Yehuda Shoenfeld, a renowned Israeli immunologist, now working at St. Petersburg State University, where he is heading a laboratory of autoimmunity mosaics, has shed light on the cause of coronavirus complications, namely a substance, whose extensive presence in the blood can result in death.
A St. Petersburg State University professor, an honorary professor at Tel Aviv University and a researcher at the Sheba Medical Center (Israel), Yehuda Shoenfeld, has determined that ferritin is a biomarker of a severe form of coronavirus infection, and that people with a high degree of ferritin present in their body are at risk of developing severe forms of COVID-19 infection, including when complications, such as bilateral pneumonia, start to develop.
“Ferritin is the protein responsible for the absorption of iron in the body,” says Yehuda Shoenfeld, the founder and head of the Autoimmune Disease Center. “Inside human body cells, ferritin serves as reserve storage of iron, binding free ions of iron, thus neutralizing its toxic properties and increasing solubility. If insufficiently present, it causes iron deficiency anemia. When in excess, however, it leads to hyperferritinemia.”
Hyperferritinemia, in turn, leads to impaired swallowing, weakness, decreased reproductive function, pathologies of the liver, heart and pancreas, neurological disorders, and vision problems. It occurs in severe cases of infectious diseases, including coronavirus infection.
Professor Shoenfeld’s team has been studying the hyperferritinemic syndrome for quite a while now, and has already published data on this condition. Sadly, in 50 percent of cases, patients do not survive.
According to Shoenfeld, an overabundance of ferritin in the human body may signal the organism’s response to infection, possibly to coronavirus as well. In case of viral diseases, ferritin is able to activate non-specific immunity cells, such as macrophages, which in turn, secrete cytokines. They sent a signal to other cells, for example, “commanding” them to initiate an inflammatory response and attack foreign agents. When the amount of cytokines is relatively small, it is good for the body, but when the amount becomes exceedingly high, this is fraught with a syndrome called the “cytokine storm” – one of the most dangerous complications of coronavirus infection. The body suffers a severe shakeup, resulting in a 50 percent mortality rate, with seniors and those with severe chronic diseases being at risk.
“As evident from studies made in China, the US and Italy, those infected with COVID-19 showed a high level of ferritin in their system. The increased content of ferritin is a marker indicating the appearance of pathogenic microorganisms inside the body. Our task is to understand how to quickly reduce the level of ferritin in the blood,” Yehuda Shoenfeld concluded.
Today, researchers working at St. Petersburg State University’s Laboratory of Autoimmunity Mosaics are looking for ways to reduce blood ferritin and use antibodies to block the synthesis of CD-143 cytokines, whose presence has been found to be a sign of a high likelihood of serious complications of COVID-19 disease. And most importantly, St. Petersburg State University is working on an anti-coronavirus vaccine based on the use of viral proteins as its main components.
“We are going to use viral proteins as a basic component of the medicine to create a vaccine,” Yehuda Shoenfeld says. “Viral proteins are not to be found inside the human body, which means that they cannot provide an unwanted immune response. The fragment is not rejected by the immune system, which is very inspiring,” he added.
Professor Yehuda Shoenfeld is an internationally renowned Israeli specialist in the study, treatment and prevention of autoimmune diseases, a physician, the founder and head of the Zabludowicz Center for Autoimmune Diseases at the Sheba Medical Center of Tel-Aviv University in Israel, and is President of the International Congress on Autoimmunity. He is editor-in-chief of Autoimmunity Reviews, IMAJ, Harefuah (Israel), co-editor-in-chief of the Journal of Autoimmunity and Autoimmunity Network, contributed to the work of the Israeli Medical Encyclopedia, and has organized over 20 international congresses on autoimmunity.
In 2016, this prominent scientist won a contest for mega-grants provided by the government of the Russian Federation for the promotion of scientific research. Since late 2016, Yehuda Shoenfeld has been heading St. Petersburg State University’s Laboratory of Autoimmunity Mosaics.
