Eighty-four million Americans remain unvaccinatedCOVID-19 is not recommended. Nearly nobody has ever knocked on their door to explain why a vaccine would be a good idea. Even though it is late, it is a good moment to get started.
Like COVID testing thousands of community health workers need to go out into the streets and back roads to convince people vaccines are safe and necessary. Daily conversations over many weeks are required to convert millions of skeptics into participants. This is the type of program that the Biden administration suggested, even though it was in an insufficient form, for contact trace before the inauguration, but never followed up on.
Certainly, the ongoing bloodbath — only inches deep but wide as a lake — isn’t just a matter of the present administration. Trump’s vindictive inaction helped kill half a million Americans the first year of the outbreak. Biden’s smug insufficiency, however, will likely add another half a million by spring. But more pointedly, it’s as much a matter of the U.S.’s structural decline that produced the holes in our public health coverage. Since the neoliberal program began nearly 50 years ago public health was gradually abandoned or monetized.
Saving lives is evident with public health spending. Ten years ago, Glen Mays and Sharla Smith were health policy analysts. found that U.S. mortality rates from preventable deaths — including infant mortality and cardiovascular disease, diabetes and cancer — fell between 1.1 to 6.9 percent for every 10 percent increase in local public health spending.
But this vital spending has fallen. In 2018, the Trust for America’s Health reported The decline in public health funding.
The Public Health Emergency Preparedness Program (PHEP) Cooperative Agreement Program was described in the report as the only federal program that helps state and local health departments prepare for and respond to emergency situations. Except for a few exceptions for Zika and Ebola outbreaks, core emergency preparedness funding was cut by more than a third (from $940million in 2002 to $667million in 2017).
The report identified state-level declines in public funding for health care. Thirty-one states have cut their public-health budgets from FY 2015-16 to FY 2016-17, with spending less than in 2008. The budget cuts made during Great Recession were never reversed.
The impact was also felt at the local level. In the decade following the Recession, 55,000 local health departments saw their staff cut. By this system’s logic, an acute emergency is also grounds for such cuts. There were thousands of health staff. furloughed during the COVID outbreak — cuts attributed in part to declines in more lucrative elective surgeries. One in five health workersDuring the pandemic, many people have quit their jobs.
The Trust for America report then described the upcoming disasters for which the U.S. was not prepared in 2018. These sound like headlines from the past year: weather catastrophes; flooding; wildfires and extreme drought; hurricanes and infectious disease outbreaks; and death of despair due factors such as racial disparities and regional disparities which continue to drive distrust in government.
Trust for America emphasized pandemics and the need for full funding of the Pandemic and All-Hazards Preparedness Act and Hospital Preparedness Program, as well as the Project BioShield Act and PHEP.
The report recommended increasing funding for public health at all levels of jurisdiction — federal, state and local. It recommended maintaining the Prevention and Public Health Fund, increasing funds to prepare for public and public health emergencies and epidemics, and establishing a public health emergency fund to provide funding during an emergency to avoid delays such as those that occurred in the Zika virus pandemic, the swine flu pandemic and Hurricane Sandy.
Trust for America concluded its report with a recommendation for a national strategy for resilience to combat despair, prevent chronic disease and expand high-impact interventions across the community.
While it is important to consider recommendations for increased funding and preparedness, it’s also crucial to take a step back and consider the system under which these suggestions are being made. Trust for America’s recommendations were wrapped in the worst of language and precepts. The report accepted the state’s class character. Public health is an instrument for cleaning up the messes created by capitalist production. The returns on investment were used to evaluate public health outcomes.
All of this is horrible. Yet, these recommendations are radical in the current context, even if they only serve to mitigate the damage done by an empire at its end. cycle of capital accumulation, organized around helping billionaires squeeze what’s left of the commons and turning decades of social infrastructure back into bunker money.
Anti-Public Health — at Home and Abroad
We see an analogous mistake in U.S.COVID policy overseas. The Biden administration has taken a stand. in favor of waiving TRIPS rulesBill Gates, tech billionaire, philanthrocapitalist, and anti-vaccine generics for COVID funding WHO efforts, effectively sets The U.S. has a policy on this matter.
