THIRD WORLD USA

America Has Not Fixed Its Deadliest Pandemic Errors

Robinson Meyer 1/1/2021

As the pandemic enters its second year, the coronavirus has remade everyday life in the United States. More than 19 million Americans have been diagnosed with COVID-19 since March, and at least 330,000 Americans have died of it, according to the COVID Tracking Project at The Atlantic. Yesterday, 3,903 Americans were reported to have died of the virus, the highest death toll since the pandemic began.

© Getty / Paul Spella / The Atlantic

Yet the U.S. is still making the same two deadly mistakes that have defined its response since the pandemic began, our ongoing investigation has found. The nation still does not have enough tests to combat the pandemic. And it is still allowing the virus to rampage through nursing homes and other long-term-care facilities

After an early failure in February left the country with growing caseloads and too few COVID-19 tests to track the outbreak, the U.S. has never caught up. By the middle of December, the country tested about 1.8 million people a day for the virus, which was close to an all-time high. But to begin fighting the virus through testing—by, for instance, identifying infected people before they pass the virus to others—the U.S. must test at least 4.4 million people a day, according to the Harvard Global Health Institute. Ideally, given the scale of the pandemic, the country would run 14 million tests a day, the institute posits.

By our count, the U.S. has conducted more than 248 million tests since the pandemic began, a staggering total. But the virus is now so widespread that if America were meeting that ideal testing target, it would run about that many tests every two and a half weeks.

© Provided by The Atlantic A line chart of US reported tests per day, from March 1 to December 31

The U.S. has never tested as many people as it needs to in order to keep the pandemic in check. It has gone weeks at a time—from late July to mid-September, most strikingly—without increasing the number of people tested every day. At moments when infection has been especially widespread, companies have taken days or even weeks to process test results. Federal regulators have been slow to approve rapid virus tests that could be used at home without a prescription, similar to pregnancy tests.

This has compounded a second crucial failure. In the spring, the country learned that the virus is deadliest in long-term-care facilities such as nursing homes. Though these facilities house less than 1 percent of America’s population, they have seen at least 38 percent of the nation’s COVID-19 deaths, our data show. (Some states report incomplete data for these facilities, meaning that this number likely undercounts the true toll originating in these settings.)

The Trump administration has claimed that saving lives at such facilities is core to its pandemic strategy. Scott Atlas, a neuroradiologist who advised Donald Trump on virus policy for much of the summer and fall, argued that there was little risk in allowing the virus to spread through the general population as long as officials focused on “protection of the vulnerable” in nursing homes.

Yet the country has never succeeded at protecting the vulnerable, our data show. In December alone, at least 20,455 people have died in long-term-care facilities and nursing homes, the greatest toll since the COVID Tracking Project began collecting long-term-care data in late May. And in every region of the country but the Northeast, more people died in long-term-care facilities in the summer and fall than in the spring.

© Provided by The Atlantic the covid tracking project

These two debacles have preyed on the effectiveness of the American pandemic response from the start. At the end of the year, the U.S. has more diagnosed COVID-19 cases than any other country, and it ranks fourth worldwide in COVID-19 deaths per capita. And December has been the deadliest month of the pandemic so far, our data show. Its death toll has exceeded that of April by 29 percent.

These data were collected by the COVID Tracking Project at The Atlantic. For each of the past 299 days, a team of volunteers and project members has watched press conferences, tracked social-media posts, and combed through dozens of government websites to compile the COVID-19 data that each U.S. state and territory provides. The project now records nearly 800 individual statistics.

The resulting database is a patchwork, built from the individual components that each state’s data systems capture and from the numbers that local political leaders allow to be published. Fusing together 56 state and territorial data sets can be a fraught, complex process, and the project publishes exhaustive documentation of what the numbers mean, how they compare to one another, and what we still don’t know, because of the variability of state reporting.

One of the most obvious elisions is the toll that the pandemic has taken on Black, Latino, and Indigenous people. The pandemic has disproportionately killed people in these communities, our data show. At least one in every 800 Black Americans has died of COVID-19, and Black people have died of COVID-19 at 1.7 times the rate of white people. Nationwide, Indigenous people and Alaska Natives have died of COVID-19 at 1.4 times the rate of white people.

Yet the full scale of this damage is not quantifiable, because many states still do not track enough data by race and ethnicity for us to identify the full, disparate impact. Texas, for instance, reports race and ethnicity data for only 4 percent of cases. New York has never reported race and ethnicity case data, which obscures our understanding of the first surge in particular, when New York’s numbers dominated every national statistic.

Only seven states report the racial breakdown of testing data, an important tool in detecting how large outbreaks are overall, because knowing the fraction of a population that has been tested can indicate the breadth of the virus’s spread.

Because of such inconsistencies and gaps, the COVID Tracking Project team has also communicated with state and federal officials hundreds of times over the past 10 months to clarify the meaning of specific numbers and to push for higher data quality and more public transparency.

This effort meant that, for months, the COVID Tracking Project published the only public database of testing and hospitalization data. Today, it is the only data set detailing each state’s and territory’s daily case, testing, hospitalization, and death numbers since the pandemic began. The federal government, including the White House Coronavirus Task Force, has used data from our investigation because it has had no alternative. The CDC Advisory Committee on Immunization Practices has repeatedly cited our data on long-term-care facilities in the course of deciding that residents of those places should get vaccinated first.

Today, the federal government publishes data on many of the same metrics we began tracking in March. But for many of these metrics, our data remain the only independent check on that federal data.

The COVID Tracking Project has repeatedly identified issues with the data shared at the state and federal level. For instance, in the spring the CDC made the state of the pandemic less clear by lumping together two different types of tests—antibody tests, which detect past infection, and diagnostic tests, which detect present illness. Test-positivity statistics, widely used to make decisions about pandemic restrictions, still show massive variability, we have found, which make them extremely difficult to use when setting interstate policy. Now the millions of inexpensive, rapid tests that the Trump administration purchased and directed to vulnerable populations are not being reported at either the state or federal level.

Over the past 10 months, we have seen the federal government struggle to acquire, present, and analyze the data necessary to understand the pandemic. This could change in the coming weeks: The incoming Biden administration has said that it plans to make a National Pandemic Dashboard. What will matter, then, is not only having the data, but using them to save lives.

WSJ Editorial Board Blasts Trump’s Election ‘Hustle’: 

Republicans ‘Should Be Embarrassed’

by This

By Josh Feldman Jan 1st, 2021,


ROBERTO SCHMIDT / AFP / Getty Images

The New York Post received a fair amount of attention after its editorial board begged President Donald Trump to end his “dark charade” trying to overturn the election — even going so far as to say he’s “cheering for an undemocratic coup.”

The Wall Street Journal editorial board followed suit this week and said there is absolutely no justification for throwing out electors from states Joe Biden won when there is simply no evidence of the fraud the Trump team is alleging.

