Thursday, May 28, 2020

The Brooklyn Rail


Field Notes

New Pandemic, Old Story


One of the most remarkable aspects of the COVID-19 pandemic is the way it has made visible and concrete the links between the social, economic, and political systems we have created for ourselves and our health. These links have been manifested both in the effects of the pandemic itself as well as in the ways we have responded (or failed to respond) to it. A second no less remarkable aspect is the sheer magnitude and unprecedented nature of the global response, a response that has perhaps made it possible to experience glimmers of ways in which we could live and be organized differently. Whether the experience will lead to real change, or whether after deaths begin to drop (and the disease settles into endemic transmission among the most vulnerable) we will all return to business as usual remains to be seen.
On a very practical level, one striking aspect of the pandemic response has been how unprepared we appear to have been, despite decades of pandemic preparedness exercises. A striking example has been that a country like the United States, one of the wealthiest countries in the world and the one that spends the largest percentage of GDP on health care, failed miserably to respond to basic needs generated by the growing spread of the virus. Nothing illustrates this more clearly than the lack of access to the tests needed to identify cases and the scarcity of protective equipment needed to protect health care workers from becoming infected themselves. Given the critical importance of case identification and contact tracing as the core public health approach to controlling epidemics in early stages, it is likely that the scarcity of testing was a major determinant of the inability to stop the spread earlier resulting in extensive community transmission and the consequent need for draconian stay-at-home measures. The inability to ensure even the most basic protective gear for health care workers (so-called PPE or personal protective equipment) has placed many at risk. The ongoing saga regarding the availability and distribution of ventilators, which even had US states bidding against each other1 is yet another example. It could be argued that the surge in cases was faster than anticipated, yet even well into the pandemic it has been extremely challenging to provide these basic resources when and where they are needed. Where is “the invisible hand of the market” when we really need it?
Of course, the lack of testing and PPE are manifestations of a much broader problem: the lack of a coordinated and cohesive public health response for the country as a whole. As a result, jurisdictions all over the US have responded as best they can, often piecemeal and with minimum (if any) coordination across adjacent geographic areas. To make things worse, the limited access to testing has meant not only that case identification for purposes of isolation and contact becomes impossible but also that basic statistics regarding the epidemiology of the disease are just not available. We have limited data on the rate at which new cases are occurring or on the proportion of the population that has already been infected. Some suggest that in some settings cases may actually be as much as 10 times higher2 than those reported. Lack of testing may also be skewing key measures like the case fatality rate (the proportion of cases that die) as well as information on the proportion of all infections that are asymptomatic, and on how soon after acquiring the infection people can transmit the disease. Data like these are critical to modelling efforts that attempt to predict the number of cases, the number of hospitalized cases, and the number of deaths that we can expect within specific time periods. Lack of information on these very basic aspects of the epidemiology of the virus are behind the highly variable estimates of the impact of the pandemic generated by various modelling groups. Only recently has the Centers for Disease Control (the premier public health agency of the United States and many would argue across the world) announced the launching of a series of population studies aimed at obtaining vital information needed to guide our response. Although it has consistently issued clear guidance via its website, the agency has been amazingly absent in guiding and coordinating national policy which has been left to politicians with variable scientific input. In this vacuum various individuals, ad-hoc groups of scientists, and think tanks have put forward multiple point plans on how we should respond, often disseminated through journal articles, social media or the press. [(As I write this, several US governors have announced that they plan to form coalitions to do the sensible thing and begin to coordinate responses across states.)]
On a more positive note, it has been striking to observe how the health threat created by the virus motivated a halt to business as usual in ways that no one would have imagined, with the explicit goal of protecting health. As it became apparent that case identification and contact tracing was not going to work to stop transmission, place after place (sometimes whole countries, sometimes cities, sometimes states) adopted “stay at home orders” or even more restrictive curfews. In a matter of weeks schools, universities, and “non-essential” businesses grounded to a halt. Life was completely transformed. Children stayed home, universities shifted to remote teaching, large portions of the workforce were instructed to work from home, all social activities and non-essential travel ceased. All this, as has been repeatedly emphasized in the press, to “flatten the curve” in order to reduce the burden of cases on the health care system and hopefully to reduce the number of deaths. Regardless of whether one believes this was justified or not, at least on the face of it, it was an unprecedented prioritization of health over the economy. Only an infectious disease pandemic, something everyone could relate to because of the fear of “contagion” (and the images of refrigerated trailers holding bodies in New York City), could accomplish this. None of the other silent killers, the 4.2 million deaths3 attributable to air pollution every year, the 1.35 million road traffic fatalities4 worldwide each year, the over 250,000 annual deaths caused by firearms5 (nearly 700 a day), the increasing mortality and morbidity linked to climate change (heat, drought, and floods) have been enough to make us question, let alone interfere with, our economy. For comparison purposes, on the day I am writing this (April 12 2020) the World Health Organization reports a total of 112,652 deaths from COVID-19, although questions remain about the accuracy with which deaths are being attributed or not to the virus.
The fact that this social distancing was implemented so quickly and so pervasively is mind boggling. Surreal images of empty city streets abound. It is hard to deny that social distancing will have an impact on reducing disease transmission although the magnitude of this impact and how it compares to other options (such as intensive case identification and contact tracing coupled with some more limited social distancing measures) is hard to determine. Numerous modelling efforts have reported often widely disparate estimates of cases and deaths expected, and speculation about whether the social distancing measures have or have not worked abounds. We probably will not know for sure for a long time (if at all), when retrospective studies have been performed. But given the threat of large numbers of deaths and an overwhelmed health care system (which was certainly real in some regions like northern Italy and even New York City), there was consensus despite significant uncertainty (and even skepticism among some scientists) that no other option was possible. [(Certainly the need for drastic measures appears to be justified by recent data suggesting that deaths in New York City during the last month were more than twice6 what would have been expected.)]
Aside from its impact on the pandemic itself, the social distancing policies are a grand natural experiment that could affect health in many different ways. One of the obvious consequences is the impact of stay-at-home orders on the slowdown of economic activity with its consequences for unemployment. This was starkly illustrated by the 17 million unemployment claims filed in the US since the start of the pandemics until April 9. Many studies have documented short-term effects of unemployment on the deterioration of physical and mental health with implications not only for those who lose their jobs but for their families.
But the closing down of the economy has had other quite remarkable impacts. Air pollution levels have dropped precipitously. Traffic has been reduced to unprecedented levels. These reductions in themselves could have major health implications given the contributions of air pollution and traffic to deaths worldwide. This is consistent with research showing that despite the adverse effects of unemployment on individuals who become unemployed, economic recessions tend to be associated with improved population health in part likely because of reductions in traffic and air pollution related deaths. We have no data on other potential health impacts of stay-at-home orders and their economic and social effects. For example how have the shut downs affected physical activity and dietary patterns? Have they increased or decreased smoking and alcohol consumption? What have been the impacts on levels of stress and mental health? What about the long -term impact of an increase in gun purchases? Many cities including cities in Latin America have reported dramatic declines in homicide rates but there have also been reports of increases in deaths related to domestic violence. One could envision both positive and negative impacts, and the overall balance of these effects is at this point very hard to predict.
A major recent development (which will be old news and likely long gone from the media’s attention by the time you read this) has been the rediscovery by politicians and the media of something that public health has documented for centuries: the fact that diseases like COVID-19 (and virtually all others, both infectious and not) are strongly socially patterned. The unequal impacts of COVID-19 by social class and race has quickly begun to emerge as the pandemic progresses. Initial comments about “COVID-19 affecting everyone equally” while well-intentioned were, not unsurprisingly, grossly inaccurate. COVID-19 is striking the poor and the working class hardest. Despite limited data, we are beginning to see this pattern emerge in cities across the US. Recent reports have also highlighted higher rates of diseases in Black Americans.The poor and disadvantaged will get more disease, will experience more severe disease when they get infected, and those who get infected will likely die more.
The link between poverty or social class and infectious disease rates is not new,⁸ and is caused in part simply by increased exposure to the virus. Housing conditions that result in overcrowding tend to be more common in poorer neighborhoods resulting in greater disease transmission. Lower income workers are more likely to have jobs that increase their exposure to others who are infected and do not have the luxury of adopting the remote work arrangements that many of us benefit from. Underlying health conditions and psychosocial stress can also affect immune responses,⁹ making the poor more vulnerable to developing disease when exposed to infectious agents. In the case of COVID-19, the poor and working classes will not only get more disease, they will also get sicker when they get it and will likely die more from it. Decades of data demonstrate that chronic diseases like respiratory and heart disease and risk factors like smoking, which make persons more vulnerable to severe and deadly COVID-19 disease, have a clear gradient by social class. In the US access to healthcare and quality of care received also differ by income and race.10 If rationing needs to be implemented, the poor and communities of color who are more likely to have underlying health conditions making their prognosis worse,11 may not fare well.
The poor and working classes will also suffer the greatest consequences of the measures we are taking to stop the pandemic. They are more likely to be laid off or lose income12 because businesses close or because their jobs simply do not allow remote work. They may experience delayed health care for other (and highly prevalent) chronic diseases like hypertension and diabetes because routine visits to health care providers are being cancelled or because the health centers they depend on are cutting back services. 13 Their housing conditions may increase adverse mental health impacts of social distancing. All these things will not only make the pandemic worse (more cases and more severe disease), they may also magnify the burden of other health problems. At the same time the poor may also benefit from some of the hidden benefits, like reductions in air pollution, in traffic and in violence. The bottom line is that the pandemic has made even more visible the fact that health depends to a large extent on factors outside the health care system: income, racism, employment and work conditions among others. These factors, sometimes referred to as “the social determinants of health,14 are rooted in social and economic structures, and have been fundamental drivers of many epidemics, including AIDS in the 1980s, the opioid epidemic in the 2010s (“deaths of despair”), and will today strongly affect the impact of COVID-19.
The big question is of course what will come after this. Based on what we know so far, this virus will not go away anytime soon, and a vaccine will not be available for many months, some say years (although remarkable efforts are being made to accelerate the process). Treatments (if they are identified) are not an efficient solution to reducing population transmission. How and when will social distancing be lifted? It appears that the most likely scenario is a combination of selective relaxation of social distancing (based on risk of severe disease) coupled with a much more intense effort at disease surveillance, case identification and contact tracing. But this will require significant investment in public health infrastructure (which has a long history of inadequate financing and repeated cuts, even in a rich country like the United States).15
Of course, globally a major question is what will happen when the pandemic fully reaches lower- and middle-income countries. Many of these countries have also adopted stay at home orders, without necessarily considering their full implications. Large proportions of populations in these countries have limited access to water and live in slums where social distancing is impossible (and where stay at home orders can have dramatic adverse consequences). There have already been reports of mass migrations16 returning to rural area from the cities in India for example. Many of these populations work in the informal economy. Will stay at home orders be used by governments to quell social protests and repress political movements? How will the global economic recession affect these countries? There are already emerging signs that food supply chains could be affected. What about increasing social unrest if stay-at-home orders and curfews are maintained? How will the fragile and very minimal health and public health systems of these countries deal with this? Will all populations have equal access to the vaccine once we have one? How much will it cost and who will pay?
The truth is that it is impossible to predict at this time what the ultimate health impact of the pandemic will be and how will it compare to other health problems averted or created by our response. There will be much for social scientists and public health researchers to describe, analyze and fully understand. There will be debates (many already occurring) on whether we did or did not act informed by science and whether the response is a success or a radical failure17 of science driven policy and international cooperation (it’s probably a mixture of all of this…). But will we learn anything from this? Will we see that grand scale changes are actually possible? Will we see that the system we live in with its inequities, health threats, and environmental impacts (these things are related, as some have traced the origins of the virus to environmental degradation)18 is nothing “natural” but rather something of our own making? Many of you will say we will not, and you may be right, but indulge me for a minute. Perhaps this crisis will open our eyes and make starkly visible what has been there all along…Chances for significant change are slim, and yes, many structural factors remain untouched, but we have never seen anything like this: a global economy stopped to protect health, an end to frantic global travel, dramatic reductions in air pollution and carbon emissions (“the steepest annual fall in C02 in history”),19 inmates who should never have been incarcerated being released, unprecedented (albeit admittedly very minimal) wealth redistribution via direct payments in times when most of us would have said the likelihood of this happening was zero. Call me a naïve optimist, but despite the hardship and the chaos, some of the things the pandemic has triggered give me a glimmer of hope.

