Mike Davis: The Coronavirus Crisis Is a Monster Fueled by Capitalism

Pandora’s Box is open, and our ruthless economic system is making everything far worse.

Mike Davis March 20, 2020

Coronavirus shows that capitalist globalization is biologically unsustainable. (Photo by LILLIAN SUWANRUMPHA/AFP via Getty Images)

Coro­n­avirus is the old movie that we’ve been watch­ing over and over again since Richard Preston’s 1995 book The Hot Zone intro­duced us to the exter­mi­nat­ing demon, born in a mys­te­ri­ous bat cave in Cen­tral Africa, known as Ebo­la. It was only the first in a suc­ces­sion of new dis­eases erupt­ing in the vir­gin field’ (that’s the prop­er term) of humanity’s inex­pe­ri­enced immune sys­tems. Ebo­la was soon fol­lowed by avian influen­za, which jumped to humans in 1997, and SARS which emerged at the end of 2002. Both cas­es appeared first in Guang­dong, the world’s man­u­fac­tur­ing hub. 

We are in the early stages of a medical version of Hurricane Katrina.

Hol­ly­wood, of course, lust­ful­ly embraced these out­breaks and pro­duced a score of films to tit­il­late and scare us. (Steven Soderbergh’s Con­ta­gion, released in 2011, stands out for its accu­rate sci­ence and eerie antic­i­pa­tion of the cur­rent chaos.) In addi­tion to the films and innu­mer­able lurid nov­els, hun­dreds of seri­ous books and thou­sands of sci­en­tif­ic arti­cles have respond­ed to each out­break, many empha­siz­ing the appalling state of glob­al pre­pared­ness to detect and respond to such nov­el diseases.

A new monster

So Coro­na walks through the front door as a famil­iar mon­ster. Sequenc­ing its genome (very sim­i­lar to its well-stud­ied sis­ter SARS) was a piece of cake, yet much infor­ma­tion is still miss­ing. As researchers work night and day to char­ac­ter­ize the out­break they are faced with three major chal­lenges. First, the con­tin­u­ing short­age of test kits, espe­cial­ly in the Unit­ed States and Africa, has pre­vent­ed accu­rate esti­mates of key para­me­ters such as repro­duc­tion rate, size of infect­ed pop­u­la­tion and num­ber of benign infec­tions. The result has been a chaos of numbers. 

Sec­ond, like annu­al influen­zas, this virus is mutat­ing as it cours­es through pop­u­la­tions with dif­fer­ent age com­po­si­tions and health con­di­tions. The vari­ety that Amer­i­cans are most like­ly to con­tract is already slight­ly dif­fer­ent from that of the orig­i­nal out­break in Wuhan. Fur­ther muta­tion could be benign or could alter the cur­rent dis­tri­b­u­tion of vir­u­lence which spikes sharply after age 50. The coro­n­avirus is at min­i­mum a mor­tal dan­ger to Amer­i­cans who are elder­ly, have weak immune sys­tems, or chron­ic res­pi­ra­to­ry problems. 

Third, even if the virus remains sta­ble and lit­tle mutat­ed, its impact on younger age cohorts could dif­fer rad­i­cal­ly in poor coun­tries and amongst high pover­ty groups. Con­sid­er the glob­al expe­ri­ence of the Span­ish flu in 1918 – 19 which is esti­mat­ed to have killed 1 to 3% of human­i­ty. In the Unit­ed States and West­ern Europe, H1N1 was most dead­ly to young adults. This has usu­al­ly been explained as a result of their rel­a­tive­ly stronger immune sys­tems which over­re­act­ed to the infec­tion by attack­ing lung cells, lead­ing to pneu­mo­nia and sep­tic shock.

In any event, the influen­za found a favored niche in army camps and bat­tle­field trench­es where it scythed down young sol­diers by the tens of thou­sands. This became a major fac­tor in the bat­tle of empires. The col­lapse of the great Ger­man spring offen­sive of 1918, and thus the out­come of the war, has been attrib­uted by some to the fact that the Allies, in con­trast to their ene­my, could replen­ish their sick armies with new­ly arrived Amer­i­can troops.

But the Span­ish flu in poor­er coun­tries had a dif­fer­ent pro­file. It’s rarely appre­ci­at­ed that a major pro­por­tion of glob­al mor­tal­i­ty occurred in the Pun­jab, Bom­bay and oth­er parts of West­ern India where grain exports to Britain and bru­tal req­ui­si­tion­ing prac­tices coin­cid­ed with a major drought. Resul­tant food short­ages drove scores of poor peo­ple to the edge of star­va­tion. They became vic­tims of a sin­is­ter syn­er­gy between mal­nu­tri­tion — which sup­pressed their immune response to infec­tion and pro­duced ram­pant bac­te­r­i­al — as well as viral pneumonia.