Some Republicans, especially Louie Gohmert, are convinced Vice President Mike Pence could save the day, but the Journal questions how exactly the vice president can have “unilateral authority to set aside electors.”

They note that there were similar objections raised by Democrats, but add that one key difference is that in 2004, John Kerry conceded. And the editorial board asks, “Does Mr. Trump want to depart by making people pine for the statesmanship of John Kerry?”

They write that Republicans “should be embarrassed” and concerned about how Trump is not only hurting his own legacy, but “giving Democrats license to do the same in the future.”

mediaite.com

After Trump Blocked UN Inquiry of Racist Violence, NGOs Are Conducting Their Own

Portland police disperse a crowd of protesters past a mural of George Floyd and Breonna Taylor on September 26, 2020, in Portland, Oregon.

NATHAN HOWARD / GETTY IMAGES

Marjorie Cohn, Truthout

PUBLISHED December 22, 2020


PART OF THE SERIES
Human Rights and Global Wrongs

Shortly after the public lynching of George Floyd, the U.S. Human Rights Network and the ACLU organized an international coalition of more than 600 organizations and individuals to urge the United Nations Human Rights Council to convene a commission of inquiry to investigate systemic racism and police brutality in the United States. George Floyd’s brother, Philonise Floyd, addressed the Council by video, stating, “You in the United Nations are your brothers’ and sisters’ keepers in America.” He implored the UN, “I’m asking you to help us — Black people in America.”

However, the Trump administration lobbied heavily against this investigation, objecting to limiting the inquiry to the U.S. The Council subsequently declined a request by a group of African countries within the Council to establish the inquiry commission. “The outcome is a result of the pressure, the bullying that the United States did, assisted by many of its allies,” said Jamil Dakwar, the ACLU’s human rights program director.

But the Council did task the High Commissioner for Human Rights Michelle Bachelet with preparing a report by June 2021 on “systemic racism, violations of international human rights law against Africans and people of African descent by law enforcement agencies, especially those incidents that resulted in the death of George Floyd and other Africans and people of African descent, to contribute to accountability and redress for victims.” In Resolution 43/1, the Council did not limit the subject matter of the report to violations in the United States.

To assist in the preparation of Bachelet’s report, the Council called for input from several entities, including nongovernmental organizations.

The International Association of Democratic Lawyers, National Conference of Black Lawyers and National Lawyers Guild responded to that call by establishing their own International Commission of Inquiry on Systemic Racist Police Violence Against People of African Descent in the United States.

Rutgers University law professor emeritus Lennox Hinds, who conceived of the idea for the commission, told Truthout, “This International Commission of Inquiry is an attempt to give voice to the international outrage resulting from the public lynching of George Floyd and to expose the racist and systemic nature of police violence against people of African descent in the United States and to hold the U.S. government accountable before the international community.”

Twelve commissioners, including prominent judges, lawyers, professors, advocates and UN special rapporteurs from Pakistan, South Africa, Japan, India, Nigeria, France, Costa Rica, the United Kingdom and the West Indies will hold public hearings from January 18 to February 6.

The commission will hear evidence in 50 cases of police violence that occurred throughout the United States from 2010-2020, including the killings of George Floyd, Michael Brown, Eric Garner, Breonna Taylor and Tamir Rice. Many resulted in the deaths of unarmed or nonthreatening African Americans.

Although the commission won’t have the money and resources a UN investigation would have commanded (were it not for Trump’s obstruction), the scope of this inquiry will go beyond the Council’s resolution by giving voice to the families of Black victims of police brutality.

Testimony of victims’ lawyers and family members, community representatives and acknowledged experts will occur in 25 cities via Zoom. The commissioners will prepare a report for submission to the UN high commissioner and the public by the end of March. They will be assisted in the hearings and preparation of their report by a team of four rapporteurs, including this writer. Students and faculty from Rutgers Law School will provide research support.

The commissioners will ask the UN high commissioner to use our report to inform her report to the Council. We will also publicize our report widely in the United States and throughout the world for people to use in litigation and advocacy.

This will be a thorough investigation of anti-Black violence perpetrated by police in the United States. It will examine: 1) Cases of victims of police violence, extrajudicial killings and maiming of people of African descent and entrenched structural racism in police practices throughout the U.S.; and 2) The structural racism and bias in the criminal “justice” system that results in the impunity of law enforcement officers for violations of U.S. and international law.

The commission will analyze whether several instances of police violence against African Americans violated international law. A 2020 study of the 20 largest cities in the United States found none whose lethal force policies complied with international human rights law and standards.

Finally, the commission will consider the lack of accountability for violations of human rights, and recommend effective measures to end impunity in the future.

Treaties the United States ratifies become part of U.S. law under the Supremacy Clause of the Constitution. They are the “supreme law of the land.” The U.S. has ratified three human rights treaties that enshrine the right to life, the right to be free from torture and the right to be free from discrimination. All three require effective measures be taken for violations of the rights protected by those treaties.

During the hearings, the testimony will describe instances of police violence that deprived African Americans of the right to life, and the rights to be free from torture and discrimination.

“We want the [UN] high commissioner [Michelle Bachelet] to actually use this report,” said Kerry McLean, a member of the steering committee that is establishing the commission. “She’s not doing hearings, so we’re doing hearings.”

The hearings will be accessible to the public. The report and findings of the commission will be published in English.

USA
2020’s Legislative Attacks on Gig Workers Will Change Labor Forever

BY Robert R. Raymond, Truthout

PUBLISHED January 1, 2021

Rideshare driver Jorge Vargas raises his "No on 22" sign in support as app-based gig workers hold a driving demonstration with 60-70 vehicles blocking Spring Street in front of Los Angeles City Hall on October 8, 2020, in Los Angeles, California.AL SEIB / LOS ANGELES TIMES

In 2020, we saw perhaps the largest protest movement in U.S. history, a presidential election whose outcome could have changed the nature of U.S. democracy, a global pandemic that has killed hundreds of thousands and has completely transformed everyday life, and a recession that has left millions unemployed.

Buried in all of these momentous events, something happened which could take labor laws in the United States down a dangerous road. California’s Proposition 22 was the most expensive ballot initiative in the country’s history — and it passed overwhelmingly in November. Bought and purchased by app companies such as Uber, Lyft, Instacart, DoorDash and Postmates — who spent more than $220 million on the campaign — Proposition 22 exempts so-called gig workers from many basic labor rights and seeks to create a new subclass of workers.

The passage of Proposition 22 means that roughly 8.5 percent of the workforce in California will not be guaranteed a minimum wage, won’t have access to unemployment insurance or overtime pay, will not get paid sick leave or family leave, and will have no protection from discrimination based on immigration status or historical traits tied to race. This is especially concerning as we now know that 78 percent of gig workers are people of color, according to a recent study conducted by San Francisco’s Local Agency Formation Commission and led by University of California, Santa Cruz professor Chris Benner.