  1. www.theguardian.com/us-news/2020/mar/31/new-york-andrew-cuomo-coronavirus-ventilators
  2. www.cnbc.com/2020/03/24/italian-coronavirus-cases-seen-10-times-higher-than-official-tally.html
  3. www.who.int/gho/phe/outdoor_air_pollution/burden_text/en/
  4. www.cdc.gov/injury/features/global-road-safety/index.html
  5. www.healthdata.org/infographic/firearm-deaths-around-world-1990%E2%80%932016
  6. www.nytimes.com/interactive/2020/04/10/upshot/coronavirus-deaths-new-york-city.html
  7. www.nytimes.com/2020/04/07/us/coronavirus-race.html
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446809/
  9. https://www.apa.org/research/action/immune
  10. www.healthaffairs.org/do/10.1377/hpb20180817.901935/full/"
  11. www.nejm.org/doi/full/10.1056/NEJMsb2005114
  12. www.nytimes.com/2020/03/20/us/coronavirus-poverty-school-lunch.html
  13. www.nytimes.com/2020/04/04/us/coronavirus-community-clinics-seattle.html
  14. www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-031210-101218
  15. www.nytimes.com/2020/03/14/us/coronavirus-health-departments.html
  16. https://www.cnn.com/2020/03/27/india/coronavirus-covid-19-india-2703-intl-hnk/index.html
  17. www.theguardian.com/commentisfree/2020/apr/09/deadly-virus-britain-failed-prepare-mers-sars-ebola-coronavirus?CMP=share_btn_tw
  18. www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/salud-planetaria-y-covid-19-la-degradacion-ambiental-como-el-origen-de-la-pandemia-actual/6112996/0
  19. www.greenbiz.com/article/coronavirus-could-trigger-largest-ever-annual-fall-co2-2020

Contributor

Ana V. Diez Roux
is the Dean of the Dornsife School of Public Health, at Drexel University, Philadelphia.
The Brooklyn Rail

The Plague and the Wrath
translated by Janet Koenig
By Charles Reeve
Field Notes


How do we make sense of the strange and singular period in which we now live? Given its tragic side, this period throws into sharp relief the weaknesses and the limits of the global capitalist system, weaknesses which only yesterday seemed to be its strength and power. Subjected to an endless loop of toxic discourses, we are at present stuck in an atmosphere of anxiety; we are helpless by the very fact of our isolation. We feel menaced by an environment where every object or individual is perceived as hostile, potentially fatal. Human relationships themselves are undermined by danger. We assiduously follow the numbers and projections of “experts” in death like stock market reports; they overwhelm and weaken us; added to these are conspiracy theories, speculations, and supposed certainties meant to reassure us. The critical spirit must blaze a trail for itself through this magma. This is the only way to reach open air and to rise above the abdication of thought in the face of fear.


In rich societies, the cult of well-being and the myth of progress, of the individual triumphing over nature, appeared to have decisively pushed away the idea of death. But this march of progress is nothing other than the destruction of life—what the enemies of the productivist ideology like Walter Benjamin and other emancipatory “pessimists” feared already a century ago.


The fragility of life and societies had been allocated to people living in poverty, in constantly expanding territories of barbarous warfare, in communities still waiting for the fruits of this terrible progress. Death had become a consumable image—a source of revolt, of course, but far away. In rich societies, the unceasing reinforcement of walls of repression and xenophobia had bolstered a sense of security. Images of refugees, the tens of thousands of people drowned in the Mediterranean, came as daily reminders. Then, without warning, the virus got around the police, the barricades and borders, and imposed itself on us. It took the easiest and most up-to-date route, that of the circulation of commodities and people, including—ironically, the one disguised as playful leisure: mass tourism. Here we are, thrown into this nothingness. We knew all this, we were warned. This time, we are the ones inside the wall! The frontal impact stunned and paralysed us. Yet, once again in history, it is only by setting larger goals that we can try to break free of this paralysis and fear and get through this surprisingly strange period.

“What doesn't kill us makes us stronger, but above all less well-behaved. 
THE STATE WILL PAY!” Photo:Philippe Gonnet.