This his­to­ry — espe­cial­ly the unknown con­se­quences of inter­ac­tions with mal­nu­tri­tion and exist­ing infec­tions — should warn us that COVID-19 might take a dif­fer­ent and more dead­ly path in the dense, sick­ly slums of Africa and South Asia. With cas­es now appear­ing in Lagos, Kigali, Addis Aba­ba and Kin­shasa, no one knows (and won’t know for a long time because of the absence of test­ing) how it may inter­act with local health con­di­tions and dis­eases. Some have claimed that because the urban pop­u­la­tion of Africa is the world’s youngest, the pan­dem­ic will only have a mild impact. In light of the 1918 expe­ri­ence, this is a fool­ish extrap­o­la­tion. As is the assump­tion that the pan­dem­ic, like sea­son­al flu, will recede with warmer weather.

The lega­cy of austerity

A year from now we may look back in admi­ra­tion at China’s suc­cess in con­tain­ing the pan­dem­ic but in hor­ror at the Unit­ed States’ fail­ure. The inabil­i­ty of our insti­tu­tions to keep Pandora’s Box closed, of course, is hard­ly a sur­prise. 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. The cri­sis dates back to the cor­po­rate offen­sive that brought Ronald Rea­gan to pow­er and con­vert­ed lead­ing Democ­rats into its neolib­er­al mouth­pieces. 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 by increas­ing cen­sus’ (the num­ber of occu­pied beds). But management’s 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.”

At the same time, Repub­li­cans have repulsed all efforts to rebuild safe­ty nets shred­ded by the 2008 reces­sion bud­get cuts. Local and state health depart­ments — the vital first line of defense — have 25% less staff today than they did before Black Mon­day twelve years ago. Over the last decade, more­over, the CDC’s bud­get has fall­en 10% in real terms. Under Trump, the fis­cal short­falls have only been exac­er­bat­ed. The New York Times recent­ly report­ed that 21 per­cent of local health depart­ments report­ed reduc­tions in bud­gets for the 2017 fis­cal year.” Trump also closed the White House pan­dem­ic office, a direc­torate 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. So 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. 

An unequal crisis

The out­break has instant­ly exposed the stark class divide in Amer­i­can health­care. 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. 

As we all know, 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 set an emp­ty plate. Like­wise, 14 states have refused to enact the pro­vi­sion of the Afford­able Care Act that expands Med­ic­aid to the work­ing poor. That’s why near­ly one in five Tex­ans, for instance, 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 is a high­ly com­pet­i­tive indus­try cap­i­tal­ized on 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 gov­ern­ments’ fail­ure to hold man­age­ment account­able for what can only be described as delib­er­ate manslaugh­ter. Many of these homes find it cheap­er to pay fines for san­i­tary vio­la­tions than to hire addi­tion­al staff and pro­vide them with prop­er training. 

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 is 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 — and we shouldn’t expect the Nation­al Guard to emp­ty bedpans.

The way forward

The pan­dem­ic illus­trates the case for uni­ver­sal health cov­er­age and paid leave with every step of its dead­ly advance. While Joe Biden will like­ly face off against Trump in the gen­er­al elec­tion, pro­gres­sives must unite, as Bernie Sanders pro­pos­es, to win Medicare for All. The com­bined Sanders and War­ren del­e­gates have one role to play at the Mil­wau­kee Demo­c­ra­t­ic Nation­al Con­ven­tion in July, but the rest of us have an equal­ly impor­tant role in the streets, start­ing now with the fights 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 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. (This used to be the case: dur­ing World War Two, Jonas Salk and oth­er researchers were enlist­ed to devel­op the first flu vac­cine.) As I wrote fif­teen years ago in my book The Mon­ster at Our DoorThe 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 that is sym­met­ri­cal with the new nation­al­ism. We talk only about the Amer­i­can work­ing class and America’s rad­i­cal his­to­ry (per­haps for­get­ting that Eugene V. Debs was an inter­na­tion­al­ist to the core).

In address­ing the pan­dem­ic, social­ists should find every occa­sion to remind oth­ers of the urgency of inter­na­tion­al sol­i­dar­i­ty. Con­crete­ly we need to agi­tate our pro­gres­sive friends and their polit­i­cal idols to demand a mas­sive scal­ing up of the pro­duc­tion of test kits, pro­tec­tive sup­plies and life­line drugs for free dis­tri­b­u­tion to poor coun­tries. It’s up to us to ensure that ensur­ing uni­ver­sal, high-qual­i­ty health­care becomes for­eign as well as domes­tic policy.

A ver­sion of this piece first appeared at Jacobin.

Mike Davis is the author of sev­er­al books, includ­ing Plan­et of Slums and City of Quartz.
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