Another issue of concern is that Proposition 22 eliminates required sexual assault training, as well as the obligations of Uber and Lyft to investigate both customers’ and drivers’ harassment claims.

Further, “the Proposition overrides any local ordinances,” Cherri Murphy, a former Lyft driver and current social justice minister, told Truthout. “During COVID, there were ordinances that were instituted to provide sick leave for workers like me in San Francisco, Oakland, San Diego and L.A. — and now they will be wiped away.”

One of the most concerning things about this ballot measure is that it prevents legislators from amending the law, requiring a seven-eighths majority to make any changes, while also preventing local policy making to expand rights for workers.

Although perhaps one of the most significant setbacks to labor rights in recent history, Proposition 22 is just one in a long line of attacks waged by ride-hailing and delivery start-ups against workers in recent years.

“2020 marks an evolution of what the companies have been doing really for the better part of the last decade,” Brian Chen, staff attorney at the National Employment Law Project, told Truthout. “Gig companies have been on the front lines of carving their workers out of employee status across state legislatures.”By codifying and locking in a new subclass of workers, what companies like Uber and Lyft are doing could just be the beginning of a much broader attack on workers in general.

Many states have already passed regulations that classify rideshare drivers as independent contractors, but those laws differ somewhat from Proposition 22, which ultimately seeks to expand these laws to other sectors, such as delivery companies, and could in fact create space for companies like Amazon or FedEx to adopt similar models that lower wages for their existing workforce.

Another reason that Proposition 22 is so pernicious is that it serves as a blueprint for similar laws to be enacted across the country. With California setting the stage, attacks on gig labor are now popping up in places like Illinois and New York, where these companies have very large numbers of workers.

But ultimately, these app companies are hoping to roll out these new labor models on a federal level. Their aim is to create an entirely new worker classification that goes beyond independent contractor or employee, further eroding any safety nets that are currently maintained at the federal level and directly attacking our most basic ideas of what work is and what work ought to provide for people.

“It’s a really dangerous proposition that these companies are advancing,” Chen said. “They are fundamentally saying their workers aren’t really workers — that they’re independent businesses and therefore they don’t need the usual basic protections that [almost] all workers have had since the New Deal.”

If these strategies are successful, the nature of work in the United States could be radically transformed. And by codifying and locking in a new subclass of workers, what companies like Uber and Lyft are doing could just be the beginning of a much broader attack on workers in general.

“There are already examples of different kinds of employers in health care, retail and hospitality that have experimented with managing their workers through a digital app so that they can escape their employer obligations,” Chen said. “And as this model continues, it’s just going to incentivize entire industries to gig out jobs that once used to provide middle-class stability.”

Although Proposition 22 was a huge win for these app companies, they are likely to face many challenges as they seek to expand to the federal level. “The federal landscape is likely to change: It could be incrementally, it could be drastically, depending on a number of factors,” Steve Smith, communications director at the California Labor Federation, told Truthout. “But under Joe Biden’s administration, we’re going to see a different posture toward gig work than we’ve seen under Trump. And so that’s the first thing that I think these companies are going to have to overcome.”

It’s difficult to predict exactly how the incoming Biden administration will handle all of this. Publicly, the administration has already decried the efforts of app companies to misclassify workers, stating that, “[a]s president, Biden will put a stop to employers intentionally misclassifying their employees as independent contractors. He will enact legislation that makes worker misclassification a substantive violation of law under all federal labor, employment, and tax laws with additional penalties beyond those imposed for other violations.”

And yet at the same time, the Biden administration has appointed Jake Sullivan to national security adviser — a previous Uber and Lyft adviser. Further, incoming Vice President Kamala Harris’s sister is married to Uber executive Tony West, who may be running for a role in the new administration. It’s been reported that West has been a longtime political adviser to Harris since she first ran for public office.

Regardless of how the Biden administration moves forward, it’s unlikely that app companies will end their attacks on regulation. They have been fighting against any attempt to rein them in for years and we will most likely continue to see this fight unfold at the local, state and federal levels for years to come.

There have already been many attempts to regulate companies like Uber and Lyft at both the state and local levels. Last year’s passage of Assembly Bill (AB) 5 in California was a major attempt to end the misclassification of workers. Unfortunately, much of the bill is going to be undone by Proposition 22.

Additionally, earlier this year, California’s attorney general, along with city attorneys from Los Angeles, San Diego and San Francisco, filed a lawsuit against Uber and Lyft, claiming the companies gain “an unfair and unlawful competitive advantage by misclassifying workers as independent contractors.”“… these companies can spend their way out of a ballot measure, but it’s a lot harder to spend their way out of worker organizing.”

But the battle doesn’t only exist in the legislatures or at the ballot box — gig workers are taking to the streets and organizing themselves as they continue to be exploited by their employers.

“Any time a group of workers is exploited over the long term, organizing is inevitable,” Smith said. “And that’s what we’re seeing in the gig economy right now, which makes us incredibly optimistic about the future, because these companies can spend their way out of a ballot measure, but it’s a lot harder to spend their way out of worker organizing.”

Drivers have organized many demonstrations and caravans to bring awareness and build their base of support, perhaps most notably in a three-day caravan that traveled from Los Angeles to Sacramento.

“The most robust on the ground organizing is done by a group of workers called the Rideshare Drivers United,” Veena Dubal, a law professor at the University of California, Hastings College of the Law, told Truthout. According to Dubal, the group has about 50 statewide leaders and somewhere between 10,000 to 20,000 members. “They now see their fight on the ground as bargaining directly with these companies, since they cannot use regulations to push the state for better working conditions.”

The group has focused on building worker power to use direct actions and things like strikes and protests to put pressure on the companies to better their working conditions.

“People are still working in these jobs and it’s even more precarious than they have been,” said Nicole Moore, a Lyft driver and labor organizer with Rideshare Drivers United. “Basic labor law is non-negotiable — we see the direction this is going and we want to protect workers. We are gonna fight back.”

Despite being a huge blow to labor rights in the United States, Proposition 22 might serve as a catalyst for a new kind of labor organizing. The nature of gig-work is often quite atomizing, but the coming together of these workers to join in a collective struggle demonstrates that they aren’t going to take it sitting down.

“I think that’s probably one of the most inspiring things that happened during Prop 22,” Chen said. “The direct, on-the-ground organizing and building worker power up to and including going on strike — the fight back is only going to continue.”

Colonization Fueled Ebola: Dr. Paul Farmer on “Fevers, Feuds & Diamonds” & Lessons from West Africa

STORYJANUARY 01, 2021

GUESTS
Paul Farmer
infectious diseases doctor and medical anthropologist. He is a professor of medicine at Harvard University, chair of global health and social medicine at Harvard Medical School, co-founder and chief strategist of Partners in Health.