We have moved out of normality, the normality of capitalism, which we have opposed but to which we have been obliged to submit, even sometimes in ways we’re not aware of. This may be a first important lesson to learn from this moment: we are all part of the system, whatever our ideas of breaking with it or experiments with practices outside the norms. But this exit from normality is unlike any we have experienced in other historical moments, when capitalist time has ruptured and subversive collective action has produced another mode of time. What we are experiencing today is a suspension of time imposed on us, not the result of autonomous action in opposition to the world. This strangeness is surely one of the sources of our anguish. We are living through a new experience that was not predictable: “the general strike of the virus,” to use someone’s apt expression. The stoppage of “business as usual” has happened without us, outside any of the schemas we have always envisaged, desired, struggled for. This is a mass strike without “masses,'' and worse, without any collective, subversive force. It is probably fair to say that we are living through the first rumblings of a general collapse of this society organized around destructive production for profit. This collapse, without any conscious collective action, is not the bearer of a new world, of plans to reorganize society on new bases. It is a product of capitalism within the limits of its barbarism, with no prospects other than those of collapse. Here stops any resemblance to the general strike, the creation of a collectivity that reclaims its power.


However, the shock that has hit us, announcing a chain of breaks in the world order, is not unrelated to the way our social system functions; it cannot be separated from its contradictions. Recent developments in capitalist globalization, in the acceleration of market exchanges, in the enormous concentration and rapid urbanization of populations, have accelerated an ecological upheaval, the destruction of the fragile reproduction of the plant, animal, and human worlds, breaking down the last barriers between them. The advent of global capitalism was not the heralded end of history, but the inauguration of a new era of ever more frequent epidemics. After the avian flu, after SARS, the imminence of a new epidemic has been feared and almost predicted. But the logic of profit in the capitalist mode of production has ruthlessly continued on its course and the emergency brake was not applied; the brake could only be applied by social forces opposed to this logic, which are still struggling to come into existence. Before us are the consequences of this logic and our powerlessness to block it.


This seems to me a path for reflection: we should not separate the viral crisis from the nature of the system. We must oppose facile explanations that accommodate the existing limits of capitalism and which barely hide the intention to restart the machine. Good examples of this are the various conspiracy delusions, including the seductive conspiracy theory of “the virus created in the lab,” where the most improbable explanation passes itself off as the most obvious. While we know that biological warfare is one of the criminal projects of the ruling class, and that disorganization and accidents are inherent in every bureaucracy, military or otherwise, the fact is that the conspiratorial vision leaves out of the equation the deadly logic of the capitalist mode of production itself. This virus was indeed manufactured, not by secret forces but by the destructive process of modern capitalism.


It is often remarked that today’s lockdown measures and the limitation of social and individual freedoms underscore class relations. Once again, this time in a macabre manner, formal equality melts away in the glare of social inequality. The viral crisis accelerates inequality. But the crisis also reveals the nature of modern capitalism and its contradictions. The everyday reality of the upheaval includes the collapse of the financial system, the collapse of stock markets, the widespread insecurity of salaried workers, the vertiginous rise of unemployment, and mass impoverishment. One breath of fresh air: the economists, who had downplayed the instability of the system and are now confused by the unexpected and short of forecasts, have practically disappeared from the landscape. While millions of unemployed add to the tens of thousands of deaths in the pandemic, gigantic fortunes jockey for government protection. The printing of money resumes and inflation, something we were told was a thing of the past, is on the rise. The aftermath already looks like an aftershock of the collapse.


It’s not surprising that the COVID-19 pandemic and those preceding it were generated in China, in territories undergoing a massive and rapid destruction of nature. China, the world’s workshop, produces viruses as it produces masks, ventilators, and pain medications. It’s all of a piece.


By its global size, the viral contamination quickly created a blockage of trade and an economic collapse, the disorganization of production for profit. One crisis led to another, one replaced another, one nestled in another. Today, everything is global. In the space of two weeks, what could hardly be imagined has become a reality: in the US alone, in one of the very centers of the infernal machine, more than 20 million workers have found themselves out of work.


Among the issues that concern us is the response from the political powers on the terrain of formal rights: the freedom-killing restraints that are shaking up the legal framework of our existence. The possibility of adopting the “Chinese model” as the reference point for a state of emergency was sketched very early in Europe and then concretized with the adoption of repressive methods and techniques for the control of daily life. To this were added exemptions calling into question provisions of the laws governing labor. In Portugal, the Socialist government has gone so far as to suspend the right to strike, giving the state “legal means to force companies to operate.”1


From experience, we have reasons to fear that once the viral crisis is over, these forms of the state of emergency will quietly “pass into common law,” to use the discreet phrase of Le Monde, the newspaper that supports all governments, especially as the end of the lockdown may be slow and lengthy. The urgent need to return to business as usual, for which the capitalist forces already clamor, will undoubtedly justify the perpetuation of these freedom-killing restraints—a new legal framework for new forms of exploitation. This means that the only opposition to this new authoritarian rule of law will be inseparably tied to the collective capacity to oppose the resumption of the logic of capitalist production and its destruction of the world, which has brought us to where we are today.


That said, the inescapable question remains: can capitalism—a powerful and complex system capable of unexpected rebounds—manage in the long run to accommodate itself to functioning in a society ruled by extreme constraints on freedom? In historical experience, a state of emergency is compatible with the reproduction of exploitation and the pursuit of production for profit with strong state intervention. It is no accident that one of the great theoreticians of the state of emergency, Carl Schmitt, was a brilliant admirer of the Nazi order, which for a dozen years established the legal framework for a modern European society at the cost of horrible suffering. Closer to us, it is indisputable that the totalitarian order inherited from Maoism has managed to generate a regime capable of building a modern capitalist power and that, for the time being, its despotic measures have been able to keep the ensuing explosion of social inequalities, conflicts, and class antagonisms under control.


Another concern is the application of this model to the societies of old capitalism dominated by private ownership, where the rule of law regulates all social relations by way of the co-management of “social partners.” This is true in principle at least; in reality economic and public affairs in liberal capitalism are moving in an increasingly authoritarian direction. This tendency was already apparent before the arrival of the pandemic and the collapse of the economy. The evolution of capitalism, its crisis of profitability, and its need to maximise profits have progressively reduced the space for bargaining and co-management, which is the basis of representative democracy and its institutions. The crisis of political representation, which we have been experiencing for years, is the immediate consequence of this.


This being said, we can ask if the implementation of freedom-killing measures is linked to a conscious project of the powers to construct-a permanent state of emergency, to be permanently accepted. Or is the adoption of these measures the only response available to the political leadership to deal with the social consequences of the pandemic? As in any crisis, the ruling class must juggle between the idea of the general interest, on which its ideological hegemony rests, and its subordination to the true order-givers: the capitalist class. In every difficult situation, the only plan B available is the reinforcement of authoritarianism, a recourse to govern through fear.

 
“I don't have Corona, I'm enraged!” Photo: Philippe Gonnet.


At the moment, the extent of the constraints demanded by the magnitude of the viral crisis poses in the long run the problem of a paralysis of the system of production itself. For now, the slowing down of the economy is only in its early stages and the continuation of the life of society demonstrates the wealth and power of modern capitalist societies. But prolonging these constraints risks a collapse of the entire economic machine. Even so, the rapid passage, within a few days, from economic stagnation to a vertiginous recession with millions out of work has signalled the fragility of the entire edifice. This explains the reluctance of part of the ruling class to adopt emergency health measures.


Defenses of liberty are justified: they should put us on guard against the loss of our already meager rights. Nevertheless, given the disastrous effects such emergency measures can have on the unstable economy, it is likely that political systems are adopting them not primarily in order to control the majority of the population or to subject the exploited to new conditions of exploitation but because they are forced to do so by circumstances beyond their control. Of course, the ruling classes know how to make good use of a state of emergency, and they take advantage of the measures involved to speed up the dismantling of “fundamental” rights, to transform the rule of law. However, facts show the ambiguity of the situation. Those very political leaders—in Europe and even in countries where social stability is fragile—have seen themselves forced to backtrack on earlier positions and decisions. To give a few examples: in France, the hated pension “reforms” and the unemployed rights “reform” have been suspended; the US, France, Morocco, and elsewhere have seen timid plans for the release of certain categories of prisoners.


