By Sam Friedman, Bill of Health, July 5, 2023
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| Sam Friedman |
Amid an emergent international consensus that the COVID pandemic is “over,” writings about the pandemic and its meanings have burst forth like the flowers of June.
This article will focus on one such book, Lessons from the COVID War: An Investigative Report. Produced by an eminently established collection of people, The COVID Crisis Group. The book is intelligently critical of what was done during the pandemic, but at all points it remains within the confines of what is “politically respectable.” This respectability, I argue, means that their recommendations are too narrow to protect Americans, much less the populations of the Global South, from pandemics ahead (barring unexpectedly marvelous advances in vaccine breadth and rapidity of deployment).
Their COVID War
The “COVID Crisis Group” is an establishment group of businesspeople and government officials plus some subject matter experts. Many, like their director, Philip Zelikow, have held high government positions and been lawyers, CEOs, or higher-managers for business. Some have also served as public health officials and/or professors. Only one of the over thirty members of the Crisis Group, Kristin Urquiza, is a community representative due to her role in Marked By Covid. When the Crisis Group organized, it saw itself as the future nucleus for a government commission on the pandemic, much like the 9/11 Commission (that Zelikow had directed). Thus, it formed very much thinking of itself in an establishment role.
Here, I will list a few of their major ideas and assumptions.
- The pandemic response in the United States, and its attendant hospitalization and death rates, represents a failure of public health. This failure was primarily rooted in not knowing how to get things done. That is, their critique is on process and competence, not on the underlying assumptions of what was done nor on whether the response was organized for the interest of the wealthy, powerful, and white in ways that hurt workers, the poor, members of oppressed racial/ethnic groups, the disabled and the elderly.
- Since the failure came from not knowing how to get things done, they see a major part of the solution as being the re-creation of the “can-do culture” for which the U.S. used to be famous.
- They emphasize a “need” for public-private ventures to get things done competently. As they see it, business has the “know-how,” as do certain parts of the military.
- They recognize the near-certainty of future pandemic outbreaks. They thus point to the need for early detection and tracking systems, and put forward a number of intelligent suggestions for how this might be done more effectively.
- They state as a main goal in responding to pandemics is getting people back to schools and work as soon as possible. That said, they do take seriously the need for layers of protection at schools and workplaces.
- They also present good ideas on the “how” side of public health. These include funding increases for public health departments and greater data sharing enabled by digitization of health and public health data.
Their omissions and errors and what else needs to be done
Perhaps their most consequential omission is a serious discussion of why potential pandemics are coming at a rapid rate during this century and how to slow this down. They do mention the issue of slowing the transmission of dangerous viruses and bacteria from other animals to humans, but dismiss this as impractical. Instead of trying to do this, they argue, the United States and other countries should set up effective systems of early detection of new potential pandemics and ways to improve reaction times to such detection. They thus accept the inevitability of zoonotic pandemics, which comes intellectually from their either seeing capitalism as a given or as seeing it as an unavoidable eternal fact.
This is a critical omission. Capitalism fuels potential zoonoses — as cities in the global south expand into forests and savannahs, as hunters seek to flood food markets with “exotic” meats, and as industrial meat producers raise and slaughter animals at massive scale. Once humans get infected with a potential pandemic pathogen, the rapidity of travel across and among continents — much of which is for the business purposes of production, distribution, and, thus, profits — makes it highly possible for disease to spread globally before it is even detected.
In other words, pandemics arise through the day-to-day operations of capitalism. For COVID, this involved financial investment by globally-prominent firms in agriculture and food markets in China that probably were the sites of early viral transmission to humans. Relatedly, within the United States, some evidence suggests that capitalist industrial agriculture may have been a driver of the pandemic in the U.S. Midwest.
A second major weakness is their superficial discussion on the misinformation and “anti-science” messages that greatly reduced the effectiveness of many public health interventions around vaccination, masking, and business closures. They discuss some of the commonly mentioned aspects of this, such as the flip-flops of President Trump in his messages about the pandemic, the growth of social media-based misinformation and its spread by “Russian and Chinese cyber mischief-making” (p. 209), and the like.
What they did not discuss is the reasons why capitalism at its current stage breeds attacks on science (such as those volleyed by political leaders against the science of climate change) and a degree of irrationalism among some groups of workers and others in the population, both of which carried over into the politics of COVID. Most importantly, perhaps, they did not discuss the sustained, systematic attacks on science by many large corporations. The tobacco industry attacked the science around smoke and cancer, agribusiness has attacked the critics of both genetically modified organisms and the critics of industrialized meat production, the fossil fuel industry and many firms dependent on it attack the science of climate change. The techniques they used in these attacks, such as sowing doubt and confusion about what science really says and myths about the muzzling and persecution of “dissenting” scientists, were then used to attack the science behind vaccines, masks, school closings, and many other public health responses to the pandemic and to promote many ineffective but supposedly “evidence-based” medications.
The COVID Crisis Group’s superficial discussion of pandemic misinformation does not address the deep-seated roots of this messaging. This is not surprising for such an establishment group, since these root causes are the use of attacks on science to defend the interests of major blocs of capital, the racism that sustains capitalist rule, and the irrationalism that is endemic to capitalism.
Relatedly, although they do report (p. 164-165) that COVID was particularly devastating for American Indians, Blacks, and Hispanics, they do not adequately analyze why this same pattern was true for the HIV/AIDS pandemic, nor why poor health and medical apartheid have been racialized throughout the history of the United States. In discussing the mistrust and disconnection from health systems that greatly weakened a variety of public health efforts during the first two years of the pandemic, they mention that his mistrust “goes deep among communities that have long felt marginalized” (p. 204). They then mention the Tuskegee Syphilis Study that left Black participants with syphilis to suffer the ravages of the disease long after effective treatments were available, but fail to mention similar atrocities such as the involuntary sterilizations that many racially oppressed women had forced on them by the American medical system and the racist eugenic “science” used to justify these actions. Not unexpectedly, with their emphasis on “how to” react to pandemics rather than on what needs to be changed, they do not offer suggestions about ending the socially structured racism that both underlies the extra burdens of pandemics on racialized peoples and contributes substantially to white “anti-science” opposition to public health actions.