We continue our conversation with medical anthropologist Dr. Paul Farmer, whose new book, “Fevers, Feuds, and Diamonds,” tells the story of his efforts to fight Ebola in 2014 and how the history of slavery, colonialism and violence in West Africa exacerbated the outbreak. “Care for Ebola is not rocket science,” says Dr. Farmer, who notes that doctors know how to treat sick patients. But the public health response was overwhelmingly focused not on care but containment, Dr. Farmer says, which “generated very painful echoes from colonial rule.”

Transcript
This is a rush transcript. Copy may not be in its final form.


AMY GOODMAN: This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman, as we continue our conversation with Dr. Paul Farmer, infectious disease doctor, renowned medical anthropologist, co-founder and chief strategist of Partners in Health, author of the new book Fevers, Feuds, and Diamonds: Ebola and the Ravages of History. Between 2014 and ’16, Ebola killed more than 11,000 people, most in Sierra Leone, Guinea and Liberia. I asked Dr. Farmer to talk about his new book and his work in West Africa during the Ebola crisis.


DR. PAUL FARMER: Well, you know, I wrote the book, a lot of it, in Sierra Leone. And as chance would have it — and I think we talked about this in 2014 — I was in Sierra Leone in June of 2014, but for an unrelated matter. I was there for a surgical conference, which I was involved, in part, in organizing. And I remember folks coming to the conference saying, “You know, there’s already Ebola in the neighboring countries. Should we really have it? Is it a safe venue?” And my response was that you don’t get Ebola through medical conferences, but through caregiving — that is, nursing the sick and burying the dead — and that we would be OK.


Shortly after that, I left, went back home to Rwanda. And as you will recall, my colleague, Humarr Khan, Sierra Leone’s leading infectious disease doctor, died of the disease on July 29th. And I began lobbying my own friends and co-workers to join in on the fight. And so, I will add, Amy, that we were very tardy to get there, in my view, and arrived in October. And what I saw then, in both Liberia and Sierra Leone, was just terrifying. It’s not like there’s a terror with a respiratory virus that’s invisible. That terror comes when someone is sickened and fell ill. But there, in the midst of this clinical desert, there were times when we saw people collapse in the street, and knew that it was likely or possibly from Ebola and, with some shame, you know, waited for those fully masked and gowned to come and help people. Now, that was not during the time which would follow in a couple of weeks in the Ebola treatment units and community care centers and abandoned public hospitals. We’re still doing a lot of that work today.


But the reason I wrote the book was I got to know a number of patients quite well. And as they recovered, we became, very often, friends, that initial group that I met in October and some that I met in Ebola treatment units in the course of the worst weeks of the epidemic. And one of them, a young man named Ibrahim, on the night that I met him, told me that he had lost more than 20 members of his family to Ebola, and asked me to interview him. And even though, as you point out, I’m an anthropologist as well as a physician, that was a very unusual kind of experience to have someone who just experienced such loss and was still recovering to make such a request. And that kind of convinced me that these stories from West Africa and the history of the place would be an important thing for me to learn about. And that was the genesis of the book.


AMY GOODMAN: And so, talk about Ebola, the outbreak and then how it was contained. You talk about it as the “caregivers’ disease.”


DR. PAUL FARMER: Well, Ebola, like the coronavirus, is an RNA virus. And also, likely, both are zoonoses. That is, they come from other species, animal species, and then leap into humans. And if you look, stand back and look, a lot of the diseases that cause the highest number of deaths among humans have these zoonotic roots. And Ebola is one of those. Its natural host is still disputed. It may be a bat. You know, that seems plausible. But in the midst of all that, its origins, in what species it came from, was not really the task at hand. The task at hand there was stopping transmission from person to person, because once introduced into the human family, Ebola spreads easily through contact.


And the two main sources of exposure are caregiving — first, you know, nursing the sick, cleaning up after them, and, second, the last act of caregiving, in most parts of the world and in most religious traditions, is burying the dead. And those were causing the transmission. Now, the problem there, unlike the United States, is that there were not professional caregivers, and there were not professional undertakers or morticians, so, of course, family members and traditional healers had to fill in that gap. And that’s why so many people got sick and so many traditional healers got sick.


And then, of course, the professional caregivers also experienced enormous risk. It wasn’t just Dr. Khan. It was thousands and thousands of nurses, laboratory technicians, ambulance drivers and doctors. And of the thousand or so that got sick during that time, probably more than half of them died. So, that’s, again, another huge loss for any country, but if you’re living in a medical desert and don’t have a lot of physicians and nurses and lab techs and ambulance drivers, it’s really something. Going back to the U.N. secretary-general’s comments about COVID, the effects of that will be felt for years and decades, if we don’t step in and work to build those health systems again.


AMY GOODMAN: Certainly —


DR. PAUL FARMER: I don’t know if that’s a — sorry.


AMY GOODMAN: Certainly, as we’ve learned, dealing with health, with epidemics, with pandemics, if people have any questions about whether altruism is a motivation, we just understand we are all connected. You, Dr. Farmer, talk in your book about colonization, the slave trade, the catastrophic consequences on African nations. Talk about — though this is not usually talked about in health terms, you put the two together.


DR. PAUL FARMER: Yeah. Well, let me just start, Amy, by saying that during the epidemic, the great majority of our attention, and certainly mine, was on the clinical response — that is, trying to make sure that Ebola treatment units, at least the ones with which we were affiliated, were not only places for isolation, but places for care.


And care for Ebola is not rocket science, even without what are called specific therapies, like an antiviral, like remdesivir, for example, for COVID. Even without specific therapies, the interventions that are required to save the lives of the majority of Ebola patients are to replace the fluids that they’ve lost through nausea, vomiting, diarrhea, sweating — right? — the torrid heat of the area. All those losses of fluids and electrolytes are what really imperil the lives of those sickened with Ebola in the short term. And we have therapies for that. They’ve been around for a hundred years. They’ve been improved over time. You know, these oral rehydration salts, what you probably call Pedialyte, are important. And for those who cannot take oral medications, because they’re nauseated or vomiting or in a coma, there are IV solutions that can save lives in that manner.


And even that was not happening across the region. And there were reasons for that, right? People were frightened. And anything that involved a sharp — that is, a needle, to put in an IV, for example, or a blood draw — poses some risk to healthcare workers, right? But it would have been better just to say, “Hey, we’re frightened,” because anyone in their right mind would be frightened. But instead, we started having arguments about what kind of care was the appropriate care. And the arguments, I mean, especially within what are called the international actors — which doesn’t mean Academy Award-winning actors, but the NGOs and humanitarian groups that had flooded this region after the civil wars that afflicted it for some time, and then returned, obviously sometimes a different cast of characters, including ones that we know well, like the CDC — came back, just a decade after this conflict ended, to be involved in the Ebola response.


And I made the argument in the book that the response was hampered by the fact that the attention was largely to containment, not to care. And, of course, this generated very painful echoes from colonial rule, which in that part of the world was largely a 20th century phenomenon. This is not remote history, as you know. So, in order to improve the quality of containment efforts, we should have focused more on the quality of care. And, you know, we’re going to face that when the next epidemic of Ebola comes along.