Neighbours and Crises: New Challenges for Russia
Through all the discussions that accompanied the preparation of the Valdai Club report “Space Without Borders: Russia and Its Neighbours”, the most clear question was whether Russia should or should not avoid repeating the historical experience of relations with its near abroad. This experience, in the most general terms, is that after Russia pacifies its western border with its foreign policy, the Russian state inevitably must turn to issues related to the existence of its immediate neighbourhood. With a high degree of probability, it will be forced to turn to its centuries-old method for solving problems that arise there: expansion for the sake of ensuring security.
Now Russia’s near abroad consists of a community of independent states that cannot ensure their own security and survival by relying only on their own forces; we cannot be completely sure of their stability. From Estonia in the west to Kyrgyzstan in the east, the existence of these countries in a competitive international environment is ensured by their link with one of the nuclear superpowers. Moreover, such connections can only complement each other with great difficulty. As the recent developments in Kazakhstan have demonstrated, they are not limited to the threat of an external invasion; even internal circumstances can become deadly.
The dramatic events in that country were intensified by external interference from the geostrategic opponents of Russia, as well as international terrorists, but it would be disingenuous to argue that their most important causes are not exclusively internal and man-made. We cannot and should not judge whether the internal arrangements of our neighbours are good or bad, since we ourselves do not have ideal recipes or examples. However, when dealing with the consequences, it is rational to fear that their statehood will either be unable to survive, or that their existence will take place in forms that create dangers which Russia cannot ignore.
In turn, the events experienced now in relations between Russia and the West, if we resort to historical analogies, look like a redux of the Northern War. The Great Northern War arose at the beginning of the 18th century as the result of the restoration of Russia’s power capabilities; the West had made great progress in approaching the heart of its territory. Within the framework of this logic, victory, even tactical victory, in the most important (Western) direction will inevitably force Russia to turn to its borders. Moreover, the reasons for paying more attention to them are obvious. This will present Russia with the need to decide on how much it is willing to participate in the development of its neighbours.
The developments in Kazakhstan in early January 2022 showed the objective limits of the possibilities of building a European-style sovereign state amid new, historical, and completely different geopolitical circumstances. More or less all the countries of the space that surrounds Russia, from the Baltic to the Pamir, are unique experiments that arose amid the truly phenomenal orderliness of conditions after the end of the Cold War. In that historical era, the world really developed under conditions where a general confidence prevailed that the absolute dominance of one power and a group of its allies creates conditions for the survival of small and medium-sized states, even in the absence of objective reasons for this.
The idea of the “end of history” was so convincing that we could accept it as a structural factor, so powerful that it would allow us to overcome even the most severe objective circumstances.
The Cold War era created the experience of the emergence and development of new countries, which until quite recently had been European colonies. Despite the fact that there are a few “success stories” among the countries that emerged after 1945, few have been able to get out of the catch-up development paradigm. However, it was precisely 30 years ago that there really was a possibility that a unipolar world would be so stable that it would allow the experiment to come to fruition. The visible recipes of the new states being built were ideal from an abstract point of view, just as Victor Frankenstein was guided by a desire for the ideal.
Let us recall that the main idea of our report was that Russia needs to preserve the independence of the states surrounding it and direct all its efforts to ensure that they become effective powers, eager to survive. This desire for survival is seen as the main condition for rational behaviour, i.e. creating a foreign policy, which takes into account the geopolitical conditions and the power composition of Eurasia. In other words, we believe that Russia is interested in the experiment that emerged within the framework of the Liberal World Order taking place under new conditions, since its own development goals dictate that it avoid repeating its past experience of full control over its neighbours, with which it shares a single geopolitical space.
This idea, let’s not hide it, prompted quite convincing criticism, based on the belief that the modern world does not create conditions for the emergence of states where such an experience is absent in more or less convincing forms. For Russia, the challenge is that even if it is technically capable of ensuring the immediate security of its national territory, the spread of the “grey zone” around its borders will inevitably bring problems that the neighbours themselves are not able to solve.
