Tuesday, March 31, 2020

Socialist Standard No. 1388 April 2020


Coronavirus crisis. Ventilator fiasco

Over the coming months, hundreds of thousands of people in the United States are going to come down with severe forms of COVID-19 infection. How many of them will pull through and how many will die of suffocation depends crucially on the availability of life-saving ventilators in the intensive care units of hospitals. A recent survey found that even acute-care hospitals have on average only eleven ‘full-feature’ ventilators. Failing urgent acquisition of many tens of thousands of additional ventilators, hospitals will be overwhelmed as the pandemic spreads.

In a desperate attempt to mitigate the disaster, hospital staff are preparing to link up each of their ventilators to two or even four patients. A video posted on YouTube shows how to link up a ventilator to four patients. As the instructor admits, this is an ‘off-label use’ of a machine designed to serve one patient at a time. I can’t help wondering whether it is really going to work.

Initially Trump took the orthodox ‘neo-liberal’ view that there was no reason for government to get involved. ‘Unfettered free enterprise’ could be trusted to rise to the occasion. However, he ended up brokering a deal for a joint venture between General Motors and Ventec Life Systems. General Motors would retool a car parts plant in Kokomo, Indiana as a ventilator production facility using Ventec’s technology. A government order for 80,000 ventilators was to be fulfilled in just two months. Trump’s enthusiasm was unbounded. ‘Go for it auto execs,’ he tweeted excitedly on March 22, ‘let’s see how good you are?’ [1]

Then suddenly it was announced that the deal was off. Officials in the Administration were unhappy about the cost – over a billion dollars, a large part of which had to be paid upfront. True, it worked out at only $13,000 per ventilator – not bad, considering that the machines usually sell within the range $25–50,000. But for Chrissake, lamented officials at the Federal Emergency Management Agency, for that money you could buy eighteen F-35 fighter jets! And if you think I made that up for ironic effect then you are wrong. They really find it distasteful to spend large sums of government money for the benefit of ordinary people. 

An interdepartmental working group under the direction of Trump’s son-in-law Jared Kushner (who was admitted to college only after his dad paid a hefty bribe – I mean ‘donation’) is now exploring the issue in detail. The GM-Ventec project remains on the table, but another dozen or so other proposals are also under consideration. The target of 80,000 ventilators has been whittled down to 20,000 and then to 7,500. You see, some officials are worried that too many ventilators may be ordered, leaving them with a wasteful surplus.

To give credit where it is due, Trump must have started to get impatient, because on March 27 he issued the following statement:

Today, I signed a Presidential Memorandum directing the Secretary of Health and Human Services to use any and all authority available under the Defense Production Act to require General Motors to accept, perform, and prioritize Federal contracts for ventilators. Our negotiations with General Motors regarding its ability to supply ventilators have been productive, but our fight against the virus is too urgent to allow the give-and-take of the contracting process to continue to run its normal course. General Motors was wasting time. Today’s action will help ensure the quick production of ventilators that will save American lives.

The Defense Production Act of 1950 authorizes the President to require businesses to sign contracts and fulfill orders deemed necessary for defense, but it has also been invoked occasionally in non-military emergencies. Democrats in Congress were urging him to invoke it in the current crisis. Trump was under pressure from corporate CEOs and the Chamber of Commerce not to do so.  

Trump then fired off tweets to General Motors and Ford, which was working on its own plan to adapt car parts for ventilators, declaring that they ‘MUST START MAKING VENTILATORS NOW!!!!!!’ (yes, in capitals and followed by six exclamation points). 

What is going on here? 

My answer is – a sterile interaction of three main forces:

  • Trump
  • his Republican Party colleagues in government and in Congress
  • corporate capitalism

I consider Trump separately from his colleagues because he is not just another Republican politician. He is one of a kind. He is influenced by the same ideology as his colleagues but less consistently, as shown by his attempt (however inept and futile) to dictate to the CEOs of General Motors and Ford instead of acting as an obedient executor of their will. 

