Category Archives: Corona virus
I heartily recommend an article in today’s New York Times entitled “Beyond Low Vaccination Rates Lurks a More Profound Social Weakness” (the original title, in the print edition, was “What Causes Vaccine Hesitancy?”). Authored by Anita Sreedhar and Anand Gopal, it makes non-vaxxers, who I still think are illogical and not looking out for themselves and others, a lot more understandable. It also makes a very important point about what’s lacking in our public health system (the same as what’s lacking in our system as a whole). There’s still some connection to Trump’s disastrous politicization of the pandemic, but that’s not the whole story. He was/is capitalizing on some big holes and weaknesses in our society as a whole, a result, I think, of the two-party political system dominated by the corporate elite (the 1%). A system like this that doesn’t work for so many can’t and won’t meaningfully address big things like disease, climate change, resource depletion, etc. And it’s a worldwide system, dominated by a few “successful” countries, as the global migrant crisis, criticized by Pope Francis this weekend, shows. What the 1% and those hanging onto their coattails don’t realize is that they and their families will eventually suffer from the big problems, too. We’re all ultimately one, standing or falling together.
On 7-15-20, Dr. Ali Khan, epidemiologist and the dean of the College of Public Health at the University of Nebraska Medical Center, was interviewed on Democracy Now!. As Amy Goodman indicated in her introduction, Dr. Khan is the former director of the Office of Public Health Preparedness and Response at the CDC and the author, with William Patrick, of The Next Pandemic: On the Front Lines Against Humankind’s Gravest Dangers, a book published in 2016 that looks at how the world’s public health community responded to outbreaks of the most dangerous infectious diseases over the past quarter of a century.
Dr. Khan told Goodman that the US response to Covid-19 has been “without a doubt, is the greatest public health failure in our nation’s history, and it just continues to be in freefall. We peaked at about 30,000 cases in mid-April, and then squandered two months of lockdown and economic collapse by failing to get the disease contained. Now we’re up to 60,000 cases a day. That’s completely out of step with Europe, Oceania, and East Asia. All of those countries have not only just contained their outbreaks, resumed their economies, and started back schools, but some have just gone all out and said, ‘We’re going to zero.’ New Zealand and some other countries have eliminated the disease. China, with 1.4 billion people, has gone nine days without a domestic case. We’re clearly the outlier with this uncontrolled, failed response here in the United States.
When Goodman asked what the US is doing wrong, he said, “We don’t have a national strategy based on the four principles that everybody else has used to get rid of this outbreak. The first principle to contain this outbreak is leadership: integrated, whole-of-government leadership on the national, state, and local levels. We still don’t have that. We can’t agree on so many things that are important. The second part is, get down community transmission. And this is the role of government, to make sure we’re testing and tracing. Nobody is talking about that anymore – isolating cases quickly, finding those contacts – nor does anybody talk about the metrics around that. The third thing is community engagement. And that’s our role, right? Wear a mask. Wash your hands. Social distance. And the fourth thing is, do what you can to make sure that people who are hospitalized are more likely to survive. And the one drug we know that does that right now is dexamethasone.
GOODMAN: Dr. Khan, you’re the former head of the CDC’s Office of Public Health Preparedness and Response, which included overseeing the Strategic National Stockpile on emergency medical supplies. Can you account for, many months into this pandemic, the United States continuing to have a shortage of tests and masks?
ALI KHAN: I have no explanation for that. I have said I could have grown polypropylene trees by this time for nasal swabs, given the ingenuity of Americans and our biomedical complex to create material, personal protective equipment, to conduct tests. I have no explanation for that. I can say, though, that we have enough testing in the United States currently, if we used it correctly and we got a timely result back and didn’t have to wait a week for the result. This goes back to strategy. We don’t have the right strategy in the United States to get this disease contained. And if we did, we wouldn’t be worried about personal protective equipment. South Korea today has 40 cases. Right? They’re not worried about personal protective equipment. So we’re worried about these things because we can’t contain the disease and not willing to do the hard things, not willing to strip politics out of this, base it on the science and get this disease under control.
