While ‘WE THE PEOPLE’ in singular terms are composed of unique individuals from all walks of life, we still seek and need common solutions in spite of the fact that the modern political party systems are product of socio-economic conflicts of the last few centuries (https://en.wikipedia.org/wiki/Left%E2%80%93right_political_spectrum). Globalisation, by being affected by internetisation, is strongly shaping and reshaping democracies around the world. More and more intensive and complex engagement of world population, i.e. individuals of “WE THE PEOPLE”, is taking place. So, the number of solutions to achieve peace, security and prosperity are becoming endless especially if sustainability, with its ‘socio-economic-environment’ pillars, is to be seriously and actively taken in consideration. However, from the Science and Technology viewpoint a problem is a solution that is not yet found’ (https://www.entrepreneur.com/article/288957; https://www.itseducation.asia/article/finding-possible-solutions; https://www.lifehack.org/articles/productivity/look-for-the-solution-within-the-problem.html; https://www.aicpa-cima.com/news/the-problem-is-the-solution.html). We are desperately seeking new solutions and this remains to be the main concern shaping this century though the problems, barriers and challenges in our modern societies are becoming multilayered in nature, complexity and even diversity. It is not straightforward to tune individuals and their political structures to the same goals, i.e. to redefine what is meant by ‘WE THE PEOPLE’ in global context. It is a spatio-temporal dynamic process coherent with an ever ongoing progress in the development of human evolution on planet Earth.

This said, the COVID-19 crisis by being part of a complex health system on planet Earth demonstrates clearly the paradox in how to define ‘WE THE PEOPLE’ from viewpoint of individuals and communities, i.e. in ‘bottom-top’ models on the one-hand; and in political structures and governmental institutions, i.e. in ‘top-bottom’ models on the other-hand. Considering the global geographical data of COVID-19 and the associated antibody tests by today (https://www.worldometers.info/coronavirus/) we may conclude that the so-called herd immunity, population immunity, or social immunity hasn’t been achieved yet as the time elapsed since the breakdown of the novel coronavirus ‘COVID-19 pandemic’ is yet very short. Herd immunity (https://en.m.wikipedia.org/wiki/Herd_immunity) is a form of indirect protection from infectious diseases that occurs when a large percentage of a population become immune to an infection. Generally, it can be achieved through previous infections thus providing a protection for individuals not yet immune. As COVID-19 is resulting from a new virus it will take longtime to achieve herd immunity and unless we keep doing at least what we are doing now we could face severe consequences. According to WHO, we are currently taking huge and yet unknown risks by reopening our economies. The spread of COVID-19 is refuelling itself and accelerating in the same way as it started back in China by the end of 2019 (https://www.cnbc.com/2020/06/19/who-says-coronavirus-enters-new-and-dangerous-phase-as-daily-cases-hits-record.html). Herd immunity can be also achieved through vaccination which in the case of COVID-19 is not yet available and may take up to several years for worldwide public use. However, there is some light at horizon as we have new reasonable explanations about the contradictions in global infection and death rates around the world. We have delayed effects in the global immunity that resulted from BCG vaccination which has been introduced and still being used in the developing countries. This is apparent from the strong correlation of reduced infection and mortality rates of COVID-19 in the developing countries. Excluding the countries with low-income levels that have few number of cases of COVID-19 per million inhabitants, i.e. 0.32± 0.09, because of risks for biases from improper reporting. The middle high and high-income countries with current universal BCG policy (55 countries) the same value of COVID-19 is 59.54± 23.29 (mean±s.e.m) cases per million inhabitants, to be compared with middle high and high income countries that never had a universal BCG policy (5 countries) with about 4 times the number of cases per million inhabitants, with 264.90± 134.88. This difference between countries is significant (p=0.0064, Wilcoxon rank sum test), suggesting that broad BCG vaccination along with other measures could slow the spread of COVID-19 (https://www.dw.com/en/can-a-tuberculosis-vaccine-help-combat-covid-19/a-53388220). The epidemiological evidence, from this German-study, indicates that differences in morbidity and mortality produced by COVID-19 across countries might be partially explained by a country’s BCG vaccination policy. Italy, for example, with very high COVID-19 mortality never implemented universal BCG vaccination. Japan with low COVID-19 mortality rate despite not implementing the most strict forms of social isolation have been implementing BCG vaccination since 1947. Iran that is heavily hit by COVID-19, started its universal BCG vaccination policy only in 1984 thus leaving anybody over 36 years old unprotected. China despite having a universal BCG policy since the 1950’s, its tuberculosis prevention and treatment agencies were disbanded and weakened during the Cultural Revolution (1966-1976). This, according to this German study, could have created (https://www.dw.com/en/can-a-tuberculosis-vaccine-help-combat-covid-19/a-53388220) a pool of potential hosts that affected by and spread COVID-19. However, the situation in China, assuming COVID-19 data from China are correct, now seems to have improved relatively fast. So the present global COVID-19 data suggest that BCG vaccination seem to significantly reduce mortality associated with COVID-19. The earlier that a country established a BCG vaccination policy, the stronger the reduction in number of