It would be to overestimate their role, and even their class intelligence, to believe that the leaders are in control of the situation and are capable of enacting measures that go beyond safeguarding the laws of profit. These are the laws that dominate their political initiatives. In the present health crisis, locking down populations seems to be the only means to avoid a social and economic disaster. The population is confined not to affirm social domination but as the only way to relieve pressure on the public health service, which is in tatters as a consequence of austerity measures. Desirous of demonstrating control of the situation, the political system tries to hide its responsibility for the healthcare disaster under the cover of defending the famous “general interest.” Perversely, the progressive blockage of the economy as a result of these measures in turn weakens the government.


Nothing says that the end of the lockdown will come with a harmonious return to the past. This, of course, is the plan of the profit lords and their political servants. The latter risk finding themselves, at the end of the state of emergency, weaker than they were before the crisis began. And with a new emergency: a widespread social crisis. The crisis of capitalism will be the second episode of the viral crisis. This is why, from now on, political leaders are seeking to prepare the exit from the shutdown as a long process permitting the integration of emergency measures into an increasingly restrictive rule of law.


The crisis of representation, a natural result of a wealthy and violently inequalitarian society, will only become more evident with the devastating effects of the economic crisis. After the suspended time of the lockdown, capitalist forces will try to impose a return to former levels of production, to the laws of profit as the only alternative. But we are not in the 14th century, with the Black Plague, and in France at least we can hope that the spirit of revolt and resistance accumulated over the last several years will take nourishment from new solidarities that have developed during the lockdown. The collective, the only source of creative liberation, will have to regain its place and expand.


An element of hope is to be found in the experience of these strange months : the experience of the healthcare workers. Working under extremely difficult conditions, with means severely circumscribed by the decisions of politicians now presenting themselves as saviors, collectives of caregivers have succeeded in taking charge of the survival of society. Rising above hierarchies and bureaucracies, they have demonstrated organization, improvisation, and invention. We owe them our thanks that the horror hasn’t spread farther. This mutual support among working communities has drawn its energy, no doubt, from the experience of several years of struggle against government-imposed austerity and want, against the worsening of working conditions, against the predatory attack of private capitalism. Faced with the injustice of death, united by the values of mutual aid, healthcare workers have reclaimed their mission, for the moment taking over control of their activity from financial managers. Because of their role, these workers are aware of their social usefulness for the survival of the community, an awareness that reinforces their commitment but also their strength to challenge. As we have seen, during catastrophes, it is this leap that can create the framework of a different future.


We live the plague, but this suspended time can also be a time when we cultivate and accumulate anger. The opportunity to express that anger will come when life returns, when the time of the scavengers is over.


Meanwhile, to calm our fears and anxieties, we can take pleasure in these few lines by Karl Marx’s old friend Heinrich Heine, who wrote them during the leaden years between the Revolution of 1848 and the Paris Commune:


Here a great calm reigns. A peace of lassitude, sleepiness, and yawns of boredom. Everything is quiet like a winter night enveloped in snow. Nothing but a mysterious, monotonous little noise, like drips falling. These are the returns on capital investment, constantly falling, drip by drip, into capitalist coffers, almost overflowing; one clearly hears the continually rising levels of the wealthy’s riches. From time to time, mingled with this muted lapping one hears a low-voiced sob, the sob of the needy. Sometimes also a slight clicking sound resonates, like a that of a knife being sharpened.2



We are in the grip of something of the same order today; silence is not always calm, it is also the time when weapons are sharpened, to one day settle accounts.

Prime Minister Antonio Costa, SIC TV Portugal, March 20, 2020
Heinrich Heine, Lettres sur la vie politique, artistique et sociale de France (Lutèce, 1855)

Contributor
Charles Reeve
CHARLES REEVE lives and writes in Paris. He is most recently the author of Le Socialisme Sauvage (Paris: L'Echappée, 2018), with translations into German, Portuguese, Spanish, and Portuguese (Brazil).
The Brooklyn Rail

Viral Biopolitics
COVID-19 and the Living Dead

By Rachel Nelson
Field Notes


“As soon as power gave itself the function of administering life, its reason for being and the logic of its exercise—and not the awakening of humanitarian feelings—made it more difficult to apply the death penalty. How could power exercise its highest prerogatives by putting people to death, when its main role was to ensure, sustain, and multiply life, to put this life in order? For such a power, execution was at the same time a limit, a scandal, and a contradiction. Hence capital punishment could not be maintained except by invoking less the enormity of the crime itself than the monstrosity of the criminal, his incorrigibility, and the safeguard of society. One had the right to kill those who represented a kind of biological danger to others.”— Michel Foucault, The History of Sexuality, Volume 1: An Introduction (1976)


“It seems likely that we will come to see in the next year a painful scenario in which some human creatures assert their rights to live at the expense of others, re-inscribing the spurious distinction between grievable and ungrievable lives, that is, those who should be protected against death at all costs and those whose lives are considered not worth safeguarding against illness and death. –”— Judith Butler, “Capitalism has its Limits.”


A letter from Tim Young, written in late March from San Quentin State Prison’s death row details his fears of the spread of COVID-19.1 According to Tim, one of the people in an adjacent cell was recently given a long swab through the meal tray slot on his cell door and told to insert it up his nostril. He was also instructed to do a throat swab. The next day, the man was taken to the Hole for quarantine—for the flu, according to the staff.2

Tim Young. Photo: San Quentin Prison.


Tim writes that dozens of people in his unit have been similarly tested and quarantined, all diagnosed with the flu. In the letter, Tim’s frustration and fear is palpable. He writes about staff handling his food trays without gloves and sneezing and coughing as they walk along the walkway, stopping at each cell to unlock the slot in the door and push the food through the narrow spaces. The flu diagnoses and the cavalier attitudes of the staff towards hygiene have left Tim oscillating between concerns about the inadequacy of medical care in San Quentin and possible cover-ups. While, Tim explains, he is filing a legal request/complaint to be provided masks and gloves, and to require staff to wear them, the pervasive sense in his letter is that anything he does will be futile. This is most apparent when at the end of the letter he writes, "I feel like they are actually trying to spread the virus to us . . . it would be a solution on death row, after all."3


The coronavirus pandemic places in stark relief the complicated relationship, in the United States and globally, between the state and public health. The current conditions of what Michel Foucault named bio-power—the exercise of power through "the administration of bodies and the calculated management of life"—is called into question in the US as hospitals run out of ventilators and protective gear for their workers and as mass unemployment sweeps the nation, leaving people unsure of how they are going to keep feeding themselves and their families, or whether they will have housing in which to shelter-in-place.4 If power is, as Foucault defines it, the ability to "foster life or disallow it to the point of death," what happens within the relationships of power and biological life when death runs rampant?5


Clearly, taking heed of the changing nature of power at such a time is of utmost importance. Some are already reckoning with emergent biopolitical forms. Giorgio Agamben, for instance, fears that the medical emergency will allow state power to implement measures that can become permanent tools of governmental tyranny once the crisis is over.6 Today’s harsh emergency powers supposedly justified by the pandemic could become tomorrow’s "apparatuses of oppression."7


Tim’s letter, however, with his apprehension that, in the US, COVID-19 could be construed on death row as a governmental solution, implies that there is something else happening within this biopolitical shakeup. The conditions he refers to—the extreme of shoddy management of life (and death) captured in his description of swabs passed through slots, the coughing staff distributing food trays through locked gates, and the sick quarantined in the Hole—force the question of what can be learned about what we can call emergent viral biopolitics through the conditions endured by those who have been condemned to die.


Tim’s letter is a stark reminder that, even without a pandemic, death row has an uneasy relationship to bio-power. With state power wielded through the ability to “make live or let die,” those whom the legal apparatus of the state have condemned to die, but whose lives are instead maintained by the state, exist in an odd limbo.8 These are the living dead. They live only to be made to die, and they do so for years. The average time that people spend on death row in most of the US, kept alive by the state, is 15 years. In California, where Tim has been on death row for over 16 years, Governor Gavin Newsom has imposed a moratorium on the death penalty. The 737 people currently on death row in that state, including Tim, are now the living dead indefinitely, with the state charged with maintaining their lives—letting them live, in a reversal of Foucault’s terms—until it can make them die.9


Given this contradiction, a mass die-off from COVID-19 would seem to be a solution, to use Tim’s word, to a glitch in the biopolitical mechanisms of state governance. But this is too easy a conclusion. The death penalty has, after all, a strategic significance within the genealogy of bio-power, as Foucault outlines it in History of Sexuality, Volume I. Instead of a malfunction or an anomaly, it has always been a solution, within the changing forms of governance Foucault describes, if to a shifting problem.