JUAN GONZÁLEZ: Dr. Khan, I wanted to ask you about the role of Anthony Fauci in terms of the handling of this disease, because, on the one hand, we see the Trump administration trying to undermine his credibility these days as he increasingly comes into conflict with what the president wants to do, but, on the other hand, there are some legitimate questions. Your assessment of how Dr. Fauci has handled the crisis?
ALI KHAN: This isn’t really about Dr. Fauci. This is about CDC, our nation’s public health agency. We need to see it get its role back of educating the American people, providing the necessary data, and getting us back into containment. There’s no doubt that there were missteps made by our public health agencies and public health professionals. But what we need now is for the talent we’ve always had at CDC to be back at the forefront talking about public health issues. That’s where our public health expertise resides.
JUAN GONZÁLEZ: How optimistic are you about the development of a vaccine?
ALI KHAN: I am optimistic; however, the road to an uncertain vaccine is paved in death. Right now we have about 60,000 cases a day, so basically 600 to a thousand new deaths every day. We can’t wait for a vaccine. And other countries have gotten their diseases contained and eliminated without a vaccine. So, yes, I would love a vaccine, but there’s lots of data that makes it problematic. Immunity may be short-lived. We’ve never had vaccines based on these technologies. But, like everybody else, I’m optimistic. I hope there’s a vaccine. But we don’t need a vaccine today so that we don’t kill another 600 to a thousand people tomorrow. We have the tools.
AMY GOODMAN: Can you talk, Dr. Ali Khan, about what it would mean if the president of the United States simply put on a mask on a regular basis? Trump seeing a mask as weakness – only this past weekend, you saw him for a minute wearing a mask, and he said, well, he was in a hospital? The significance of what this would mean at the federal level? Then you see it go down to the state level – his biggest allies, DeSantis, the governor Florida, for the first time donning a mask. In Arizona – we’re going to speak with the mayor of Tucson today…Governor Ducey, a recent death in Arizona of a Mexican-American man. His daughter said, ‘I say that the governor and the president have blood on their hands.’ Do you feel the same way, Dr. Khan?
ALI KHAN: I believe all of government has blood on its hands…136,000 deaths, preventable deaths, a tragedy, especially since most of the rest of the world has contained this disease, and some have even eliminated it. But what you saw in countries that were successful was that each and every politician, regardless of their party, followed the science. So, everybody said, ‘Wear masks.’ No controversy. Everybody wore a mask. We need to see that here right now at every political level. Wear a mask. That’s one of the four strategies that will get us out of this mess. We need everybody to be wearing a mask at this point.
AMY GOODMAN: Let me ask you about some of the recent studies out of China, Germany and Britain, suggesting that people who have had COVID-19 begin losing their antibodies in just a few months. So, even if there was a vaccine, the significance of this, Dr. Khan, and also of the younger people that we are seeing get sick and die all over the country?
ALI KHAN: Two great questions. Yes, if your immunity is short-lived, that makes finding a vaccine chasing a rainbows to some extent. Again: we don’t need a vaccine to get out of this mess. We can get this outbreak under control. As far as young people are concerned, without a doubt, we see less severe disease. However, young people also can get sick, get hospitalized, die. We’re now learning that about 50% of all people who get infected with this disease are left with some sort of heart abnormality. So, even if you don’t die, there can be long-term complications.
JUAN GONZÁLEZ: And, Dr. Khan, speaking of young people, your sense of how various states and school districts around the nation are handling the issue of the reopening of public schools?
ALI KHAN: I’ll be very honest with you. As a pediatrician, as a father, as a public health professional, we need kids back in school for numerous reasons. But we have to do it safely. And we know we can do this. You know, I just did a review of over 15 countries that were able to safely get kids back in school. But that’s based not just on the safety measures we take and wearing masks and everything else that the kids need to do. It’s based on dropping community transmission. Unless you have approximately 25 cases per million population per day, you can’t reopen schools. So, drop your community transmission. Work with the local health department. Make sure they have the support they need to test and trace everybody. This is what we need to do to get our kids back in school.