deaths per million inhabitants, consistent with the idea that protecting the elderly population might be crucial in reducing mortality. Similar studies have been performed around the world, researchers from the Murdoch Children’s Research Institute in Australia (MCRI) organized a trial to investigate whether the tuberculosis (TB) vaccine known as the bacille Calmette-Guerin (BCG) might offer protection against COVID-19 (https://www.medicalnewstoday.com/articles/covid-19-could-tb-vaccine-offer-protection). Earlier work has shown that it might reduce the risk of some respiratory infections that are entirely unrelated to TB (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31025-4/fulltext). In this publication it is indicated that in addition to the specific effect against tuberculosis, the BCG vaccine has beneficial nonspecific (off-target) effects on the immune system that protect against a wide range of other infections and are used routinely to e.g. treat bladder cancer. This led to the suggestion that vaccination with BCG might have a role in protecting health-care workers and other vulnerable individuals against severe coronavirus disease 2019 (COVID-19). Also in a study carried out in France and The Netherland (https://www.france24.com/en/20200403-could-tb-vaccine-protect-medics-from-covid-19) it is stated that though BCG vaccine does not directly protect against the coronavirus, it can provide a boost to the immune system which may lead to improved protection and a milder infection. So, the race to develop COVID-19 vaccines has well and truly begun, but amid this research excitement another, rarely talked about vaccine is suddenly getting a lot of attention (https://www.gavi.org/vaccineswork/can-bcg-vaccine-protect-against-covid-19). During its long existence, an array of evidence has emerged suggesting that BCG vaccine may also offer beneficial off-target effects, providing some protection against not just some forms of TB but other diseases as well as it appears to help boost the immune system.

So, putting COVID-19 in a global historical perspective what regards the evolution of pandemics and diseases that threatened humanity reveals and uncover many important and strategic issues (https://www.converse.edu/story/reflections-on-current-past-pandemics/; https://www.historyassociates.com/the-covid-19-pandemic-in-historical-perspective/; https://www.psychiatrictimes.com/view/spanish-flu-pandemic-and-mental-health-historical-perspective). Until around 1970, historical research about pandemics had been virtually non-existent. Some novels and popular histories appeared over the decades, but it was Alfred Crosby’s 1976 book Epidemic and Peace, 1918 (reissued in 1989 under the title America’s Forgotten Pandemic: The Influenza of 1918) that paved the way for international research about the subject. One of the book’s major achievements was to draw attention to the fact that the pandemic quickly disappeared as a topic of public conversation soon after it was over, ignored by periodicals and textbooks for decades. To many historians, this collective silence is as much a part of the pandemic’s story as the course of the disease itself. The first outbreak of global diseases occurred from 1347 to 1351, killed up to 50% of the Europe’s population (https://www.converse.edu/story/reflections-on-current-past-pandemics/). King Edward III of England ordered English ports to be closed before the plague reached England late in the summer of 1348. The best advice, that remains to be true until today, anyone could offer was to flee, in essence a form of social distancing. As in this case distancing all the population of England by closing its borders. A more recent pandemic, the influenza of 1918-1919 also has even more lessons for us to learn (https://www.historyassociates.com/the-covid-19-pandemic-in-historical-perspective/). The 1918 influenza pandemic occurred in a world devoid of viral vaccines, relatively minimal medical knowledge, medical infrastructure, and limited global communications. Most important, a century ago, medical professionals didn’t categorize the flu as a viral infection and there were no efficient, precise ways of diagnosing and documenting the influenza. There were neither a World Health Organization for global coordination of health issues nor scientific know-how to allow for isolation of viruses and the generation of quick effective antiviral tests. The origin of the 1918-1919 disease is still undetermined, it seemed to simultaneously appear in the USA, Europe, and Asia. Usually, influenza affects the young and the elderly, described as a ‘U’. The outbreak of 1918-1919 described as a ‘W’ shape as young, elderly and many in the twenties and thirties were affected too. Over 500 million people were infected worldwide, i.e. one-third of world’s population at that time. Between 50 and 100 million people died worldwide and 675,000 people in the USA. The period 1918-1919 overlapped with WW-I, so in addition to the huge lack of understanding of infectious diseases and medical responses, specially to civilians, the WW-I itself put more constraints on medical reserves and full implementation of social distancing both in Europe and the USA. Both Europe USA and other countries were placing most of their attention and support to the war. In the USA for example, as the flu found a foothold, Philadelphia’s health commissioner ignored warnings from medical experts and proceeded with a planned parade to support the war effort. While St. Louis issued warnings almost immediately when the first cases appeared and its health commissioner promptly banned public gatherings exceeding twenty people, closed schools, theaters, churches, and other places for several weeks. The death rate in St. Louis amounted to less than half, per capita, of that in Philadelphia. Flattening the Curve by social distancing was already used in 1918 though other cities around the world still went business-as-usual in running civil and public sevices, and businesses promoting the war.

