Saturday, February 27, 2021

 

The Year the World Went Viral - Gilles Dauve

header image taken from communists in situ site

Until the early days of 2020, when they spoke of "viruses", Westerners usually meant something was wrong with their computers (Asians were arguably better informed). Of course, everyone knew the medical meaning of the word, but these viruses remained far away (Ebola), relatively silent despite the 3 million annual deaths from AIDS (HIV), even banal (winter flu, cause of "only" 10,000 deaths in France each year). And if sickness struck, medicine worked miracles. It had even done away with space: from New York, a surgeon could operate upon a patient in Strasbourg.

Back then, it was mostly the machines that got sick.

Until the first days of 2020.

YOU DIE THE WAY YOU LIVE

Covid-19 is a contagious disease with a rate of spread much higher than that of influenza: it causes few serious cases, but their severity is extreme, particularly for at-risk individuals (especially over 65), and requires intensive care hospitalisation of patients in danger of death. Hence also the need to test on a large scale.

Epidemics and pandemics are nothing new.

In the Roman Empire, the plague probably claimed nearly 10 million victims from 166 to 189 AD. In the aftermath of 1918, between 20 and 100 million deaths were attributed to the "Spanish" flu. At the same time, typhus killed 3 million Russians during the Civil War. In 1957-1958, the "Asian" flu caused the death of about 3 to 4 million people worldwide. The "Hong Kong” flu is estimated to be globally responsible for 1 million deaths (31,000 in France) between the summer of 1968 and the spring of 1970.

Impressive figures indeed, often uncertain (20 to 100 million, or even 3 to 4 million, that’s quite a gap), sometimes erased from collective memory: in France, before February 2020, no-one remembered the 31,000 people who died in 1968-70. (At the time, there were no general public health measures, and the press ignored or minimized the epidemic.)

We are flooded with Covid-19 statistics that are all the more incomprehensible as their criteria vary. Everything changes whether one notes the tally of deaths since the beginning of the epidemic or on a specific day, the number of contaminations, the increase in the number of contaminations compared to a given date, the rate of transmission, hospitalisations or beds occupied in intensive care. The more tests there are (in most countries, they were very rare in the early months), the more people are registered as infected, irrespective of whether the death toll decreases or increases.

We are now familiar with the difference between morbidity, mortality and lethality, the latter being the most significant, as its rate indicates the number of disease-related deaths relative to the total number of patients. Not forgetting the distinction between apparent and actual lethality rates. Only the latter gives the ratio of the number of deaths to the number of cases actually tested positive; the former is based solely on the estimate of those who have been infected.

It is equally difficult to understand the “R number”, which measures the capacity of an infectious disease to spread. In the case of Covid-19, the notification rate of new cases is easier to define (there are three definitions in France) than to calculate, and estimates vary considerably from country to country.

Figure-wise, it is true that 9 out of 10 people who die from Covid are over 65, but all causes of death combined, the proportion of old people now dying is not that much higher than what it was in non-Covid-19 times – they die of old age, illness, poverty and related diseases.

In sum, we are left with a welter of constantly updated and conflicting data. As important as they are, Covid-19 figures miss the broader picture: while they tell us about the scope of the pandemic (over 1,7 million deaths in 2020), they overlook its social causes and their effects.

Like any serious disease, Covid-19 is likely to kill people weakened by age, another disease, and/or a debilitating lifestyle: poor diet, air pollution (estimated to kill between 7 and 9 million people worldwide), chemical pollution, sedentary habits, isolation, old people out of work and therefore out of society - all factors contributing to effects such as diabetes or cancer... favourable ground for Covid. Out of the 31,000 deaths recorded in France at the end of August 2020, at least 7,500 are reckoned to be due to co-morbidity (25% caused by arterial hypertension, 34% by cardiac pathology).

Various non-measurable factors together create a non-quantifiable excess mortality with a class dimension: unemployment, insalubrious housing, junk food (obesity is more common among the poor). Tuberculosis (1,5 million deaths worldwide in 2014) re-emerged in the 1980s and 1990s because of unsanitary urban conditions and increased poverty. If you're sick, it's better to be rich... and White, usually: "When White man has a cold, Black guy gets pneumonia," they say in the US. All these conditions are made worse by the human cost of lockdown: lower income, anxiety, depression, deprivation of visits for those living in old people’s homes, etc.

“A ‘person with pre-existing medical conditions’ is often just another term for ‘older worker/proletarian’. [..] A middle-aged man ‘with low qualifications’ has an eight times higher risk of taking early retirement due to cardiovascular disease than a man of the same age ‘with high professional qualifications’.” (Wildcat: reference in “Further reading”)

This combination of social and environmental factors, despite its considerable role in the spread of diseases, is difficult to quantify and therefore escapes statistical scrutiny.