Gates declared April will see:
There are only so few vaccine factories in the world. People are very concerned about vaccine safety. And so moving something that had never been done, moving a vaccine from, say, a J&J factory into a factory in India, that, it’s novel, it’s only because of our grants and our expertise that can happen at all. The thing that’s holding things back in this case is not intellectual property, there’s not like some idle vaccine factory with regulatory approval that makes magically safe vaccines.
The reality is quite different. Last month AccessIBSA and Médecins Sans Frontières identified 120 companies in Africa, Asia, Latin America and the Caribbean have the potential to make mRNA vaccines. Human Rights Watch reported:
“Global vaccine production forecasts suggesting there will soon be enough Covid-19 vaccines for the world are misleading,” said Aruna Kashyap, associate business and human rights director at Human Rights Watch. “The US and German governments should press for wider technology transfers and not let companies dictate where and how lifesaving vaccines and treatments reach much of the world as the virus mutates.”
Two months earlier The New York TimesHad investigated The possibility:
“You cannot go hire people who know how to make mRNA: Those people don’t exist,” the chief executive of Moderna, Stéphane Bancel, told analysts.
Public health experts from rich and poor nations argue that expanding production to areas most in need is possible. This is necessary for protecting the world from dangerous variants and ending the pandemic.
Setting up mRNA manufacturing operations in other countries should start immediately, said Tom Frieden, the former director of the Centers for Disease Control and Prevention in the United States, adding: “They are our insurance policy against variants and production failure” and “absolutely can be produced in a variety of settings.”
Apologists for the pharmaceutical industry say that no idea can be made or pursued, even if the largest companies make billions. Our men of year should be treated as gods with rocket wings. Few in the respectable establishment have even described the fallacy.
Others were more shrewd in their comments, linking increasing wealth concentration to COVID failures.
- Matthias Schmelzer, Economic historian started one Twitter thread early December: “The global concentration of capital is extreme: The richest 10% own around 60-80% of wealth, the poorest half less than 5%, according to just published World Inequality Report.”
- Americans For Tax Fairness reported: “America’s billionaires got $1 TRILLION richer in 2021, a 25% gain in collective wealth that will go largely untaxed.”
- Jack Califano is a union organizer encapsulated the damage of such an arrangement: “COVID has been a perfect illustration of how our government now works. In times of crisis, it will provide some benefits but not the absolute minimum necessary to safeguard the system from political turmoil. And then, as soon as stability is restored, it will take them away.”
The Pandemic ThinkTank addressed the core issue in similar terms. In a report it released in November, the ad hoc group — comprised of a social psychiatrist, disease ecologist, medical anthropologist, epidemiologist, critical care physician and county official — unpacked the origins of the COVID trap that the U.S. placed itself in and offered a plan of escape other than “go to work.”
The team discussed how social systems influence the spread of epidemics, the damage that accrued in America’s system of disease control long prior to SARS-2, the history and success of public health efforts before that destruction, as well as what a functioning public health system looks like.
We can learn a lot from the COVID-19 pandemic, which will help us plan for the next one.
First, there are three ‘partners’ in this enterprise: the government, the public health establishment, and the communities. Each partner plays an important role in helping us learn from our mistakes and be better prepared for the next challenge. There is a deeper issue with the American oligopoly, and the politicians who are allied to them, that enables them to hold too much power. They profit in power and wealth from the array of policies David Harvey (2019) labeled ‘accumulation by dispossession’.
To examine the threat of pandemics seriously, one-sided power must be questioned. The oligopoly has been able to gain and maintain power by undermining communities and dismantling their organizations. This may be a short-term gain, but it can pose a serious threat to long-term survival. Rebuilding community power and capacity is an essential part in epidemic control.