The striking analogy proposed by one colleague was the “hallway of hell” that Russia may soon face on its southern borders, making us raise the question that the absence of topographic boundaries within this space makes it necessary to create artificial political or even civilisational lines, the protection of which in any case will be entrusted to the Russian soldier. This January we had the opportunity to look into this “hallway of hell”. There is no certainty that the instant collapse of a state close to Russia in the darkest periods of its political history should be viewed as a failure in development, rather than a systemic breakdown of the entire trajectory, inevitable because it took shape amid completely different conditions.
Therefore, now Russia should not try to understand what its further strategy might be; in any case, particular behaviour will be determined by circumstances. Our task is to explore the surrounding space in order to understand where Russia can stop if it does not want to resort to the historical paradigm of its behaviour. The developments in Kazakhstan, in their modern form, do not create any grounds for optimism or hopes for a return to an inertial path of development. Other states may follow Ukraine and Kazakhstan even if they now look quite confident. There are no guarantees — and it would be too great a luxury for Russia to accept such a fate.
This is primarily because the Russian state will inevitably face a choice between being ready for several decades of interaction with a huge “grey zone” along the perimeter of its borders and more energetic efforts to prevent its emergence. It is unlikely that Moscow would simply observe the processes taking place on its immediate periphery. This is not a hypothetical invasion of third forces — that does not pose any significant threat to Russia. The real challenge may be that in a few decades, or sooner, Moscow will have to take on an even greater responsibility, which Russia got rid of in 1991. Even now, there seems to be a reason to believe that thirty years of independence have made it possible to create elements of statehood that can be preserved and developed with the help of Russia.
from our partner RIAC
Do as You’re Told, Russia Tells the Neighborhood
The Kremlin has always argued that it has special interests and ties to what once constituted the Soviet space. Yet it struggled to produce a smooth mechanism for dealing with the neighborhood, where revolutionary movements toppled Soviet and post-Soviet era political elites. Popular movements in Georgia, Ukraine, Moldova, Kyrgyzstan, and most recently Kazakhstan have flowered and sometimes triumphed despite the Kremlin’s rage.
Russia’s responses have differed in each case, although it has tended to foster separatism in neighboring states to preclude their westward aspirations. As a policy, this was extreme and rarely generated support for its actions, even from allies and partners. The resultant tensions underlined the lack of legitimacy and generated acute fear even in friendlier states that Russia one day could turn against them.
But with the activation of the hitherto largely moribund six-nation Collective Security Treaty Organization (CSTO) in Kazakhstan seems to be an entirely different matter. Here, for the first time since its Warsaw Pact invasions, Russia employed an element of multilateralism. This was designed to show that the intervention was an allied effort, though it was Russia that pulled the strings and contributed most of the military force.
CSTO activation is also about something else. It blurred the boundaries between Russia’s security and the security of neighboring states. President Vladimir Putin recently stated the situation in Kazakhstan concerned “us all,” thereby ditching the much-cherished “Westphalian principles” of non-intervention in the internal affairs of neighboring states. The decision was also warmly welcomed by China, another Westphalia enthusiast.
In many ways, Russia always wanted to imitate the US, which in its unipolar moment used military power to topple regimes (in Afghanistan and Iraq) and to restore sovereignty (in Kuwait.) Liberal internationalism with an emphasis on human rights allowed America and its allies to operate with a certain level of legitimacy and to assert (a not always accepted) moral imperative. Russia had no broader ideas to cite. Until now. Upholding security and supporting conservative regimes has now become an official foreign policy tool. Protests in Belarus and Kazakhstan helped the Kremlin streamline this vision.
Since Russia considers its neighbors unstable (something it often helps to bring about), the need for intervention when security is threatened will now serve as a new dogma, though this does not necessarily mean that CSTO will now exclusively serve as the spearhead of Russian interventionist policy in crises along its borders. On the contrary, Russia will try to retain maneuverability and versatility. The CSTO option will be one weapon in the Kremlin’s neighborhood pacification armory.
Another critical element is the notion of “limited sovereignty,” whereby Russia allows its neighbors to exercise only limited freedom in foreign policy. This is a logical corollary, since maneuverability in their relations with other countries might lead to what the Kremlin considers incorrect choices, like joining Western military or economic groupings.
