europe stands as one of the epicenters of the pandemic, with around a million cases just among the five most populous countries. They have been among the hardest-hit countries, although in certain countries, the number of cases is beginning to plateau.

Prior to the outbreak of coronavirus, Euroscepticism was a major political force in European politics. Euroscepticism is defined by Encyclopedia Britannica as a “European political doctrine that advocates disengagement from the European Union (EU). Political parties that espouse a Eurosceptic viewpoint tend to be broadly populist and generally support tighter immigration controls in addition to the dismantling or streamlining of the EU bureaucratic structure.”

This political force comes in a variety of flavors, depending on the country in question. But the underlying factor behind it is a dissatisfaction with what the European Union is and how it functions. The most recent manifestations of Euroscepticism have emerged out of the 2008–09 financial crisis and the 2015 migrant crisis.

The 2008–09 financial crisis, among other issues, brought once-fringe political parties, such as Britain’s UKIP and Italy’s Five Star Movement (M5S) to the political spotlight. Europe’s South was particularly hit hard, with Portugal, Italy, Greece, and Spain facing their worst economic performances in decades. Unemployment rose sharply and the European Union imposed a fiscal policy of austerity. These conditions fomented the rise of Eurosceptic parties across the continent, but particularly in the South, leading to a North-South divide.

Meanwhile, the 2015 migrant crisis opened up additional cracks among EU member states. While Germany, France, and Sweden were among the more receptive countries to migrants and refugees, other countries were not. Among the post-communist EU states, Euroscepticism rose to new heights. In Poland and Hungary, the Law and Justice (PiS) and Fidesz parties, respectively, utilized anti-migrant rhetoric to gain political appeal and refused to comply with the EU’s migrant quotas. At the same time, Italy and Greece—where most migrants and refugees first arrived on European soil—were overburdened. This then helped fuel the rise of far-right parties, such as Italy’s Lega (Lega Nord) and Greece’s Golden Dawn.

The North-South Divide 

This Euroscepticism is likely to be amplified by the coronavirus. The political fissures of the past decade are likely to become more defined as the coronavirus crisis continues to impact the continent’s politics, economy, and social cohesion.

In this crisis, European solidarity has been belated and will leave its mark. Like the previous two crises, the North-South divide has become ever more apparent. Anger and tensions have bubbled up to the surface. Spain and Italy, the two hardest-hit European countries, have accused their northern neighbors of not doing enough to assist them. Spanish prime minister Pedro Sánchez, a usually pro-EU politician, has even warned that the bloc could “fall apart.” Italian prime minister Giuseppe Conte has expressed the same concerns. 

In March, both Germany and France announced bans on the export of personal protective equipment, moves that EU officials said could harm collective efforts to combat the virus. Other EU countries also prohibited the export of medical supplies. This resulted in Italy and Spain procuring these supplies from outside the EU. What happened next was that China and Russia sent medical supplies to Italy and Spain, among other EU countries. 

The political significance of these countries receiving medical supplies from what are de facto adversarial and rival states like China and Russia is quite profound. While the EU’s North was slow to assist their southern neighbors, outside powers came to their aid.

As a result, Euroscepticism has reemerged onto the European political scene. Although Euroscepticism had begun to subside as the continent’s economies began to recover from the financial crisis, coronavirus may just reverse that trend. 

Politico’s Jacopo Barigazzi has reported that “There’s a widespread perception among the Italian public that the country has been left by the rest of the EU to fend for itself.” If this perception of inaction by the EU increases then, support for populism will increase in Italy, if not the rest of Southern Europe. As one of the founding members of the European Union, if Italy were to hold an EU membership referendum, then it would be catastrophic for the EU’s credibility and legitimacy. 

In terms of the EU’s economy, there has been a sharp divide over how to provide economic assistance. While France, Spain, and Italy have called for EU member states to share the burden of economic relief—in the form a “eurobond”—countries in the richer North, like Germany and the Netherlands, have been reluctant. Only in the past two weeks have EU finance ministers agreed on a financial support package worth half-a-trillion euros. Yet disputes continue, as the most recent meeting has shown. 

What Can Berlin and Paris Do? 

As the two leading EU states, Germany and France are looked up to and burdened with the responsibility of guiding the Union through crises. German chancellor Angela Merkel and French president Emmanuel Macron are tasked with leading the EU out of this new crisis. 

Unlike the response to the financial crisis, the current one should be more robust and forward-thinking. Politically, Berlin and Paris must win the public relations war against Eurosceptics across the continent, not just in the South. Former Italian prime minister Enrico Letta has said that “Half of the Italian public opinion is anti-European because it believes it is abandoned when something goes wrong.” The lackluster response thus far has also provided opportunities for Eurosceptic leaders, such as Hungary’s Viktor Orban. A rise in authoritarianism could occur. 

To counter this, Merkel, Macron, and EU officials should show EU citizens the extensive work that the EU is doing to provide medical and financial assistance. A widely publicized media (both traditional and social media) and communications campaign displaying the EU’s accomplishments would be a good start.

Economically, lending an ear (and a hand) to the bloc’s Southern European countries is vital. Given the apparent insolvency of these countries, both Germany and France should push for shared debt. This would signify that they, and the EU as a whole, are serious about solidarity. 

In terms of public health, Germany and France should spearhead an initiative to establish an EU consortium of biopharmaceutical companies and universities focused on collaborative vaccine research and testing kit development. The uncoordinated approach taken by the EU-27 towards these needs has slowed progress in these efforts. If this were established, then governments and public health officials could properly assess the spread of the coronavirus and lay down the necessary containment and mitigation infrastructure for future pandemics.

If the European Union is to survive this crisis intact, then there must be proactive action. Indeed, if the EU is to fulfill one of its key roles of bringing peace, prosperity, and unity to a once war-ravaged continent, it must rise to the occasion. The lives of hundreds of millions depend on it.