To rehearse this history briefly, in the pre-modern exercise of power, the death penalty was the central means through which sovereign rulers exercised their authority. “Power in this instance was essentially a right of seizure: of things, time, bodies, and ultimately life itself; it culminated in the privilege to seize hold of life in order to suppress it."10 Governing power was administered through death and the threat of death, made manifest through the "elaborate ceremonials of monarchical sovereignty from the court to the scaffold; from the coronation to the fields of war."11


In modernity—roughly, since the 18th century—as power begins to operate through the management of life, capital punishment took on a different role. Foucault points out a seeming paradox: "How could power exercise its highest prerogatives by putting people to death, when its main role was to ensure, sustain and multiply life, to put this life in order?"12 The incongruity is resolved as execution becomes a social sorting mechanism. As Foucault explains, the death penalty comes to invoke “less the enormity of the crime itself than the monstrosity of the criminal, his incorrigibility, and the safeguard of society. One had the right to kill those who represented a kind of biological danger to others."13


This is the real paradox; the death penalty provides the answer for how power can hold authority without an ever-present threat of death. People now adhere to the workings of power thanks to more nuanced methods of coercion. This is the key to the most essential aspect of bio-power. When power becomes management—the ordering of life—it is exercised through the production of classifications that come to feel natural to people. Those condemned to death are the subjects of the ultimate classification within this system; they are those who are so monstrous they must die, even if their death is deferred.14 They serve as the end limit to all other classifications.


If this is how death row has served power in the U.S., and I believe it an apt description, the question returns: Within emergent viral biopolitics, how is death row being repositioned—made, as Tim fears, another solution—within the changing relations of power and biological life? What roles will the living dead, those made monsters and left to molder in modernity’s cages, play as the end limits of the social order necessarily adjust to a pandemic? Tim details the odd perversities of this shifting ordering. Although the governor of California issued a statewide shelter-in-place order on March 19, until March 27, when Tim and hundreds of others on death row received notice that a guard had tested positive for COVID-19, they were still given the option to go to the yard each day. When he describes the process of how people are taken to the yard, Tim moves into writing in third person as he explains why he has been choosing to stay in his cell for 24 hours a day and forgo going outside:


The protocol for yard release is as follows. The officer unlocks the tray slot, and instructs the prisoner to strip completely naked. They have the prisoner open his mouth, stick out his tongue, run his fingers through his hair, and after that, lift up his genitals. They instruct the prisoner to turn around, show the bottom of each foot, and then squat and cough. After the strip search, the prisoner is instructed to hand over any clothing or items that they are wearing or taking to the yard. The officers do a manual search of the prisoner’s property. After the inspection they return the prisoner's property back through the tray slot and instruct the prisoner to get dressed. Once the prisoner is dressed he is handcuffed through the tray slot. At that point the cell door is opened up. The prisoner is physically escorted downstairs to where he is scanned with a handheld metal detector, and his belongings are trolled through an x-ray machine.15



Tim notes that neither the guards nor the people being searched wear gloves or masks as they repeat this ritual of debasement. In a time of social distancing, the intimacy is shocking—all that touching. With both the staff and the people on death row ungloved and unmasked as clothing is taken off, passed back and forth, and put back on, the people who talk about COVID-19 as the great equalizer come to mind.16 No one, in what Tim describes, seems safe from the pandemic, regardless of who is clothed and who is made to squat and cough.


When Tim details the procedure that would allow him to leave his 10 by 4 1/2 foot cell, however, he makes it clear that there is nothing equal about the spread of the coronavirus in San Quentin. As he explains, visitation has been cancelled for weeks, and it is only through contact with the staff that the virus could wreak its havoc on the lockdown unit. This means the elaborate performance of safety, with the strip search enacted through a slot in the cell door, the handcuffs, and even the final extra step of the metal detectors, is a charade of security. The ritual of control actually fosters the spread of the virus from staff member to prisoner, staff member to prisoner, all the way down the long metal walkway of his 54-person tier and through the 540-person unit. Who is safe from whom?


In the time of COVID-19, what Tim recounts is not the procedures of security made ridiculous, or obsolete. It is, rather, the viral remaking of the death penalty. The intricate measures ensure that death row and its inhabitants are not immune from the pandemic. With each strip search—that extreme enactment of biological intimacy—they are instead centered within it, made probable carriers of the virus. If the death penalty delineates those at the end limits of the system supposedly serving the care and maintenance of life, the seemingly inept technologies of power that Tim describes ensures that those end limits are still operational within viral biopolitics. As the maximal variance within the social order, Tim and the other 736 people on California’s death row continue to make more palatable the vast inequities of that ordering, including normalizing who lives and who dies within the pandemic.


The emergent viral biopolitics encapsulated in Tim's letters is not entirely new. In 2003 Achille Mbembe challenged Foucault's idea that the maintenance of life is central to modern biopolitics by pointing to power’s propensity for killing and maiming.17 This could be seen in European colonial projects and slavery in the United States, and in "the contemporary ways in which the political, under the guise of war, of resistance, or of the fight against terror, makes the murder of the enemy its primary and absolute objective."18 Mbembe argued that the maintenance of life is certainly not always the object of power. Instead, "the ultimate expression of sovereignty resides, to a large degree, in the power and the capacity to dictate who may live and who must die."19


While this seemed a vital revision of Foucault’s ideas at the beginning of the 21st century, the pandemic now brings into question the first part of Mbembe's definition of power. The ability to "dictate who may live" is becoming more and more fraught. As death is rampant, with bodies piling up in morgues and hospitals, social and political structures all around us are being revealed to be incapable not only of the maintenance and care of life but even of the ability to allow persons to live—the “letting live” at the crux of biopower in all its forms. The US healthcare system is crumbling, with insufficient beds, respirators, and testing capacity. Millions and millions of people file for unemployment each week. And the estimated 550,000 people who are unhomed remain unable to shelter-in-place. The government is not "dictating" life in these conditions. COVID-19 reveals that all that is left in the US of technologies of power that once could either “make live or let die" or prescribe "who may live and who must die" is social ordering—the ability to make sense out of the lives and deaths in a pandemic. In emergent viral biopolitics, whether by design or inability, political power no longer maintains life, something the coronavirus has not caused but instead reveals. The maintenance of life falls now entirely within the realm of economics, decided by capital’s investment decisions; the socio-political serves primarily to demarcate those who can die without social remorse. And, with more and more statistics revealing the racialized and class paradigms of who is dying in the US, the system is hard at work.


In late March, Judith Butler warned that the coronavirus was sure to be another opportunity for "re-inscribing the spurious distinction between grievable and ungrievable lives, that is, those who should be protected against death at all costs and those whose lives are considered not worth safeguarding against illness and death."20 Those who are already the living dead—who can already be made dead within the social imaginary—are an obvious place to start the sorting. Of course it takes weeks for guards in San Quentin to be supplied with masks and gloves.


By the beginning of April, after Tim had spent 27 days without the yard or visitation and an uninterrupted 648 hours in his tiny cell, his hesitation to talk on the phone came up in a letter.21 Tim prefers writing letters; making a call in San Quentin is always frustrating. He has to first sign up for a time slot. Once his day and time come up, a guard wheels an ancient phone booth to his cell and passes the receiver through the slot in the door. The call is processed by GTL, a private corporation and "Corrections Innovations Leader," and the system makes it difficult and costly to accept his collect call.22 When calls do get through, Tim has 15 minutes to have a conversation that is closely monitored. An automated message breaks through the call every few minutes to explain the monitoring process, and the person doing the monitoring will sometimes end the call randomly. The bars of the prison never recede very far during these brief and fragmented conversations.23


With the severe social distancing that Tim is now subjected to, however, phone calls are a necessity. Mail service is more disrupted in San Quentin by the day, letters are taking longer and longer to get through, and the isolation is extreme. But now the phone has become perilous. As Tim explains, next to contact with staff, the phone is sure to be the biggest conduit of the virus.