Are we going to wait till January to get things going in a semi-right direction (assuming Biden defeats Trump)? A lot of people have been, are, and will be suffering from Trump’s “policy” moves in the meanwhile, the latest being foreign students who’ll be barred from the country if they don’t attend in-person classes in the fall. Trump’s self-serving (and serving nobody else) “leadership” on the pandemic is the worst, and the next 6 months are critical in that regard. According to Laurie Garrett, a former senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize winning science writer, the corona virus will become endemic (never leave us) if we don’t get a handle on it right away, and to do that we need a national and global team effort based on science, the opposite of what Trump is doing. Impeach him, declare him unfit for office, mount a revolution, whatever is necessary to get him out of the way, and put someone else (not Mike Pence!) in charge now!! Our lives and the quality of our lives are on the line. Sort out the politics later.
The Texas state supreme court just ended its stay on evictions for nonpayment of rent, and other states will soon follow suit, with the federal government cheering them on rather than taking up the slack. Thrown out onto the street, evictees will have to join the currently unhoused (well over half a million people), crowd into homeless shelters, or beg friends or family for living space, creating a rise in Covid-19 infections while houses and apartments stand empty. With unemployment at 40% or higher and unemployment benefits unavailable to many and stopping at some point for the rest, this crisis will only get worse. If landlords are hurting that much financially — and some may be — they need federal assistance in order to continue the moratorium on evictions — unlikely to come from the Trump administration or a Republican-controlled Senate. A second Trump term will only intensify this insanity, and a Biden presidency probably won’t do enough to change it. We need to dump the millionaire politicians and create a system that works for all of us.
The Coronavirus Crisis Is a Monster Fueled by Capitalism by Mike Davis, In These Times, 3-20-20
…A year from now we may look back in admiration at China’s success in containing the pandemic and in horror at the US failure. Since at least 2000 we’ve repeatedly seen breakdowns in frontline healthcare. Both the 2009 and 2018 flu seasons, for instance, overwhelmed hospitals across the country, exposing the shocking shortage of hospital beds after years of profit-driven cutbacks of in-patient capacity. According to the American Hospital Association, the number of in-patient hospital beds declined by an extraordinary 39% between 1981 and 1999. The purpose was to raise profits, but the goal of 90% occupancy meant that hospitals no longer had the capacity to absorb patient influx during epidemics and medical emergencies.
In the new century, emergency medicine has continued to be downsized in the private sector by the ‘shareholder value’ imperative of increasing short-term dividends and profits, and in the public sector by fiscal austerity and reductions in state and federal preparedness budgets. As a result, there are only 45,000 ICU beds available to deal with the projected flood of serious and critical Corona cases. (By comparison, South Koreans have more than three times more beds available per thousand people than Americans.) According to an investigation by USA Today “only eight states would have enough hospital beds to treat the 1 million Americans 60 and over who could become ill with COVID-19.”
Local and state health departments – the vital first line of defense – have 25% less staff today than they did twelve years ago. Over the last decade, moreover, the CDC’s budget has fallen 10% in real terms. These shortfalls have only been exacerbated under Trump, who also closed the White House pandemic office established by Obama after the 2014 Ebola outbreak to ensure a rapid and well-coordinated national response to new epidemics.
We are in the early stages of a medical version of Hurricane Katrina. After disinvesting in emergency medical preparedness at the same time that all expert opinion has recommended a major expansion of capacity, we lack basic low-tech supplies as well as respirators and emergency beds. National and regional stockpiles have been maintained at levels far below what is indicated by epidemic models. The test kit debacle has coincided with a critical shortage of protective equipment for health workers. Militant nurses, our national social conscience, are making sure that we all understand the grave dangers created by inadequate stockpiles of protective supplies like N95 face masks. They also remind us that hospitals have become greenhouses for antibiotic-resistant superbugs such as S. aureus and C. difficile which may become major secondary killers in overcrowded hospital wards.
The outbreak has instantly exposed the stark class divide in our country. Those with good health plans who can also work or teach from home are comfortably isolated provided they follow prudent safeguards. Public employees and other groups of unionized workers with decent coverage will have to make difficult choices between income and protection. Meanwhile, millions of low-wage service workers, farm employees, the unemployed, and the homeless are being thrown to the wolves.