AMY GOODMAN: Your description of people, the life histories of the Ebola survivors, is deeply moving. Can you talk about Ibrahim Kamara and Yabom Koroma, some of the people that you dedicate this book to?


DR. PAUL FARMER: Well, you know, it’s not always been easy to talk about them, because they endured such losses, and they were not easy to hear about. Of course, having been involved in their care, I thought I knew something about their losses, but it turns out there were many more. And I had an epiphany, which I’m embarrassed to share. But, of course, it wasn’t long before we understood that every adult patient that we cared for who survived Ebola — or didn’t — had also survived a brutal civil war.


And when I started talking with Ibrahim, who is the very man I mentioned earlier, who’s the person, really, in a way, who inspired me to write this book, I couldn’t believe the details, and spent many, many months — and in the case of Yabom, years — interviewing and learning about them. And, of course, this happens over time. But Yabom’s story was different. If I could just go back and say, Ibrahim was probably 26 when he fell ill with Ebola, and did not have children of his own. His most grievous losses were his mother, his siblings, family members, grandparents, aunts, uncles. Yabom, on the other hand, was 39, and she lost, in addition to her husband, some of her children, her mother also, and other family members.


And what I learned about these two was that they moved between villages and the capital city during the war, after the war and even during the epidemic, because, very often, they were called to perform those caregiving services for afflicted members of their family. And again, in the case of those who perish, who was going to bury them at the time that they fell ill? And this was in August of 2014. So, they faced these impossible choices — another reason it was difficult and painful to write about them — choices that I’ve never faced, like: Do we respect our mother’s dying wish to be buried in her home village? And, of course, that was also against the recommendations of public health authorities. But there wasn’t enough in the way of assistance with caregiving or with respectful burial of the dead until later in the epidemic. And so, their compassion led to their own infections and to infections among other members of their families.


Now, I will add, Amy, that, of course, I still am friends with these people, and they’ve recovered, to varying extents. Yabom almost lost her eyesight, as well, because, as I think we discussed when we were together in August of 2014 to talk about Ebola, one of the complications is a blinding inflammation, that can be readily treated with steroids and eyedrops that cost pennies or a dollar to save someone’s vision. So there were lots of complications, to say nothing of grief and psychological and emotional complications. There were lots of complications that endured in the months after the epidemic was declared brought under control.


AMY GOODMAN: Dr. Farmer, you write that every American and most Europeans who fell ill with Ebola in West Africa survived. “Different mortality outcomes emerged from the same strain of Ebola, depending on care that was or wasn’t available depending on your country of origin.” If you can explain this, and then expand that to what we are seeing today in this country, for example, also on the issue of racial differentials and disparities?


DR. PAUL FARMER: Well, you know, this is something that I encourage my students to grapple with or our trainees in clinical medicine, you know, which is case fatality rate, because case fatality rate is a report card on the quality of the medical system, right? And there are many parts to that — referral to a clinical facility able to manage complications.


And we’re going to be facing the same challenge in the coming weeks. If hospitals become saturated, if we don’t flatten the curve, then they become overwhelmed. And not only do they perform more poorly in terms of caring for those sickened by the pandemic — or, in the case of Ebola, the epidemic — they also fail to provide the services that people need for other problems, other illnesses and injuries. And we saw a lot of that during Ebola, but we’ve also seen it in the United States once our hospitals in New England and New York became overwhelmed. And that’s, of course, exactly what happened in West Africa, as well. It just happened earlier and more devastatingly.


But that’s just the first part of the equation. You know, case fatality rate is a marker, a report card, on what happens after you get infected, right? We also have racial disparities and other social disparities, as you’ve noted, in risk of infection. So, all along that noxious path, we have to make interventions that lessen the risk for infection, but also that lessen the risk for a bad outcome once infected. And I think that is the goal before us with COVID-19, just as it was a goal during Ebola.


Now, why am I bringing this up as a controversial matter? Because if the report card is only about disease control — that is, stopping the epidemic — and not about survival once infected, why is it that people would go to an Ebola treatment unit to be isolated, if they fear they will not receive care? And the answer is, they won’t. Right? And this was not new. Treatment centers and treatment units that were really isolation and quarantine facilities proliferated across the continent of Africa during — under colonial rule and remained a feature there even after the end of colonial rule. And that pathology of focusing on disease control over care, I think, really weakened the epidemic.

AMY GOODMAN: Dr. Paul Farmer, author of the new book Fevers, Feuds, and Diamonds: Ebola and the Ravages of History. He’s chair of global health and social medicine at Harvard Medical School, co-founder and chief strategist of Partners in Health, also featured in the documentary Bending the Arc.

Dr. Paul Farmer: Centuries of Inequality in the U.S. Laid Groundwork for Pandemic Devastation

STORYJANUARY 01, 2021

GUESTS
Paul Farmer
infectious diseases doctor and medical anthropologist. He is a professor of medicine at Harvard University, chair of global health and social medicine at Harvard Medical School, co-founder and chief strategist of Partners in Health.


As the United States sets records for COVID-19 deaths and hospitalizations, we speak with one of the world’s leading experts on infectious diseases, Dr. Paul Farmer, who says the devastating death toll in the U.S. reflects decades of underinvestment in public health and centuries of social inequality. “All the social pathologies of our nation come to the fore during epidemics,” says Dr. Farmer, a professor of medicine at Harvard University, chair of global health and social medicine at Harvard Medical School and co-founder and chief strategist of Partners in Health.

Transcript
This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman.

As we continue our coverage of the COVID-19 crisis, we turn now to the world-renowned infectious disease doctor and medical anthropologist, Dr. Paul Farmer. He’s chair of global health and social medicine at Harvard Medical School and co-founder of Partners in Health, an international nonprofit that provides direct healthcare services to those who are sick and living in poverty around the world. Dr. Farmer co-founded the group in 1987 to deliver healthcare to people in Haiti. In 2014, Partners in Health was one of the first organizations to respond to the Ebola crisis in West Africa. Dr. Farmer’s new book is titled Fevers, Feuds, and Diamonds: Ebola and the Ravages of History. I spoke to him in early December and asked him how it’s possible for the United States to have nearly 20% of the world’s infections and deaths while having less than 5% of the world’s population.


DR. PAUL FARMER: Well, I mean, we are facing the consequences of decades and decades of underinvestment in public health and of centuries of misallocation of funds away from those who need that help most. And, you know, all the social pathologies of our nation come to the fore during epidemics. And during a pandemic like this one, we’re going to be showing the rest of the world, warts and all, how — we have shown the rest of the world how badly we can do. And now we have to rally, use new tools that are coming online, but address some of the older pathologies of our care delivery system and of our country. I think that’s where we are right now.


AMY GOODMAN: What needs to happen right now in the United States?