"The phone is not being cleaned and sterilized between uses," Tim writes. "I would guess it never has been really cleaned, in all the years it's been pushed around the unit. And, we aren't being given gloves to handle it with. Instead, they have a towel attached to it now. We are supposed to use the towel to wipe the receiver before we use it." Tim continues, "I have no intentions of touching that shared towel."24


He has instead come up with his own method to clean the phone and a plan to avoid touching it with his bare hands. He also has a makeshift mask to wear when he uses the phone. Meanwhile, the towel hangs off the phone as a warning—or a message in code. What it is saying is that it does not matter if Tim touches the towel. And, although this is no reassurance to Tim, no one needs to die on death row from COVID-19. Tim and the rest of the living dead are already playing their role within emergent viral biopolitics. Those squatting and coughing to go into the yard, those who swipe the towel across the mouthpiece of the phone, and, even those who refuse to do this, have been remade once again as biological dangers, monsters who fall outside of structures of empathy and care. They are made to perform their monstrosity and normalize the shifting parameters of viral biopolitics.25 In fact, maybe it is better for those who exercise power that no one on death row does die because of the coronavirus. The living dead, remember, are monstrous because they do not die.


Tim does not mention his innocence claim often in the letters he writes. Only once did he note briefly that there is a witness who identified another shooter in the crime for which he has been sentenced to die. Another time, he wrote about the appellate court system, describing the difficulties of procuring a full reversal once one has been convicted of a crime. Instead, his letters usually are about strategies for organizing against the death penalty.


Tim well knows that the position he inhabits—a monster who will not die—is necessary to power in a time in which socio-political systems are no longer in place to maintain lives. So Tim, in what he calls his tiny "coffin-like cell," is made to both embody and hide the workings of emergent US biopolitics.26 This is a horrific position even outside the daily tortures of solitary confinement. To be the one who acts as the end limit of society’s ability to care is to be the proxy through which huge swathes of the population are made to join Tim as the living dead: the two million Palestinian people who have been imprisoned in Gaza under full military blockade with US backing for 12 years; the over 50,000 children detained by US immigration agencies; the US-imposed sanctions on Iran that are crippling the country’s ability to respond to COVID-19; the 15 million children (21 percent) living in poverty in the US; to name just some examples. Tim has been forced to figure within all of this suffering.27 His small cell gets crowded indeed.


When Tim organizes against the death penalty instead of around his own claims, this is not selflessness. It is instead an acknowledgment that against the potency of this power, even those deemed innocent within this system are still subject to its sorting. This means that what is required now is not organizing on any one person's behalf. Instead, as Tim demonstrates, we must act on behalf of all those whose lives will not be maintained by power, even as their deaths will certainly be made instrumental. We must fight back against both the impending waves of death and also resist the reanimation of the living dead.

Since August 2019, I have been corresponding with Tim Young, who has been on death row in San Quentin since 2006, as part of an art project by jackie sumell called Solitary Garden. Tim is a prolific writer and is very much my thought and writing partner on this essay, which could not have been conceived without him. Many of Tim’s letters and essays can be read at https://ias.ucsc.edu/timothyjamesyoung. Tim Young, “Letter to Rachel Nelson,” March 23, 2020. See also Tim’s recent essay: “Tim Young, Coronavirus: The Invisible Enemy Behind Enemy Lines,” SF Bay View National Black Newspaper, April 2020. https://sfbayview.com/2020/04/coronavirus-the-invisible-enemy-behind-enemy-lines/
What Tim calls the "Hole" is officially named the Adjustment Center (AC). It is the highest security unit at San Quentin and typically used to house people who have been found or alleged to have broken the rules of the institution. Tim Young, “Letter to Rachel Nelson,” April 2, 2020.
Tim Young, “Letter to Rachel Nelson,” March 23, 2020.
Michel Foucault, History of Sexuality: Volume 1, An Introduction, translated by Robert Hurley (New York: Random House, 1978), 140.
Ibid. 138.
In an article written at the very first stages of the COVID-19 epidemic in Italy, Agamben characterized the measures implemented in response to the COVID-19 pandemic as an exercise in the biopolitics of the “state of exception.” In an argument that was both polemical and dangerous as more and more people succumbed to the virus, Agamben wrote that the “invention of an epidemic offered the ideal pretext” for further limitations to basic freedoms. Recognizing that despite the problematic framework of the argument, that question about the biopolitical regime emerging in response to the coronavirus did warrant attention, the European Journal of Psychoanalysis put together a special section on “Coronavirus and philosophers” with a translation of Agamben’s polemic and the responses to it (February-March, 2020): http://www.journal-psychoanalysis.eu/coronavirus-and-philosophers/.
See also Panagiotis Sotiris’s reading, and rebuttal, of Agamben’s writings on COVID-19, which includes some examples of biopolitics within this current state of exception. Panagiotis Sotiris, “Against Agamben: Is a Democratic Biopolitics Possible?,” Viewpoint Magazine, March 20, 2020 https://www.viewpointmag.com/2020/03/20/against-agamben-democratic-biopolitics/.
Michel Foucault, “Society Must Be Defended”: Lectures at the College de France, 1975-76 (New York: Picador, 2003).
As I will discuss below, this is related to what Achille Mbembe calls necropolitics, the form of biopolitics born of colonization and slavery that takes its authority from “the capacity to dictate who may live and who must die.” There is a difference, however, that will be discussed subsequently. Achille Mbembe “Necropolitics.” Transl. Libby Meintjes. Public Culture15, no. 1 (Winter 2003): 11-40.
Foucault, History of Sexuality, 136
Michael Meranze, “Michel Foucault, the Death Penalty and the Crisis of Historical,” Historical Reflections / Réflexions Historiques 29, no. 2 (Summer 2003): Interpreting the Death Penalty: Spectacles and Debates, (Brooklyn: Berghahn 2003), 191-209.
Foucault. History of Sexuality. 138
Ibid.
It is imperative to note that in the lectures he gives towards the end of his life, Foucault names racism as another technology aimed at permitting the “sovereign right of death.” And, this is an interlocking point. In the US, not only are people of color disproportionately incarcerated, studies spanning more than 30 years covering virtually every state that uses capital punishment have found that race is a significant factor in death penalty cases.
Tim Young, “Letter to Rachel Nelson,” March 25, 2020.
Politicians and people insulated by wealth, including NY governor Andrew M. Coumo, have been seemingly impressed that celebrities, wealthy people, and politicians of different races and ethnicities—including elite White people—also contract the virus, leading some to call it the great equalizer. Of course, access to medical care and the ability to socially distance is clearly unequal, with employed poor people and people of color largely working as "essential workers" in food service, transportation, etc, with vastly different rates of contraction and mortality: Bethany L. Jones and Jonathan S. Jones, “Gov. Cuomo is Wrong, COVID-19 is Anything but an Equalizer,” Washington Post, April 5, 2020 https://www.washingtonpost.com/outlook/2020/04/05/gov-cuomo-is-wrong-covid-19-is-anything-an-equalizer/ and Akilah Johnson and Talia Buford, “Early Data Shows African Americans Have Contracted and Died of Coronavirus at an Alarming Rate,”ProPublica, April 3, 2020 https://www.propublica.org/article/early-data-shows-african-americans-have-contracted-and-died-of-coronavirus-at-an-alarming-rate.
Achille Mbembe. “Necropolitics.” Transl. Libby Meintjes. Public Culture 15, no. 1 (Winter 2003): 11-40. See also Jasbir Puar, The Right to Maim: Debility, Capacity, Disability. (Durham, NC: Duke University Press, 2017).
Mbembe 11
Ibid.
Butler also wrote, "Social and economic inequality will make sure that the virus discriminates. The virus alone does not discriminate, but we humans surely do, formed and animated as we are by the interlocking powers of nationalism, racism, xenophobia, and capitalism." Judith Butler, “Capitalism has its Limits," Verso Blog, March 30, 2020, https://www.versobooks.com/blogs/4603-capitalism-has-its-limits,
Tim Young, “Letter to Rachel Nelson,” April 2, 2020.
https://www.gtl.net/
Tim related this process both through a letter postmarked April 2 and a phone call on April 4. Tim Young, “Letter to Rachel Nelson,” April 2, 2020.
Ibid.
The racialized history of this kind of politics of performance is key here with much that could be said about the relationship to the performances forced from people enslaved. See Saidiya V. Hartman, Scenes of Subjection: Terror, Slavery, and Self-Making in Nineteenth Century America (Oxford: Oxford University Press, 1997).
Tim Young, “Letter to Rachel Nelson,” August 8, 2019.
National Center for Children in Poverty, “Child Poverty,” http://www.nccp.org/topics/childpoverty.html.
Contributor
Rachel Nelson
is interim director of UC Santa Cruz Institute of the Arts and Sciences. Nelson has curated and organized numerous exhibitions and programs and has published exhibition catalogues, journal articles, book chapters, and reviews, including in the forthcoming Under the Skin (Oxford University Press).
The Brooklyn Rail