More importantly, the events in Kazakhstan also showed that Russia is now officially intent on upholding the conservative-authoritarian regimes. This fits into a broader phenomenon of authoritarians helping other authoritarians. Russia is essentially exporting its own model abroad. The export includes essential military and economic help to shore up faltering regimes.
The result is a virtuous circle, in the Kremlin’s eyes. Not only can it crush less than friendly governments in its borderlands but it also wins extensive influence, including strategic and economic benefits. Take for instance Belarus, where with Russian help, the dictator Aliaksandr Lukashenka managed to maintain his position after 2020’s elections through brutality and vote-rigging. The end result is that the regime is ever-more beholden to Russia, abandoning remnants of its multi-vector foreign policy and being forced to make financial and economic concessions of defense and economics to its new master. Russia is pressing hard for a major new airbase.
A similar scenario is now opening up in Kazakhstan. The country which famously managed to strike a balance between Russia and China and even work with the US, while luring multiple foreign investors, will now have to accept a new relationship with Russia. It will be similar to Belarus, short of integration talks.
Russia fears crises, but it has also learned to exploit them. Its new approach is a very striking evolution from the manner in which it handled Georgia and Ukraine in 2008 and 2014, through the Belarus and Armenia-Azerbaijan crises in 2020 to the Kazakh uprising of 2022.
Russia has a new vision for its neighborhood. It is in essence a concept of hierarchical order with Russia at the top of the pyramid. The neighbors have to abide by the rules. Failure to do so would produce a concerted military response.
Author’s note: first published in cepa
Russia’s Potential Invasion of Ukraine: Bringing In Past Evidence
Since mid-November 2021, the U.S. intelligence community and media have been warning of a Russian military buildup along the country’s western border. As the military activities are widely interpreted as a sign of Russia’s upcoming invasion of Ukraine, NATO needs to carefully analyze Russia’s motivations and previous behaviors, as well as hammer out policy options in case the existing fears prove to be correct.
Although Russia’s record of deception and recent statements about red lines make current tensions particularly worrisome, there is no hard evidence that an invasion is indeed being planned. The present situation is one of ambiguity (which is probably deliberate), and the West should treat it as such. Washington and its allies should be prepared for the worst without assuming that the negative scenario will inevitably come true. In particular, NATO should consider continuing its policy of tailored deterrence while refraining from steps that can lead to escalation themselves.
What Makes the Invasion Possible
Putin’s modern Ukraine policy originates from two basic assumptions about Russia’s relations with the West after the end of the Cold War. The first assumption is based on the broken promise narrative. According to Mary Sarotte, the Soviet Union did expect that NATO would not move eastward, whereas German Foreign Minister Genscher did promise that NATO “would not expand itself to the East.” The assurances have never been codified. However, NATO’s close military cooperation with Ukraine is viewed by Russia as violating the spirit of the Final Settlement with Respect to Germany of 1990. The historical fear of an attack from the West makes this perception even more vivid. The second assumption is that protests, revolutions, and major political shifts in the post-Soviet space can usually be attributed to Western malicious intentions. The 2014 pro-European revolution in Ukraine is therefore referred to by Moscow as a coup d’état. As unpleasant as they are, the two preconceived notions have a substantial impact on Russian foreign policy, leading the Kremlin to take radical military and diplomatic steps.
Further, Russia’s previous behaviors indicate that Moscow can actually use force against its neighbors, which means that military scenarios should be given serious consideration. It is known that Russia used military force to take control of Crimea in 2014, as President Putin admitted Russia’s involvement and disclosed secrets of the “takeover plot” quite a while ago. It is also known that Russia occupied large swaths of Georgia in 2008, even though Russia’s sovereignty was not directly threatened by skirmishes in South Ossetia. It is presumed, yet denied by Russia, that Moscow has been directly engaged in the Donbas War, which began in mid-2014.