The BCG vaccine (https://en.m.wikipedia.org/wiki/BCG_vaccine) first became available in 1921 and it appears on the World Health Organization (WHO) List of Essential Medicines. More than 100 million babies globally receive the BCG vaccination each year. Aside from TB, the BCG vaccine also protects against other conditions that involve mycobacterium (https://en.m.wikipedia.org/wiki/Mycobacterium) including leprosy. Scientists produce the vaccine using live Mycobacterium bovis (https://en.m.wikipedia.org/wiki/Mycobacterium_bovis) taken from bovines, which they have attenuated to reduce their virility. Although no studies, to date, have investigated the BCG vaccine’s influence over SARS-CoV-2, the scientists hope that the story might be similar. If the BCG vaccine can bolster and strengthen the immune system, it might reduce the infection rates of SARS-CoV-2 or lessen the severity of COVID-19 (http://theconversation.com/could-bcg-a-100-year-old-vaccine-for-tuberculosis-protect-against-coronavirus-138006). This is actually an important finding of the careful studies and examination of the global spatio-temporal data of COVID-19. So, without the collaboration of world health institutions, collation, coordination and compilation it would have been impossible to arrive to such achievement which is an essential conclusion for the advancement in science and technology. This is a reminder of the strategic importance of Goal 17 of the UN-SDGs “Goal 17 seeks to strengthen global partnership to support and achieve the ambitious targets of the 2030 Agenda to bring together national governments, the international community, civil society, the private sector and other actors”. Again the Goal 17 itself can’t be achieved without promoting and implementing a web of many other underlying infra-structures that are very-well defined in the UN-SDGs. Such underlying infra-structures allow stronger coupling of the citizens and communities to their multi-layered governmental and institutional bodies and organizations on all levels and scales. It is a matter of improving and strengthening vertical and horizontal communications in ‘botton-top models’. ‘Top-bottom models’ are not as effective and efficient in the developing and less-favored countries, it can be also the case in some developed countries. This is how to arrive to the proper operational definition of “WE THE PEOPLE”, i.e. empowering the citizens to enhance their performance in the very basic three pillars of sustainability: social, economic and environmental. A global transformational process where the responsibility is shifted more and more towards citizens to achieve knowledge-based democracy of engaged and well-informed citizens.

“Globalisation” (https://en.m.wikipedia.org/wiki/Dimensions_of_globalization) means different things to different people, and the same applies to “Democracy” (https://en.m.wikipedia.org/wiki/Democracy). Globalisation has benefits, challenges e.g. risks and contradictions (https://www.chathamhouse.org/london-conference-2015/background-papers/overcoming-risks-and-contradictions-globalization; https://velocityglobal.com/blog/globalization-benefits-and-challenges/; https://www.newyorkfed.org/newsevents/speeches/2017/dud170511) with tectonic transformation and challenges associated with it. It has Pros And Cons for the poor and the rich countries in terms of access of small businesses, multi-nationals and working people to free markets. Not all barriers in globalisation, that hider the promotion and implementation of the UN-SDGs, can be eliminated overnight and risks still remain for social injustice, abuse of human rights, unfair working conditions, mismanagement of natural resources, and ecological damage, violation of intellectual properties, spread of infections and diseases, human trafficking and degradation of social welfare in general (https://www.forbes.com/sites/mikecollins/2015/05/06/the-pros-and-cons-of-globalization/amp/). We have also to take in consideration the existing illiteracy, corruption and misconduct in developing countries. Also, the remains of destructive impacts in the socio-economic fabrics that resulted from centuries of colonisation and slave-handel.