Universal coverage in any meaningful sense requires universal provision for paid sick days. A full 45% of the workforce is currently denied that right and virtually compelled to either transmit the infection or go hungry. Fourteen states have refused to enact the provision of the Affordable Care Act that expands Medicaid to the working poor, so nearly one in five Texans, for example, lacks coverage.
The deadly contradictions of private healthcare in a time of plague are most visible in the for-profit nursing home industry which warehouses 1.5 million elderly Americans, most of them on Medicare. It’s a highly competitive industry characterized by low wages, understaffing and illegal cost-cutting. Tens of thousands die every year from long-term care facilities’ neglect of basic infection control procedures and from government failure to hold management accountable. Many of these homes find it cheaper to pay fines for sanitary violations than to hire additional staff and provide them with proper training. So, it’s not surprising that the first epicenter of community transmission was the Life Care Center, a nursing home in the Seattle suburb of Kirkland. I spoke to Jim Straub, an old friend who’s a union organizer in Seattle area nursing homes. He characterized the facility as “one of the worst staffed in the state” and the entire Washington nursing home system “as the most underfunded in the country – an absurd oasis of austere suffering in a sea of tech money.” Straub pointed out that public health officials were overlooking the crucial factor that explains the rapid transmission of the disease from Life Care Center to nine other nearby nursing homes: “Nursing home workers in the priciest rental market in America universally work multiple jobs, usually at multiple nursing homes.” He says that authorities failed to find out the names and locations of these second jobs and thus lost all control over the spread of COVID-19. Across the country, many more nursing homes will become coronavirus hotspots. Many workers will eventually choose the food bank over working under such conditions and stay home. In this case, the system could collapse.
The pandemic illustrates the case for universal health coverage and paid leave with every step of its deadly advance. We must organize against evictions, layoffs, and employers who refuse compensation to workers on leave. But universal coverage and associated demands are only a first step. It’s disappointing that in the primary debates neither Sanders nor Warren highlighted Big Pharma’s abdication of the research and development of new antibiotics and antivirals. Of the 18 largest pharmaceutical companies, 15 have totally abandoned the field. Heart medicines, addictive tranquilizers, and treatments for male impotence are profit leaders, not the defenses against hospital infections, emergent diseases, and traditional tropical killers. A universal vaccine for influenza – that is to say, a vaccine that targets the immutable parts of the virus’s surface proteins – has been a possibility for decades, but has never deemed profitable enough to be a priority.
As the antibiotic revolution is rolled back, old diseases will reappear alongside novel infections and hospitals will become charnel houses. Even Trump can opportunistically rail against absurd prescription costs, but we need a bolder vision that looks to break up the drug monopolies and provide for the public production of lifeline medicines. As I wrote fifteen years ago in The Monster at Our Door: The Global Threat of Avian Flu, “Access to lifeline medicines, including vaccines, antibiotics, and antivirals, should be a human right, universally available at no cost. If markets can’t provide incentives to cheaply produce such drugs, then governments and non-profits should take responsibility for their manufacture and distribution. The survival of the poor must at all times be accounted a higher priority than the profits of Big Pharma.”
The current pandemic expands the argument: capitalist globalization now appears biologically unsustainable in the absence of a truly international public health infrastructure. But such an infrastructure will never exist until peoples’ movements break the power of Big Pharma and for-profit healthcare. This requires an independent socialist design for human survival that includes, but goes beyond a Second New Deal. Since the days of Occupy, progressives have successfully placed the struggle against income and wealth inequality on page one – a great achievement. But now socialists must take the next step and, with the healthcare and pharmaceutical industries as immediate targets, advocate social ownership and the democratization of economic power.
We must also make an honest evaluation of our political and moral weaknesses. The leftward evolution of a new generation and the return of the word ‘socialism’ to political discourse cheers us all, but there’s a disturbing element of national solipsism in the progressive movement. In addressing the pandemic, socialists should find every occasion to remind others of the urgency of international solidarity. We need to demand a massive scaling up of the production of test kits, protective supplies, and lifeline drugs for free distribution to poor countries. Disease knows know boundaries, so evenr if you don’t believe in global solidarity, ensuring universal, high-quality global healthcare is in everyone’s interest.
Mike Davis is the author of several books, including Planet of Slums and City of Quartz.