On the syndemic nature of crises: A Freeman perspective.

In this paper we draw a parallel between the insights developed within the framework of the current COVID-19 health crisis and the views and insights developed with respect to the long term environmental crisis, the implications for science, technology and innovation (STI) policy, Christopher Freeman analyzed already in the early 90's. With at the time of writing, the COVID-19 pandemic entering in many countries a third wave with a very differentiated implementation path of vaccination across rich and poor countries, drawing such a parallel remains of course a relatively speculative exercise. Nevertheless, based on the available evidence of the first wave of the pandemic, we feel confident that some lessons from the current health crisis and its parallels with the long-term environmental crisis can be drawn. The COVID-19 pandemic has also been described as a " syndemic ": a term popular in medical anthropology which marries the concept of 'synergy' with 'epidemic' and provides conceptually an interesting background for these posthumous Freeman reflections on crises. The COVID-19 crisis affects citizens in very different and disproportionate ways. It results not only in rising structural inequalities among social groups and classes, but also among generations. In the paper, we focus on the growing inequality within two particular groups: youngsters and the impact of COVID-19 on learning and the organization of education; and as mirror picture, the elderly many of whom witnessed despite strict confinement in long-term care facilities, high mortality following the COVID-19 outbreak. From a Freeman perspective, these inequality consequences of the current COVID-19 health crisis call for new social STI policies: for a new "corona version" of inclusion versus exclusion.

Policy Lessons From Medical Responses to the COVID-19 Crisis.

This article discusses the medical/therapeutical responses to the COVID-19 pandemic and their political economy context. First, the very quick development of several vaccines highlights the richness of the basic knowledge waiting for therapeutical exploitation. Such knowledge has largely originated in public or non-profit institutions. Second, symmetrically, there is longer-term evidence that the private sector (essentially big pharma) has decreased its investment in basic research in general and has long been uninterested in vaccines in particular. Only when flooded with an enormous amount of public money did it become eager to undertake applied research, production scale-up and testing. Third, the political economy of the underlying public-private relationship reveals a profound dysfunctionality with the public being unable to determine the rates and direction of innovation, but at the same time confined to the role of payer of first and last resort, with dire consequences for both advanced, and more so developing countries. Fourth, on normative grounds, measures like ad hoc patent waivers are certainly welcome, but this will not address the fundamental challenge, involving a deep reform of the intellectual property rights regimes and their international protection.

A multiscale model of virus pandemic: Heterogeneous interactive entities in a globally connected world.

This paper is devoted to the multidisciplinary modelling of a pandemic initiated by an aggressive virus, specifically the so-called SARS-CoV-2 Severe Acute Respiratory Syndrome, corona virus n.2. The study is developed within a multiscale framework accounting for the interaction of different spatial scales, from the small scale of the virus itself and cells, to the large scale of individuals and further up to the collective behaviour of populations. An interdisciplinary vision is developed thanks to the contributions of epidemiologists, immunologists and economists as well as those of mathematical modellers. The first part of the contents is devoted to understanding the complex features of the system and to the design of a modelling rationale. The modelling approach is treated in the second part of the paper by showing both how the virus propagates into infected individuals, successfully and not successfully recovered, and also the spatial patterns, which are subsequently studied by kinetic and lattice models. The third part reports the contribution of research in the fields of virology, epidemiology, immune competition, and economy focussed also on social behaviours. Finally, a critical analysis is proposed looking ahead to research perspectives.