Both democracy and globalisation are dynamic in evolution and depends on political structures around the world. The shift from agricultural and rural societies to industrial and urban ones has forced new challenges that resulted in economic development but also economic competition. Advances in science and technological were major drivers that resulted in screwed shifts and systematic changes with trends in more and more differentiated, polarised and degenerated globalisation and democracies (https://ged-project.de/globalization/what-are-the-drivers-behind-economic-globalization/) in favour of trade and economic structures as defined and driven by growth and linear economies. Growth and linear economies, as consequences of screwed globalisation and democracies, are in flavour of developed countries that have easy and prompt access to science and technology on all aspects (https://ourworldindata.org/is-globalization-an-engine-of-economic-development; https://www.salon.com/2014/08/02/how_the_middle_class_got_screwed_college_costs_globalization_and_our_new_insecurity_economy/). Currently, globalisation is not an accurate descriptor of the 21st century as there has been tectonic and huge internet-driven transformational changes sweeping in all public and private sectors, trade and businesses. Yet, the international economic landscape is not tuned to incorporate within it the UN-SDGs. It is unfortunate that the UN-SDGs are degraded and reduced to only one goal, i.e. Goal 13: The Climate Action. Though Climate Action is important in itself, the same can be said for all goals as evident from COVID-19. The term internetisation is believed to be a replacement for the concept of globalisation as time and geography are irrelevant (https://www.google.se/amp/s/theconversation.com/amp/internetization-a-new-word-for-our-global-economy-88013). Internetisation is the contemporary face of globalization as it includes all modern tools of electronic globalisation and embraces the digital connectivity and empowerment of the internet and the World Wide Web. Globalisation of knowledge, including science and technology, and the associated impacts on industrialisation and economy, has benefitted, almost entirely the developed countries, through the considerable brain-drain from the developing countries either actively or passively. In passive terms, all researchers around the world are forced to publish in international journals that either controlled by the science and technology policies serving mainly growth and linear economies or fit in the science and technology strategies defined by the developed countries.

The gradual and systematic shift from ‘globalisation’ to ‘internetisation’ has also negative and positive impacts as is the case for globalisation. IOT, ICT and social media are still controlled by free market economy, i.e. linear and growth economy. This evolution has affected the way individuals define ‘WE THE PEOPLE’, i.e. from viewpoint of the citizen which is not coherent with how the political structures define it. We are not any longer living in isolated bubbles. Here are some literature that explain how countries, citizens and businesses around the world are becoming more interconnected, as various drivers such as technology, transportation/travel, social media, and global finance make it easier for goods, services, ideas, innovation and people to move freely across traditional and classic borders and boundaries (https://courses.lumenlearning.com/marketing-spring2016/chapter/reading-globalization-benefits-and-challenges/). These changes underline the ongoing transformation from ‘slow globalisation’ to more and more ‘fast globalisation’, i.e. ‘internetisation’. In any case, the major impacts on businesses that provide an abundance of worldwide benefits comes with major challenges for individuals, stakeholders and governments (https://www.google.se/amp/s/www.globalization-partners.com/blog/benefits-and-challenges-of-globalization/amp/; https://www.mtholyoke.edu/acad/intrel/spero.htm). As globalisation or ‘internetisation’ can open and create new markets and technological advances with potential to empower and enrich everyone, so far it has created global unsustainable ‘socio-economic-environment’ inequalities. So, more and more political challenges have emerged that urge us, our governments, institutions and multilateral policy-makers to overcome the associated risks and contradictions. As companies, and stakeholders alike, start to grow and expand they face new difficulties to navigate and reach their global expansion goals and overcome competition barriers, decentralisation of industires, protectionism and cultural differences around the world. However, it is time to end the profit-at-all-costs mentality, because if we don’t build an economic future within a sustainable framework in which we are respectful of our planetary boundaries, and the need to change our energy, use of natural resources and technology systems, then we will not have a living planet for human beings. It is also, very important for countries to recognize there are essential services that need to be provided in terms of healthcare, education, good governance and a social safety that cannot be compromised on. The volume of needs that we have today made it clear that global cooperation is imperative and abundantly clear.