DR. PAUL FARMER: Well, first of all, you know, I think that it’s a great tragedy that such matters as masking or social distancing or even shutting down parts of the economy, that contribute to risk but are — it’s just a shame that that’s been politicized. These are not political or partisan actions. They are public health strategies. Right now they’re all we’ve got.


But even when the vaccine is online or begins to come online, we have no history of seeing a vaccine taken up so rapidly that it would alter the fundamental dynamics of a respiratory illness like this. So, we’re facing, as President-elect Biden said, a long, dark winter. And if we can make a difference that could spare tens of thousands and perhaps more than 150,000 lives, then we should do that.


And whether or not these are called mask mandates or pleading from the president, we need state and local authorities to come together and underline the nonpartisan and life-saving nature of some of these basic protective measures. We need to invest very heavily in making sure the vaccine goes to those who need it most and those who have been shut out of previous developments like this or shut out for too long.


So we have a lot of work ahead of us this winter, but no small amount of it is going to rely on individual families and communities to take up some of these measures rapidly to make sure that the dark winter does not lead to a blighted spring.


AMY GOODMAN: Dr. Farmer, can you comment quickly on these vaccines, for people to understand, the first what’s called mRNA, messenger RNA, vaccines, what they actually do in the human body? Do they make you immune, or you can get sick and be a carrier, but you, yourself — I mean, you can be infected and be a carrier, but you, yourself, will not get very sick? Explain the choice of who gets the vaccine, also the fact that this has not been studied in children, people under 14, and so what this means for kids.


DR. PAUL FARMER: Well, in general terms, let me just say that in the 30-plus years I’ve been involved in this work, I’ve never seen such a rapid development of a novel preventive for a novel vaccine. So there’s a lot to celebrate in terms of the global effort to come together to develop new vaccines.


Again in general terms, the idea is that instead of having a natural infection — in this case, breathing in the novel coronavirus and getting sick, which leads to the outcomes that we know: death or recovery with sequelae — it also leads probably to immunity. That’s what it’s like with other viral infections in humans, or almost all of them. So, what the vaccine does is introduce something that will trick the body into believing that it’s being invaded by the virus — in this case, it’s focused on a particular protein on the outer surface of the virus — and generate that immune response, which is often robust and enduring, at least with other viruses. Now, in the case of any novel pathogen, we don’t know for sure how long that immunity lasts, right? I mean, how could you? It hasn’t been studied for long. But we know about other viruses and can take some lessons from those.


And in the case of this new vaccine or this new type of vaccines, the mRNA vaccine, we’re also dealing with that unknown. This is a new kind of vaccination. This is a new approach. It’s very exciting, in part because it seems to confer that immunity without significant adverse effects. So, I think, again, on the side of development of a novel technology, these vaccines, whether mRNA vaccines or others, are great news, right? And maybe they will influence a new generation of vaccines for other pathogens, particularly viral pathogens, which tend to be the worst ones among humans. So, that’s where we are with the development of new technology.


Unfortunately, as I said and as you’ve underlined many times, Amy, the old pathologies of our society make it unlikely that the rollout will be smooth and evenly taken up across various communities, some of them with well-founded fears and mistrust of any kind of public health campaign. So, we’re in a bit of a pickle. I’m optimistic about what will happen in this country, but as you pointed out in opening up the hour, a lot of us are concerned with what’s going to happen in the Global South and among those who might as well be considered living in the Global South in wealthy and egalitarian countries like the United States and parts of Europe.


So, it’s going to be a rocky winter, with some highs and lows. And I hope there are more highs than lows. I hope there’s more reason for celebration than for grief. But I think it’s going to be a very, very difficult winter.


AMY GOODMAN: Just before we go to this remarkable book about dealing with Ebola and what it meant, I wanted to ask you about property rights, about patents and about countries like South Africa and India pushing for a temporary suspension of intellectual property rights and patents so that COVID-19 vaccines and medications become more accessible, particularly in the Global South.


DR. PAUL FARMER: Well, I’d just like to say something we’ve had a chance to discuss before in previous years. You know, when you look at what happened around HIV, which by 1995, '96, those of us in the infectious disease world understood that this would be a life-saving suppressive therapy — like as with diabetes requiring insulin, you'd have to keep taking it, but this would save millions of lives, and maybe even more, and prevent transmission of mother to child — the same debates about intellectual property of course came up then.


The average wholesale price for a three-drug regimen in the years immediately after the discovery of these new agents was $15,000, sometimes $20,000, per person per year. So, if you split your time between Harvard and Haiti, as I had and do, you would imagine, if you couldn’t have an imagination beyond conventional property rights discussion, that the majority of the world would be shut out of access to this therapy. And, of course, that made the most difference, on a continent level, in Africa, where the majority of people living with HIV and dying with HIV were at the time.


And what happened later was the production of generic versions of these drugs, often in India or China or even South Africa — right? — so that a much lower cost could be tied to the same agents. And when I say “much lower,” I mean a reduction, really even within those early years, from $15,000 to $20,000, to about $300 per person per year. And with groups like the Clinton Foundation getting involved, those prices dropped even further. And right now you can get a really good three-drug regimen, even with some pediatric formulations for children, for about $60 per patient per year.


So, you could say that took a long time, but it didn’t take a long time in terms of the impact that it could have. Millions and millions of lives, maybe even 16 to 20 million lives, are being saved by these drugs. But in some places, like Rwanda, where I’ve spent 10 years, you saw the virtual eradication of AIDS among children, because if mom is on therapy, the transmission to babies in utero, or through breastfeeding probably, really does not occur. And this is not a hypothetical development. This has already happened in Rwanda, which is a very poor country with a very robust public health and care delivery system.

AMY GOODMAN: Dr. Paul Farmer. We’ll return to our interview in a moment and talk about his new book, Fevers, Feuds, and Diamonds: Ebola and the Ravages of History.

The Freedom Struggle in 2020: Angela Davis on Protests, Defunding Police & Toppling Racist Statues

STORYDECEMBER 31, 2020

GUESTS
Angela Davis
world-renowned abolitionist, author, activist and professor at the University of California, Santa Cruz.

Image Credit: Yalonda James / The SF Chronicle via Getty Images

In a Democracy Now! special, we revisit our June 2020 interview with the legendary activist and scholar Angela Davis about the uprising against police brutality and racism launched in May after the police killing of George Floyd in Minneapolis. The protests have helped dramatically shift public opinion on policing and systemic racism, as “defund the police” became a rallying cry of the movement. Davis is professor emerita at the University of California, Santa Cruz. For half a century, she has been one of the most influential activists and intellectuals in the United States and an icon of the Black liberation movement.

Transcript
This is a rush transcript. Copy may not be in its final form.


AMY GOODMAN: We begin today’s special looking back at the uprising against police brutality and racism following the police killing of George Floyd in Minneapolis on May 25th. The protests helped shift public opinion on policing and systemic racism, with “defund the police” becoming a rallying cry of the movement.