More importantly, Russia has a record of denying its role in crises where Russia’s involvement was suspected by others from the outset. It is only in April 2014 that Putin admitted responsibility for the takeover of Crimea that had taken place between late February and early March. A more recent example of deception is Russia’s anti-satellite test in November 2021. Initially, the Vice-Chair of the Defense Committee in Russia’s Parliament said that “[t]here is no limit to the fantasies of the State Department. Russia is not engaged in the militarization of space.” Foreign Minister Lavrov speculated that “there is no evidence.” Later that day, Russia’s Defense Ministry admitted that the test had been conducted. There are even more cases of Moscow’s presumed malicious activities where Russia has never admitted its role. Those include the Donbas War, the downing of MH17 in July 2014, and the poisoning of Skripal and Navalny.
Given this record, Russia’s assurances that no invasion is being planned cannot be taken at face value. Moreover, Russian officials have made a number of worrisome statements recently. Since late November, President Putin has been calling for “security guarantees” from the West to prevent further NATO enlargement. On November 22, Russia’s Foreign Intelligence Service released a statement on the tensions over Ukraine, saying that “[w]e observed a similar situation in Georgia on the eve of the events of 2008.”
Rationality, Restraint, and History Lessons
Yet, it may seem that a full-scale invasion of Ukraine would be contrary to Russia’s interests, which is in fact true. A fait accompli along the lines of the 2014 takeover of Crimea is no longer possible, as Ukraine’s Army has been forged in the combats of Donbas. The covert war scenario for an entire country does not seem feasible either. Not only would an invasion result in numerous casualties for both sides, but it would also constitute a drain on Russia’s budget for years to come. A brutal war against Ukraine would literally destroy Moscow’s “fraternal peoples” narrative underlying much of Russian foreign policy.
The irrationality of attacking Ukraine is not the only reason why risks for NATO in the current situation may be exaggerated. Although Russia has used military force in a few notable cases, there have been even more examples of Russia’s restraint. In 2018, Russia refrained from attempting to keep in power Armenia’s Serzh Sargsyan in a revolution that was framed by many as inherently pro-Western. Russia did not take sides in the 2020 Nagorno-Karabakh War, even though Azerbaijan was explicitly supported by NATO member Turkey. Russia was sticking to a “wait and see” approach during much of the attempted revolution in Belarus in 2020. Finally, Russia has tolerated coups and revolutions in Central Asia, including most recently the Kyrgyz Revolution of 2020. In other words, understanding what Russia could have done but chose not to do is no less important than the awareness of what has indeed occurred. Russia is not inherently expansionist, and the domino logic does not apply.
However, this in no way means that an invasion of Ukraine is impossible. Irrational, previously unknown, and even “impossible” events tend to occur from time to time, as the 1941 attack on Pearl Harbor demonstrated 80 years ago. Even crazier twists and turns have probably been averted thanks to diplomacy and deterrence. This is why contingency planning is an integral part of any foreign and defense policy. NATO’s goal is to preempt, prevent, and be prepared for an invasion rather than predict whether it will happen or not.
While a full-scale invasion of Ukraine has not been launched, Western policy can rely on traditional deterrence instruments tailored to the crisis in question. In doing so, the United States and its allies should not act as though an invasion were inevitable, which it is not. NATO’s response to the current tensions should be very limited and focused, yet commensurate with the Western interest in countering Russian adventurism and short of upending the status quo for no apparent reason. First, the U.S. and its allies may continue providing military aid to Ukraine and even increase it, which is in line with previous policies. That said, troop deployments in Ukraine and enhanced military presence in the Black Sea would not be helpful, as such measures could alienate Russia without providing any benefits to the West. Second, NATO should dissuade Ukraine from attacking first, as Georgia did in 2008. Russia should be put in a position where any attack it might undertake would be unprovoked and very explicit. However, NATO should find it in its interest to refrain from providing any specific guarantees to Ukraine. The nature of Ukraine-Russia tensions makes provocations on both sides highly likely; assurances and alliances would only heighten risks, boosting Ukraine’s and Russia’s self-confidence.
A full-scale war between Russia and Ukraine is possible. Still, it is neither inevitable nor likely. When everyone takes war for granted, the question arises whether the United States still has a foreign policy capable of fostering a positive environment for the prosperity of the American people.
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