They say almost nothing about Long COVID — two short paragraphs and a short footnote. They do recognize that Long COVID is poorly understood and that some people with Long COVID have organized for care and research. One might think that these uncertainties about the extent of Long COVID, its duration, and thus the threat it poses to the population and the workforce would make it worth discussing in depth. After all, if too many people become disabled by it this would show that the COVID Crisis Group was badly mistaken in claiming that getting people back to school and work is a main priority of policy and in supporting the policy of getting back to normalcy in 2023.
In supporting the return to normalcy, they do not discuss one of its large-scale and extremely harmful effects — that of excluding millions of people in the United States (and elsewhere) from social life. Examples include people with asthma or other respiratory infections, or those with impaired immune systems (such as those undergoing chemotherapy for cancer, or those with HIV except when it is totally under control), and elderly people. Thus, the policy of “opening up” and of “normalcy” amounts in practice to excluding tens of millions of people from many jobs and stores. This is not a surprise — by and large, businesses and governments around the country have given lip service to including people with disabilities in society, but actions on this have trailed far behind words
As a final critique, and as a first step in presenting ideas for political actions in future outbreaks of COVID or in the next pandemic (or even a bad epidemic in one country), the COVID Crisis Group discusses the failures and successes of what happened in the United States response to COVID in a thoroughly top-down matter.
They focus on what government agencies and politicians did, on what researchers did, and on what pharmaceutical companies did. In doing this, they failed to discuss the remarkable and sometimes successful actions of ordinary people and workers. They fail to see how members of local communities mobilized mutual aid projects to held neighbors unable (or afraid) to get groceries or needed medications. They fail to discuss and analyze the actions of nurses and other health care workers to organize care, to support each other when sick, and to force hospital managements to procure PPE like masks. They fail to discuss the strikes by various groups of front line workers that arose in dangerous conditions. Further, in their emphasis on the need to re-open schools, they fail to discuss the heroic actions of some teachers’ unions in refusing to return until changes in ventilation and case detection procedures were established that would keep kids, their relatives, and school workers as safe as reasonably possible. They fail even to discuss Marked by COVID and its efforts, in spite of the fact that the COVID Crisis Group includes the founder of Marked by COVID as a member, much less discuss groups like People’s CDC, which have been involved in community education and politics opposed to some of what the COVID Crisis Group proposes.
In short, they base their analysis on thoroughly elitist grounds. They treat the public as the objects acted upon by public health institutions and as a potential obstacle to implementing public health. In the next section, I take the exact opposite view. I see the actions of community mutual aid and worker groups as the solution to ending the system that evokes pandemics and, until then, as fundamental to mitigating the pandemics that arise through the everyday search for profit and power by capitalist institutions.
Solutions
In preparation for the next pandemic, and perhaps during it, we need to empower workers at workplaces to defend themselves. I do not see this primarily as a call to change laws, although passing laws to increase workers’ rights to avoid unsafe working conditions and to organize unions, and even to speak freely with each other at work, would clearly be helpful, and I do support their passage. Laws, however, are likely to be abrogated by employers and the state during emergencies like pandemics. What is needed now, and in the future, is for workers to organize their power and their collective willingness and ability to strike effectively regardless of what the law says and even regardless of what union leaders say. During the COVID pandemic, hospital workers did this, as did some teachers and other workers. Much more is needed.
Similarly, people in the most-effected communities developed many skills at how to cope with sickness and how to organize mutual aid for each other. When confronted with police violence and killings in 2020, people demonstrated around the U.S. and, indeed, the world as part of the Black Lives Matter movement. What is needed now, and in the future, is for neighborhoods and larger communities of poor people, racially or otherwise oppressed people, and working people to develop organizations of mutual solidarity and aid, and a willingness and ability to take direct action to defend themselves and to meet their needs regardless of what employers or governments say.
COVID ravaged prison populations, nursing homes and the homeless with particular ferocity. To prepare for future pandemics, these groups too will have to organize, together with various abolitionist groups. They alone will have limited power, but together with the worker and community groups discussed, more can be done.
Although all of the above will be essential in meeting the threats of a renewed COVID outbreak and of future pandemics, they alone will not be enough. We also will need many of the more intelligent proposals that the COVID Crisis Group put forward, such as improved forms of detecting new pathogens as soon as they arise and rapidly responding to reduce their spread and to develop medicines and vaccines quickly through improved and sustained scientific and public health capabilities.
Preventing pandemic destruction is not just a question of “how to,” as the COVID Crisis Group thinks. It is a question of organizing power from below so people can get rid of capitalism and its pandemic-creating needs and set up a society where people can take care of their needs and of each other without evoking pandemics or climate change. Given the damage that capitalism has already done to the metabolic interchanges between humans and the rest of nature, some of the specific proposals of the COVID Crisis Group will be useful. The economic, political and human structures and ways of thought that we will need to set up, however, will in no way resemble the public-private or military “can-do structures” that are their ideal.
I would like to acknowledge the intellectual input of fellow members of the People’s CDC, and especially Fran Green, Karyn Pomerantz, Howard Waitzkin, and Rob Wallace.
Samuel R. Friedman is a research professor at a leading New York university and previously the Director of the Institute for Infectious Disease Research at National Development and Research Institutes in New York. He can be reached at sam4wp@netscape.net