Well, for more on the historic protests, we turn to the legendary activist and scholar Angela Davis, professor emerita at the University of California, Santa Cruz. For half a century, Angela Davis has been one of the most influential activists and intellectuals in the United States and an icon of the Black liberation movement. I interviewed her in early June and asked her if she thought this moment is truly a turning point.


ANGELA DAVIS: This is an extraordinary moment. I have never experienced anything like the conditions we are currently experiencing, the conjuncture created by the COVID-19 pandemic and the recognition of the systemic racism that has been rendered visible under these conditions because of the disproportionate deaths in Black and Latinx communities. And this is a moment I don’t know whether I ever expected to experience.


When the protests began, of course, around the murder of George Floyd and Breonna Taylor and Ahmaud Arbery and Tony McDade and many others who have lost their lives to racist state violence and vigilante violence — when these protests erupted, I remembered something that I’ve said many times to encourage activists, who often feel that the work that they do is not leading to tangible results. I often ask them to consider the very long trajectory of Black struggles. And what has been most important is the forging of legacies, the new arenas of struggle that can be handed down to younger generations.


But I’ve often said one never knows when conditions may give rise to a conjuncture such as the current one that rapidly shifts popular consciousness and suddenly allows us to move in the direction of radical change. If one does not engage in the ongoing work when such a moment arises, we cannot take advantage of the opportunities to change. And, of course, this moment will pass. The intensity of the current demonstrations cannot be sustained over time, but we will have to be ready to shift gears and address these issues in different arenas, including, of course, the electoral arena.


AMY GOODMAN: Angela Davis, you have long been a leader of the critical resistance movement, the abolition movement. And I’m wondering if you can explain the demand, as you see it, what you feel needs to be done, around defunding the police, and then around prison abolition.


ANGELA DAVIS: Well, the call to defund the police is, I think, an abolitionist demand, but it reflects only one aspect of the process represented by the demand. Defunding the police is not simply about withdrawing funding for law enforcement and doing nothing else. And it appears as if this is the rather superficial understanding that has caused Biden to move in the direction he’s moving in.


It’s about shifting public funds to new services and new institutions — mental health counselors, who can respond to people who are in crisis without arms. It’s about shifting funding to education, to housing, to recreation. All of these things help to create security and safety. It’s about learning that safety, safeguarded by violence, is not really safety.


And I would say that abolition is not primarily a negative strategy. It’s not primarily about dismantling, getting rid of, but it’s about reenvisioning. It’s about building anew. And I would argue that abolition is a feminist strategy. And one sees in these abolitionist demands that are emerging the pivotal influence of feminist theories and practices.


AMY GOODMAN: Explain that further.


ANGELA DAVIS: I want us to see feminism not only as addressing issues of gender, but rather as a methodological approach of understanding the intersectionality of struggles and issues. Abolition feminism counters carceral feminism, which has unfortunately assumed that issues such as violence against women can be effectively addressed by using police force, by using imprisonment as a solution. And of course we know that Joseph Biden, in 1994, who claims that the Violence Against Women Act was such an important moment in his career — the Violence Against Women Act was couched within the 1994 Crime Act, the Clinton Crime Act.


And what we’re calling for is a process of decriminalization, not — recognizing that threats to safety, threats to security, come not primarily from what is defined as crime, but rather from the failure of institutions in our country to address issues of health, issues of violence, education, etc. So, abolition is really about rethinking the kind of future we want, the social future, the economic future, the political future. It’s about revolution, I would argue.


AMY GOODMAN: You write in Freedom Is a Constant Struggle, “Neoliberal ideology drives us to focus on individuals, ourselves, individual victims, individual perpetrators. But how is it possible to solve the massive problem of racist state violence by calling upon individual police officers to bear the burden of that history and to assume that by prosecuting them, by exacting our revenge on them, we would have somehow made progress in eradicating racism?” So, explain what exactly you’re demanding.


ANGELA DAVIS: Well, neoliberal logic assumes that the fundamental unit of society is the individual, and I would say the abstract individual. According to that logic, Black people can combat racism by pulling themselves up by their own individual bootstraps. That logic recognizes — or fails, rather, to recognize that there are institutional barriers that cannot be brought down by individual determination. If a Black person is materially unable to attend the university, the solution is not affirmative action, they argue, but rather the person simply needs to work harder, get good grades and do what is necessary in order to acquire the funds to pay for tuition. Neoliberal logic deters us from thinking about the simpler solution, which is free education.


I’m thinking about the fact that we have been aware of the need for these institutional strategies at least since 1935 — but of course before, but I’m choosing 1935 because that was the year when W.E.B. Du Bois published his germinal Black Reconstruction in America. And the question was not what should individual Black people do, but rather how to reorganize and restructure post-slavery society in order to guarantee the incorporation of those who had been formerly enslaved. The society could not remain the same — or should not have remained the same. Neoliberalism resists change at the individual level. It asks the individual to adapt to conditions of capitalism, to conditions of racism.


AMY GOODMAN: I wanted to ask you, Angela Davis, about the monuments to racists, colonizers, Confederates, that are continuing to fall across the United States and around the world. Did you think you would ever see this? You think about Bree Newsome after the horror at Mother Emanuel Church in Charleston, South Carolina, who shimmied up that flagpole on the grounds of the South Carolina Legislature and took down the Confederate flag, and they put it right on back up. What about what we’re seeing today?


ANGELA DAVIS: Well, of course, Bree Newsome was a wonderful pioneer. And I think it’s important to link this trend to the campaign in South Africa, Rhodes Must Fall. And, of course, I think this reflects the extent to which we are being called upon to deeply reflect on the role of historical racisms that have brought us to the point where we are today.


You know, racism should have been immediately confronted in the aftermath of the end of slavery. This is what Dr. Du Bois’s analysis was all about, not so much in terms of, “Well, what we were going to do about these poor people who have been enslaved so many generations?” but, rather, “How can we reorganize our society in order to guarantee the incorporation of previously enslaved people?”


Now attention is being turned towards the symbols of slavery, the symbols of colonialism. And, of course, any campaigns against racism in this country have to address, in the very first place, the conditions of Indigenous people. I think it’s important that we’re seeing these demonstrations, but I think at the same time we have to recognize that we cannot simply get rid of the history. We have to recognize the devastatingly negative role that that history has played in charting the trajectory of the United States of America. And so, I think that these assaults on statues represent an attempt to begin to think through what we have to do to bring down institutions and reenvision them, reorganize them, create new institutions that can attend to the needs of all people.


AMY GOODMAN: Can you talk about racism and capitalism? You often write and speak about how they are intimately connected. And talk about a world that you envision.