Did a pangolin meet a bat ? Or did some lab experiment go wrong ? Maybe we’ll never know. One thing is certain: capitalism is co-morbid. Capitalist civilisation did not create Covid-19, but it has promoted its spread, through the ever-wider circulation of people and goods, accelerated unhealthy global urbanisation, factory farming favourable to pathogens, and the degradation of social security systems in so-called developed countries. Since the beginning of the 20th century, out of 11 worldwide viral pandemics, 5 have occurred during the last 20 years.

"To govern is to foresee": a rule that capitalist society does not ignore, but which it applies according to its own logic. Whenever prevention is an obstacle to competition between firms, to the search for the minimum cost of production, to the profits and short-term interests of the dominant class, prevention takes second place. The precautionary principle will never be a priority in this society.

MAKING THE WORST OF THE BAD

The tragedy that has unfolded was not biologically preordained to take the forms it has. Although more contagious and lethal than seasonal flu, Covid-19 is benign for a vast majority of the population but very serious for a small fraction, probably 1 out of 1,000 people infected.1 It could have been relatively easy to contain the pandemic by systematically screening infected people as soon as the first cases appeared, tracing their movements and placing the (few) people concerned in quarantine. The technique of screening tests requires the organisation and equipment that highly industrialised countries can manufacture and set up in a few weeks. Plus mass-distributing masks to the entire population likely to be contaminated. The dismantling of the European and North American health care systems, however, helped turn this virus into a catastrophe.

This is well-known, but begs the question:

Why was one Earthling in three locked down for weeks, months sometimes, and why is it happening again, albeit differently, whenever the States deem it necessary (Israel in September, 2020, later Wales and Ireland, then England, France and more countries…) ?

If it is true that the internationalisation of capitalism makes it vulnerable, this is not enough to explain the partial paralysis of the world economy. Why has the fight against contagion taken the form of locking up populations, with the forced closure of a large number of businesses ?

Phase One: Cassandra calling

“In early 2018, during a meeting at the World Health Organization [...], experts [...] coined the term “Disease X”: They predicted that the next pandemic would be caused by an unknown, novel pathogen that hadn’t yet entered the human population. Disease X would likely result from a virus originating in animals and would emerge somewhere on the planet where economic development drives people and wildlife together. Disease X would probably be confused with other diseases early in the outbreak and would spread quickly and silently; exploiting networks of human travel and trade, it would reach multiple countries and thwart containment. Disease X would have a mortality rate higher than a seasonal flu but would spread as easily as the flu. [...] In a nutshell, Covid-19 is Disease X. » (Michael Roberts, March 15, 2020)

Phase Two: Cassandra unheeded

The 2018 warning fell on unreceptive ears. Less than two years later, when a disease that had all the features of “X” came along, the States started by downplaying or flatly denying the issue.

As early as 31 December 2019, the Taiwanese authorities had warned the WHO of the dangers of the virus, but the WHO chiefs contested the seriousness of the situation. So did most governments, and the pandemic remained invisible for a long time in Asia, and also in European countries which detected it several weeks late. On 30 January, the director of the WHO visited China, declared everything was under control and praised the Chinese authorities. He also advised against any restrictions on travel and movement, when Taiwan had already been closed for a month.

Nearly all States prioritized economic interests and took no protective measures, such as cutting air links with China.

The Bergamo province is a case in point. It was one of the world’s regions hardest hit by the virus. In its textile industry, most firms today are Italian-Chinese joint ventures. “Chinese technicians and subcontractors constantly travel back and forth between China and Bergamo ...] some of them are even weekly commuters. The virus probably came to Italy via this traffic in December or January. When the Italian government banned direct flights to China, the companies organised connecting flights via Moscow or Bangkok - people entered the country without any controls [..].” (Wildcat) On 28 February, the bosses launched a "Bergamo keeps working !” campaign: they apologised (only five weeks later) but managed to keep production going almost until the end of March.

In France, on Sunday 14 March, it was a civic duty to leave one’s front door to go and vote in the municipal elections.

Phase Three: Health management takes momentary priority over economic imperatives

When official assessments were belied by conditions in the field, governments could no longer brush aside the issue, and they coped with it according to their own logic and with the means at their disposal. In a country such as France, the event revealed the extent to which modern pseudo-abundance masks a real shortage: the "world's 7th largest economy" lacks nurses, hospital beds, tests, means of protection... Therefore, on Tuesday 16 March, the French citizen was required to stay at home, under pain of fine or possible imprisonment.

In most Western countries now, the health service operates on a fee-for-service principle: i.e., treating the ratio before the patient. Hospitals are run on a just-in-time basis: like in a textile factory or a supermarket, they only maintain personnel and equipment that are strictly necessary, regard an unoccupied bed as a waste of money, they outsource whatever is deemed unessential and, if need be, they hire temporary staff on short-term contracts. In September 2019, just a few months before the crisis, the French NHS introduced bed managers in order to "smooth the flow of patients into and out of the various wards".