Their Money or Your Life
By Paul Mattick

"In 20 years, more than 100,000 hospital beds eliminated. We don't forget, we don't forgive." Photo: Philippe Gonnet AUSTERITY GUTTED HEALTH CARE


The social disruption that has come with the novel coronavirus SARS-CoV-2 has an all too visible side expanding day by day and a more occult one waiting in the near future. First of all, there are the effects of the virus itself: the infection and sickening of millions of people, and then the steps taken to limit these effects. National governments, unprepared for the emergency despite decades of warnings, have reacted, after deadly delays, by limiting social movement to control the infection rate. The economy, thus put into an induced coma, is being kept on life support by way of massive loans to businesses and a small increase in unemployment relief. While the evaporation of stock and bond values is wiping out pensions and nest eggs, along with some percentage of hedge funds, a cascade of business closures is producing mass worklessness on a scale rivaling that of the Great Depression.


SARS-CoV-2 is only the latest in the series of pandemics that have accompanied the development of capitalist agriculture and urbanization since before the Industrial Revolution. Its novelty and the rapidity of its spread in a world of global supply chains, international labor migration, and mass tourism—one path was apparently opened for intercontinental transmission, for example, by the use of low-wage Chinese garment workers by Milanese fashion companies—make it stand out against the background of influenza deaths, cancer fatalities due to environmental and workplace pollution, and such mundane killers as automobile and truck accidents. The new virus, easier for the rich to guard against and to treat when stricken, illuminates the depth of social inequality and the general subordination of everyday life, including the requirements of human and animal health, to “the economy,” as we call the system subordinating the production of goods and services to the need of capitalist investors to accumulate profits.


Apart from some generalities, the longer-term effects of the medical crisis-turned-economic-shutdown are still unknown. The eventual production of a vaccine may well help make COVID-19 a part of normalcy, alongside other social ills like lead poisoning, industrial accidents, drug overdoses, starvation, and warfare. In the official discourse of economic policy, the stimulus and bailout measures decreed by governments and set in motion through the money-creating facilities of central banks are intended as relatively short-term efforts. Once the virus runs its course, businesses will supposedly reopen and workers return to their jobs; in theory, at least some of the trillions of dollars of government loans will eventually be repaid. The normal process of concentration and centralization of capital ownership will have been accelerated, along with the general inequality of wealth, as government largesse flows to the largest companies. In theory at least, capitalism will continue on its merry way, spawning little New Zealands of billionaires amidst a sea of growing impoverishment.


In reality—and this is the second aspect of the crisis, nearly hidden from view by the sudden check to economic activity in response to the medical catastrophe—an economic recession was well on the way before the coronavirus tipped us over the edge. During the last quarter of 2019 Japan’s GDP slumped by 6.3% to a growth rate of -1.6%, while Germany’s GDP growth (and this is the world’s fourth-largest economy) fell to zero. Europe as a whole claimed 1.1% growth in 2019. Among the economically stronger countries, China’s growth rate of 6% was the lowest in 30 years, and U.S. GDP, with flat growth in the last quarter, increased by only 2.3% in 2019, the lowest since 2016, and economists were expecting a fall to below 2% in 2020.1


What made such developments especially meaningful was the fact that the debt load of non-financial companies had reached an all-time high by the end of 2019, attesting to their failure to generate profits sufficient for their needs. And 51% of bonds issued that year were classified as BBB, the lowest rating. 25% were junk bonds, unrated because below investment grade.2 Global finance has increased since the 1980s to four times the value of world production; China’s corporate debt alone grew to $20 trillion. “In the United States, against the backdrop of decades-long access to cheap money, non-financial corporations have seen their debt burdens more than double from $3.2 trillion in 2007 to $6.6 trillion in 2019.”3 Many firms turned from public ownership to private equity to avoid financial regulation; today private equity firms have debts equal to 600% of those firms’ annual earnings. The result is a global economy spectacularly threatened by any freezing up of credit—such as that happening in response to the pandemic.


Not surprisingly, inequality reigns among corporations as it does in society at large. The top 10% (in terms of revenue) of non-financial corporations have led in downsizing while increasing shareholder wealth; the bottom 90%, facing stiffer competition than the big firms, still need capital investment to stay in business while satisfying their shareholders.4 The result is large numbers of “zombie” firms, with low or negative profits, maintaining a simulacrum of life thanks to constant infusions of debt via the junk bond market. “Zombies now account for 16 percent of all the publicly traded companies in the United States, and more than 10 percent in Europe, according to the Bank for International Settlements, the bank for central banks.”5 These firms face extinction as credit dries up or becomes expensive.


This row of dominoes was not set up in a year, or in four years. The recession of the early 1970s brought an end to the 30 years of post-war prosperity that had seemed to promise a henceforth crisis-free economy. Since then, through the ups and downs of the business cycle, each recovery has been weaker, and rates of investment in plant and equipment declined. It was this that led to the steady increase of debt, which had tripled by the eve of the collapse of 2008, to keep the world economy growing after 1980. Central banks responded to the Great Recession with an especially large flood of newly-created money, to replace the debt vaporized in the crash. This easy money went, however, not into an expansion of production—in fact, large firms increasingly downsized—but into buying stocks, bonds, and other speculative assets.


Government borrowing grew alongside private debt, in efforts to contain the damage done by recurrent recessions and financial crises. The inability of the economy to grow as a productive mechanism did not, however, inspire governments to step into the workboots left empty by the private sector, with infrastructure projects, say, or the expansion of health-care facilities or low-income housing. Instead, government money flowed through financial institutions to corporations which recycled it, via stock buybacks and acquisitions, into fortifying the income and wealth of their owners.


Though the stock and bond values vaporized in periodic crashes like the present one can be replenished by central banks, what keeps capitalist society going over time is the steady production of goods and services that can be sold to yield profits reinvested in plant, equipment, and labor able to generate yet more value and profit. Financial instruments represent claims on the profits of future production; for those claims to be realized, goods must be produced and sold. That investors understand this on some level, however much they may believe in the magic of creative finance, shows in the collapse of the stock and bond markets in response to the economic freeze.


It might be asked: when is the perpetually postponed reckoning coming due? The answer is that it has been coming due for decades, with the steady worsening of working and living conditions of the world’s wage workers, allowing for the concentration of wealth—real and fictitious—in a diminishing percentage of hands, despite a stagnant economy. The coming depression will simply be an acceleration of this tendency, even as some of the money generated in the last go-round is burned off. The new trillions poured out by the state will be intended as an accompaniment to austerity, not an alternative to it.


Despite official optimism, there has already been talk in Washington about a jobs program, no doubt intended to evoke the New Deal Works Progress Administration. That such a thing is even discussed testifies to the fear, felt by the more rational among the ruling elite, of economic collapse and social unrest, already on view in the many small strikes and sick-outs over hazardous working conditions and disappearing paychecks. It was, of course, the Democrats who floated this idea, with its redolence of the glorious past along with its difficulty of realization under present circumstances, a day or so after Trump dismissed talk of invoking the War Powers Act to compel corporations to produce ventilators and other needed equipment by reminding us that “you know, we’re a country not based on nationalizing our business. Call a person over in Venezuela, ask them how did nationalization of their businesses work out? Not too well.” European elites have historically been less squeamish about nationalization, but they, too, are mainly concerned to support private companies with public funds.




It should be remembered that the WPA and related programs (just like Hitler’s similar efforts) did not do much to bring the American economy out of the depression; full employment (at least a lowering of the unemployment rate to 4.7%) came only with the onset of full-scale war production in 1942. To deal with what is shaping up to be an even deeper crisis, and certainly one affecting a larger portion of the world’s population than that of the 1930s, would take government intervention on a scale actually amounting to nationalization of the economy. At the moment, a government busy using the coronavirus months to finish the gutting of the weak environmental protections still in place is more likely to try to save the oil and coal industries, home to many zombie firms. Even the Democrats admit the jobs program talk was more an electoral-season stunt than a serious proposal, and have turned their attention to making sure that the airline companies, fresh from enhancing their stock values with buybacks, can participate fully in the federal bailout program.