ANGELA DAVIS: Yeah, racism is integrally linked to capitalism. And I think it’s a mistake to assume that we can combat racism by leaving capitalism in place. As Cedric Robinson pointed out in his book Black Marxism, capitalism is racial capitalism. And, of course, to just say for a moment, that Marx pointed out that what he called primitive accumulation, capital doesn’t just appear from nowhere. The original capital was provided by the labor of slaves. The Industrial Revolution, which pivoted around the production of capital, was enabled by slave labor in the U.S. So, I am convinced that the ultimate eradication of racism is going to require us to move toward a more socialist organization of our economies, of our other institutions. I think we have a long way to go before we can begin to talk about an economic system that is not based on exploitation and on the super-exploitation of Black people, Latinx people and other racialized populations.

But I do think that we now have the conceptual means to engage in discussions, popular discussions, about capitalism. Occupy gave us new language. The notion of the prison-industrial complex requires us to understand the globalization of capitalism. Anti-capitalist consciousness helps us to understand the predicament of immigrants, who are barred from the U.S. by the wall that has been created by the current occupant. These conditions have been created by global capitalism. And I think this is a period during which we need to begin that process of popular education, which will allow people to understand the interconnections of racism, heteropatriarchy, capitalism.

Covid-distancing and social solidarity needed against new virus variant

Author: Martin Thomas WORKERS LIBERTY

National Education Union joint general secretary Kevin Courtney has called for the start of the second school term to be delayed to 18 January to give time and space for the government's proposal for mass testing in schools to be organised.

Lisa Nandy, for the Labour Party leadership, has opposed the proposal to delay to 18 January. But even for people sceptical about the idea of closing schools in October-November (Wales did that, and its lockdown was much less effective than others that kept schools open), the spread of the new virus variant gives good reason to support the NEU call. In fact, to support longer closures and a full lockdown comparable to spring 2020's.

On 30 December, the "Independent SAGE" group of scientists called for a new lockdown and for schools to close for at least a month. "We are no longer in the same pandemic we were in up to December. The very rapid rise of cases in London, the South East and East of England under restrictions that previously kept growth much slower, highlights the need for a radical rethink... "

The Independent SAGE also implies calls for:

• Full isolation pay for all
• Publicly-provided quarantine accommodation

That is good. Activists will press the labour movement to redouble efforts for those measures of social solidarity, and for:

• Bring social care into the public sector
• A public-health test-trace operation, in place of the Serco-Deloitte contracted-out mess
• Emergency public ownership of private hospitals and of NHS supplies and logistics
• Workers' control of workplace virus curbs

But Independent SAGE's stated criteria for ending (or, apparently, even easing) a new lockdown are unworkable; that "all those with the disease and in contact with them are isolated, with support where necessary" and there is "managed isolation" for a quarantine period of all arrivals from abroad. In a foreseeable future of months, the UK's public health system lacks the means even to know how many infected, contacted, and arriving people are self-isolating fully. (As far as we do know, fewer than 20% of those testing positive, let alone contacts and arrivals, are self-isolating properly).

A more workable criterion would be to start easing the lockdown once the infection curve turns down again (and do it step by step, as many European countries did successfully in mid-2020 until the foolish July reopening of bars, cafés, and tourist industries). Schools, especially primary schools, should be priorities for reopening, as they were for example in Denmark back in April.

But Independent SAGE are right that rapid and drastic action is called for, and that we have no comprehensive option other than the old one of lockdown. This time it must be accompanied by full isolation pay, requisitioning of PPE supplies and private hospitals, and bringing social care into the public sector.

Infections are rising fast across the UK. Viruses mutate all the time, and no union or government can control that. The new variant VUI-202012/01 spreads faster. The government says, maybe 70% faster.

Even the strict lockdowns of March-April brought only a slow decrease (average 22% decrease in reported infections per week in the "best" period, 22 April to 2 July; it was about 10% decrease per week in the November lockdown).

Add a 70% more transmission to such slow decrease, and you get a rising rate of infection, if a big majority of the cases are the new variant.

And being more transmissible also makes new variants outpace old variants, and come to be dominant even when they start with only one case. According to the WHO on 31 December, this has already happened once, though less dramatically. "A variant of SARS-Cov-2 with a D614G substitution in the gene encoding the spike protein emerged in late January or early February 2020. Over a period of several months [this] replaced the initial SARS-Cov-2 strain identified in China and... became... dominant... The strain with the D614G substitution has increased infectivity and transmission".

The new variant may not be as much as 70% faster to transmit. More people will have some immunity now, through having Covid already with or without symptoms, and that will slow transmission. As vaccinations spread, over 2021, and especially as they spread into younger sections of the population, that should slow transmission further. We don't know how much, because we don't know how much the vaccine inhibits transmission as well as inhibiting symptoms, but the vaccinations could slow transmissions too.

It's certain that infection rates will be high for some weeks yet. It is probable that they will be rising for a good few weeks or even months. It is possible that they will be rising for even longer than that. We still have no reliable general method to depress transmission other than the clumsy and costly age-old one of covid-distancing.

Certainly universities should go online, or almost all online, as they did in spring. Probably lockdown-level measures of covid-distancing will be needed for months yet.

Schools are an essential service. School closures (especially of primary and lower secondary schools) are a last resort - because such closures have great social costs; because school-aged children suffer less from Covid than adults and especially older adults; because where schools have been open adult school workers, unlike health workers, care workers, bus workers, etc. have not had above-average Covid rates. On the balance of the evidence since early 2020, school closures add relatively little to the transmission-reducing effect of a package of distancing policies.

But probably by now we are in "last resort" territory. We are scrabbling for even marginal additions to transmission-reduction.

GCSE and A Level exams scheduled for summer 2021 should be cancelled now. GCSEs require no replacements (16 year olds should simply be allowed to enter whatever apprenticeships or further study they want). A levels do need temporary makeshift replacement pending a (needed) drastic revision of the university system. That makeshift should be worked out now, in consultation with teachers, to get something that minimises the disadvantage for students from worse-off backgrounds who mostly will have lost more school time already and are often short of the technology, resources, quiet space (and confidence) needed to study online from home.

Frequent and quick-response mass testing, where everyone in a workplace or campus is tested twice a week and has to show a negative test result to enter, does seem to be effective. It has worked relatively well, for example, at the University of Illinois Urbana-Champaign, in the USA, producing much lower rates of infection on its campus than in the surrounding area. It may help schools to reopen earlier than otherwise.

But the NEU - and head teachers' associations too - are right to say that it needs to be well-organised, with adequate trained staff to administer and process the tests, and the Tory government is nowhere near giving schools the resources to do that by early January.

For the months ahead, when they reopen, schools also need extra funding for the virus-precaution measures which should have been installed already: running rotas and conscripting extra accommodation to reduce class sizes, fixing ventilation, hiring extra regular staff to cover staff absences and avoid bringing new people into the school. They need extra funding now to distribute laptops and hire extra staff for online teaching.

Botched mass testing may even be counterproductive. Many scientists have argued that the government's one-off mass population testing in Liverpool was a useless publicity stunt. There have been claims that the one-off population mass testing in Slovakia in early November was effective, but the statistics since then su

 

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