Consequently, since the first phase (mass screening) had been missed and human and material resources were lacking, lockdown and curfew were imposed: they did not protect so much the population from the virus as the State from its own mishandling of the epidemic. Staying indoors gives people a protection of sorts, in the same way as State-organised civil defence saves lives during an aerial bombing caused by the war unleashed by that same State.

Because governments were unable to deal with the effects of a crisis they had helped to create, their only way out was to scare the population into submission, while resorting to successive expedients. Official talk treads the thin line between reassuring and scaremongering, with help from the “scientific community” and resonance in the media.

In most of the world, lockdown - leading to the partial halt of production and trade - proved to be the only way to temporarily limit the epidemic. What you can’t master, you have to mismanage, and if no contingency plan is ready, you improvise, dressing up the debacle as policy. The key is to keep control – or fake it, with negative effects upon small as well as big business.

Phase Four: Return to business as usual – Not quite

After about two months, the pandemic, though far from over, and even proving now deadlier in some countries, seemed manageable enough without any serious socio-political effects. Moreover, it was noted that the vast majority of the dead had passed the age of going to work: in the US, by September 9, 2020, 78% of Covid victims were over 65; in France, this was the case of 90% of the deceased between 1 March and 28 August. For those of working age, however, the probability of dying from the Covid was low: it was therefore urgent to send them back to the workshop or office - with the promise, of course, of adequate protection. People had restricted or no access to restaurants, “unessential” shopping was difficult or impossible, partying was restricted or banned, but crowds had to pile up in suburban trains on the way to their job premises. Work is not just a means to earn money, it is the main social regulator and it disciplines people.

The “Spanish” flu and “Hong Kong” flu both lasted two years. Instead of gradually and evenly phasing itself out, Covid-19 may be decreasing in a few areas, but others are seeing spikes. While daily life constraints and prohibitions are partially lifted in some countries, they are toughened elsewhere. Vaccine or no vaccine, governments impose tier-system makeshift measures, reintroduce curfews, close and re-open borders, tighten or loosen the screws, depending on the spread of the epidemic, the needs of the capitalist economy in general and shopping in particular.

WAGING WAR

Governments and institutions proclaim themselves at war against an "invisible enemy". Let’s take them at their word.

War is the continuation of society (in the present world, of capitalist society) by other means, but also the temporary disruption of fundamentals. Whether a country wins or loses a war, for its ruling classes, the cost is not negligible, and often proves to be exorbitant: they can leave all or part of their wealth or power behind. But the rationality of a conflict cannot be understood or measured in dollars or yuan. A State does not go to war to make money, and what determines it differs from an entrepreneur’s logic: it is the result of social and political forces and (im)balances, both inside and outside the country. The decision to go to war will be taken in the interest of the dominant classes… in so much as they conceive it. The ruling elites of the four empires (German, Austrian, Russian and Ottoman) which were dismantled after 1918 had embarked four years before in a war which they hoped would further their interests. Nor had the invaders of Iraq in 2003 foreseen the Islamic State. In each case, whatever the costs, capitalist leaders reckon that not going to war would be worse. Once the process is launched, if solving a particular issue brings about a fresh one, then they proceed to deal with it. Take one crisis at a time, and stick to the possible in order to calm more crises than are generated.

Most governments are aware of the causes and effects of global warming, against which they only come up with palliative measures. Why would they act otherwise faced with a pandemic ? Since they were unable to take precautions for elderly people already suffering from serious illnesses, to test massively, to quarantine any infected person, to adequately hospitalise extreme cases, and provide us with personal protective equipment, they were left with the good-bad but easiest solution: to implement what amounted to a social shutdown.

The dominant classes cannot address the causes of a crisis which is largely their doing. Responses have varied in the extreme, from Germany to Brazil, with sanctions ranging from 6 months’ imprisonment in France to 7 years in Russia. But in all cases, managing the epidemic and controlling the population are one and the same thing: in France, forest walks were forbidden during the (first) lockdown, because these vast spaces, although favouring "physical distancing", make surveillance more difficult. The price to be paid by the dominant classes (risk of political discredit, loss of production and therefore of profit) was not negligible, but secondary compared to the imperative of maintaining order - social, political and sanitary at the same time.

And even trade-dependent South Korea and Taiwan, although they could test and distribute masks on a large scale and therefore limit “confinement” to proven cases, were forced to slow down their highly export-driven economies, because importing countries were closing up. Similarly, Germany, despite a restrained lockdown, had to scale down its trading activities.

Capitalism develops through a succession of downturns and upswings. This time, a global standstill did not result from a worldwide depression, but from what seemed to be the only option left and, all present things considered, a rational decision: a large number of countries injected themselves with a dose (fairly strong but temporary) of forced rest, before setting off again in good health, hopefully.

LONG READ; GILLES DAUVE IS NEVER SHORT

IT CONTINUES HERE

The Year the World Went Viral - Gilles Dauve (libcom.org)

No comments:

Post a Comment