Rebellion as Intervention
So there are people who know more about the country than the establishment. In contrast to the president’s chief medical advisor Anthony Fauci and a CDC that repeatedly places commerce and empire before people, Pandemic ThinkTank explicitly counsels a rebel alliance:
In many localities and counties, local health departments must incite revolution.
Like all revolutions, this must take place in secret with interactions with community groups, such as neighborhood bars, playgrounds or houses of worship, and barbershops/beauty shops.
The health department must have the social and politically powerful muscle to influence the elected executive to reform relevant agencies in order to improve public health and pandemic response.
The pressure from empowered communities must be felt by health departments to create egalitarian planning councils that can produce plans that are acceptable to and supported by the diverse elements that make up the local communities.
Contrary to the COVID CollaborativeWe can see why the Pandemic ThoughtTank has no direct line to the president. There are many established epidemiologists who, like CDC, advocate a more individualistic approach in public health. Indeed, ultimately, it’s going to take everyday people from beyond the Beltway to help bend epidemiology back into a science for the people.
Younger epidemiologists are embracing this spirit and turning on Biden, their more connected colleagues, in confrontational terms. Most journeymen are punished for this.
- Perhaps with the COVID Collaborative and ex-Harvard epidemiologist and now chief science officer at the eMed diagnostic company Michael Mina in mind, Columbia University’s Seth Prins tweeted: “Turns out lots of blue check public health experts moonlight as pandemic profiteers.”
- Ellie Murray, of Boston University’s School of Public Health, tweeted: “Honestly baffled by people who claim the COVID plan put in place by the president of the united states, ‘leader of the free world’, was so fragile that an assistant professor tweeting on her coffee breaks could undermine it, & that *isnt* somehow worse than the plan just failing?”
- Justin Feldman, a social epidemiologist at the Harvard FXB Center for Health & Human Rights, who wrote his own critique of Biden’s COVID year, followed up: “There’s ‘a lot to unpack’ about how the only substantive criticism the media has been willing to pursue wrt Biden’s pandemic response is failing to make a consumer product (rapid tests) available to individuals.”
- From abroad, Botswanan doctor Letlhogonolo Tlhabano weighed in: “I’m an intensivist and have been taking care of COVID patients since this pandemic begun, and the new AHA guidelines are idiotic. We’re not martyrs. The CDC guidelines are based on the need to protect capital and not necessarily science. We’re on our own.”
- Lucky Tran, science organizer and biochemist commented: “We are not ‘learning to live with COVID’. When we give up on protecting our healthcare systems, workers, the immunocompromised, and the vulnerable, in reality we are ‘surrendering to COVID.’”
- It speaks to the current tenor of our time when March for Science was held. retweets Black radical Bree Newsome discusses the out-of-pocket cost of COVID testing.
I tried warning people about Biden’s pandemic-related policies before the inauguration, twice,And authored a book entitled Dead Epidemiologists, underscoring the mortally wounded thinking of even some of the field’s best and brightest practitioners.
These younger scientists’ advocacy work may indicate that our dark future can also offer hope. A more recent invitation to my millennial colleagues that we had a world to win reminded me of the generation-appropriate Marx t-shirt I’m getting my kid for his birthday: “You’re A Wizard, Harry.”
Of course, I don’t have all the answers on how we’ll get through this shit show — to use the technical term. I’m always learning alongside this new generation.
Due to the ethical dilemma in which Gates had us all trapped, I experienced a bout with booster hesitancy. Why a third inoculation for me when much of the world hasn’t gotten stuck a single shot? It was a shameful experience, complete with reddened faces and shortness of breathe. I came to the conclusion that being alive allowed my to advocate for a better public health system around the world.
Ending a pharmaceutical industry that focuses on commoditizing healthcare and reinvesting in public health around our shared commons both here and abroad is the only way to end this pandemic. Otherwise, we will be left to watch the virus go away by itself by 2025. early models projected. The Black PlagueAfter eight years, Europe was finally wiped out. We will have to accept the possibility of suffering a pandemic similar in duration if we do not act now to reestablish an active, onthe-ground public healthcare mobilization that helps people block-by–block and farm–by–farm.