In addition to the immediate effects of the coronavirus and the underlying economic weakness, there is a third aspect to the ongoing disruption of social order, potentially the most significant. The coincident health emergency and economic shutdown have transformed daily life with a previously unexperienced suddenness and scale. Millions who went to work every day find themselves at home; children unregimented by schools must, with the adults around them, learn to occupy their own time. The consumer activities that are the normal compensation for the stresses of middle-income working life—the going to restaurants, bars, concerts, gyms, shopping of all sorts—are mostly unavailable. Those who were already dependent on food banks for survival are finding them overwhelmed from one day to the next. Everyone is forced to rethink what life is about, not to mention how to keep it going. The question, for instance, whether housing is some kind of a right even when there is no money to pay the rent has suddenly become a practical one for millions not used to thinking about the conflict between human needs and private property. People have been thrown out of accepted patterns onto their own resources.


Those resources, as always in times of disaster, are shared. There has been an explosion of mutual aid in myriad forms, from amateur mask-making to bringing food to health workers to something as complex as improvising a computerized health-care system (in Cape Town, South Africa). In Spain 200 taxi drivers, many of them from Pakistan, organized themselves to provide free transportation for doctors and other medical workers.6 As George Monbiot put it concisely, “All over the world, communities have mobilized where governments have failed.”7 Unusual (in the US) forms of action have reappeared, as groups of workers—from delivery drivers and postal workers to doctors and nurses—strike or take other actions, often in defiance of union efforts to tamp things down, to demand some consideration for their health and welfare from their employers. In the words of Josh Eidelson, “By giving workers something bigger to fear than their boss, and rechristening often-forgotten workers as essential, the coronavirus has laid the groundwork for a new worker rebellion.”8 One of the most striking examples was the protest by General Electric workers in Lynn, Massachusetts, due to be laid off, who asked that the company, instead of firing them as planned, convert its jet engine factories to make ventilators.9 This raised the idea of mutual aid to a level threatening the institution of corporate property itself, with workers demanding to control not just the pay for and the conditions of their work, but its goal. In a neighborhood of Marseilles, France, workers at a McDonald’s restaurant took this step by occupying the premises—of course, against the protests of the company—to prepare meals for local people, using supplies donated by shopkeepers, residents, and food banks.10


The shutdown of business as usual has had other positive effects: blue skies over Beijing; dolphins in the canals of Venice; a relatively traffic- and smog-free Los Angeles. Due to the decrease of pollutants usually produced by various industries, many thousands of lives statistically doomed to what is called “premature death” have already been saved. According to the World Health Organization, “Air pollution kills an estimated seven million people worldwide every year.”11 Within China alone, calculates Marshall Burke, a professor in Stanford’s Earth-system science department, “a pandemic-related reduction in particulate matter in the atmosphere—the deadliest form of air pollution—likely saved the lives of 4,000 young children and 73,000 elderly adults . . . over two months this year.”12


The businesspeople and policymakers dreaming of a swift revival of the economy once the medical emergency has come under control no doubt do not specifically regret the longer lives of Chinese and other children. In the weird, upside-down world of economic theory, such matters can be considered unsentimentally, in terms of dollars and cents: Economist Michael Greenstone of the University of Chicago has calculated—on the basis of EPA estimates of the monetary value of human life—that the value of lives saved from COVID-19 by the shutdown “amounted to $7.9 trillion, or roughly $60,000 per U.S. household.”13 Unfortunately, these trillions, unlike those manufactured by the Federal Reserve Bank, will remain purely imaginary. To make real money, industry will have to grind into action again; cars, trucks, ships, and planes will have to move. Fossil fuels will be extracted and burned. (The Canadian shale-oil company behind the XL Keystone project has not even waited for the end of the emergency to recommence building the pipeline.) To the extent that the economy recovers, the death rates from pollution will return to normal and the catastrophe of climate change will get back up to speed.


Most people who have to work for a living are understandably eager to get back to being paid for their time, whatever the ecologically destructive byproducts of their labor. But it is not unthinkable that if the economic breakdown is deep and long enough people may be inspired or even forced to invent new social arrangements for meeting the requirements of existence, when waged labor has become hard to come by. After all, even if jobs are scarce, work still needs to be done, and the resources to do it with still exist. Without the pressure of wealth preservation and profitability, decisions favoring the survival of humanity rather than that of corporate capital might get the upper hand. Perhaps a lasting disruption of business as usual will open ways to considering the long-term welfare of humanity even while people fight for day-to-day survival.


The workplace actions that have responded to the sudden shock of societal semi-collapse and the incompetence demonstrated by those who currently dominate social decision-making demonstrate people’s capacity to grasp when their lives are in danger and to understand the weapons at hand for defending them. Whatever their views on the coming presidential election, those GE workers understood clearly the importance of turning their skills to the building of ventilators. If, as seems likely, the slow-moving depression we have gotten used to calling a stagnant economy speeds up and deepens even as the medical emergency comes under control, such experiences can provide the basis for further-reaching responses to the social crisis that lies ahead.

Phillip Inman, “Japan's Economy Heading for Recession, and Germany Wobbles,” The Guardian, February 17, 2020, https://www.theguardian.com/business/2020/feb/17/japan-economy-heading-for-recession-and-germany-wobbles / “U.S. Economic Growth Flat in Final Three Months of 2019,” CBS News, update January 30, 2020, cbsnews.com/news/us-gdp-flat-in-final-three-months-of-2019. (All these data should, as usual, be taken with a grain of salt, but they serve to indicate trends.)
OECD.org, “Corporate Bond Debt Continues to Pile Up,” February 18, 2020, https://www.oecd.org/corporate/corporate-bond-debt-continues-to-pile-up.htm.
Joseph Baines and Sandy Brian Hager, “COVID-19 and the Coming Corporate Debt Catastrophe,” SBHager.com, March 13, 2020, https://sbhager.com/covid-19-and-the-coming-corporate-debt-catastrophe/.
Ibid.
Ruchir Sharma, “This Is How the Coronavirus Will Destroy the Economy,” New York Times, March 16, 2020, https://www.nytimes.com/2020/03/16/opinion/coronavirus-economy-debt.html?action=click&module=Opinion&pgtype=Homepage.
Paula Blanco, “Pakistani taxi drivers give free rides to Spanish health workers,” Al Jazeera, April 9, 2020, https://www.aljazeera.com/news/2020/04/pakistani-taxi-drivers-give-free-rides-spanish-health-workers-200408120354440.html.
George Monbiot, “The horror films have got it wrong. This virus has turned us into caring neighbors,” The Guardian, March 31, 2020, https://www.theguardian.com/commentisfree/2020/mar/31/virus-neighbours-covid-19.
Josh Eidelson, “Now is the Best and Worst Time for Workers to Go on Strike,” Bloomberg, April 7, 2020, https://www.bloomberg.com/news/articles/2020-04-07/coronavirus-marks-the-best-and-worst-time-for-workers-to-strike.
Edward Ongweso Jr., “General Electric Workers Launch Protest, Demand to Make Ventilators,” Vice, March30, 2020, https://www.vice.com/en_us/article/y3mjxg/general-electric-workers-walk-off-the-job-demand-to-make-ventilators.
Mateo Falcone, “Un McDo marseillais réquisitionné par les travailleurs pour donner de la nourriture dans les quartiers,” Révolution Permanente, April 9, 2020, https://www.revolutionpermanente.fr/Un-McDo-marseillais-requisitionne-par-les-travailleurs-pour-donner-de-la-nourriture-dans-les?fbclid=IwAR3cfJatqaAL_IT-DJyLfcTPEG9Ow8532PKeDRKY7fgG1ig6MjtLbuSWAEs.
World Health Organization, “Air Pollution,” https://www.who.int/health-topics/air-pollution#tab=tab_1.
Marina Koren, “The Pandemic Is Turning the Natural World Upside Down,” The Atlantic, April 2, 2020, https://www.theatlantic.com/science/archive/2020/04/coronavirus-pandemic-earth-pollution-noise/609316/.
Eduardo Porter, “Economists, Too, Are Scrambling to Understand an Upended World,” The New York Times, April 6, 2020, p. B3.
Contributor
Paul Mattick

Paul Mattick is the Field Notes Editor.