Continually changing his mind, Trump sometimes forgets how capitalism works, even though most of the time he understands this very well. How else could he fondly imagine that a corporation might be induced to satisfy a human need, irrespective of whether doing so is made commercially viable – that is, profitable? He does not blame capitalism, of course, choosing instead to blame individuals, such as Mary Barra, current CEO of General Motors, who – according to Trump – makes a mess of everything in which she is involved. In sharp contrast to the ‘very stable genius’ standing at the country’s helm.    

As of this writing (March 30), no new facility for the production of ventilators is yet in operation in the United States. 


 [1] This account relies mainly on three articles published in the Daily Kos on March 27: here and here and here.
Stephen Shenfield

America's Farm Workers and COVID-19

America’s farmworkers have always done the essential work of feeding the nation for little reward and with few codified protections or benefits. Researchers and advocates estimate between 60% and 75% of California’s more than 400,000 agricultural workers are undocumented. The United Farm Workers of America estimates only about 10,000 are unionized. An additional 20,000 are in California on H2A visas, a visa category that has seen some processing delays amid coronavirus shutdown orders. With the more farming-intensive spring season about to set in, and a surge in Covid-19 cases expected state-wide, there’s a small and rapidly closing window to establish meaningful safety measures in the fields.

In California, which grows two-thirds of the country’s fruits and nuts and one-third of its vegetables, the pressure to shift and bolster that fast-changing food system is felt acutely. The state’s roughly 400,000 agricultural workers are exempt from shelter-in-place orders, and vital agriculture work is continuing to keep markets stocked nationwide. Growers and labor contractors say they are putting new practices and measures in place to keep workers socially distanced and maintain sanitized common facilities.

But workers and their advocates tell a different story: of vulnerable, low-wage workers operating in fear, without proper protections let alone information about the risks involved in their essential labor, and without hope of any share in expanded unemployment benefits should they fall ill or lose work.
“Nothing has changed at work,” Amadeo Sumano said . “The distance principle, 6 feet between people, does not work in agriculture.” He worries about getting sick, or having his hours cut as some growers contend with a loss in food service orders, and the financial pressure that would come with either scenario, made even more intense because of his undocumented status. "I have lived and worked in this country for many years and paid taxes, but cannot access benefits,” said Sumano. “If either working hours are cut or we contract the virus, we are likely to not be able to pay rent and would become homeless.”
Armando Elenes, secretary-treasurer of the United Farm Workers of America. “The last hands that touched that produce before the consumer puts it in their mouth is a farmworker’s hands, so we better care about what happens to these workers.” He laughed at the notion of growers voluntarily offering hazard pay to compensate for their new risks, as some front line workers in other sectors have demanded. “The ‘essential’ part doesn’t show up on their paycheck. They’re lucky to get minimum wage,” he said.

“They’re getting paid the same, yet they’re exposing themselves to more dangers,” said Irene de Barraicua, spokesperson for Lideres Campesinas, an advocacy organization of and for California female farmworkers. “There is no standard for safety orientation. Sometimes we’re hearing they just get a five-minute talk – stay six feet apart, don’t do this, don’t do that – but they’re working in big crowds. It feels like it’s not being taken seriously because the money is more important.”

Things have changed and can still change

Imagine being told that all schools will be closed, all public gatherings will be cancelled. Hundreds of millions of people around the world will be put out of work, billions told not to leave their homes  and governments launching some of the largest bail-outs in history while landlords are stopped from collecting rent and banks letting mortgage payments to fall into arrears while the homeless are housed in hotels free of charge. Governments are helicoptering cash payments to households, writing out checks,  and some on the Right are even adopting the left-wing idea of the universal basic income. Would you have believed what you were hearing?

There is a pessimistic view is that the pandemic crisis inflames xenophobia and racist scape-goating.

Mike Davis, author of the 2005 book, “The Monster at Our Door. The Global Threat of Avian Flu” explains that “In a totally rational world, you might assume that an international pandemic would lead to greater internationalism. In a rational world, we would be ramping up production of basic essential supplies – test kits, masks, respirators – not only for our own use, but for poorer countries, too. Because it’s all one battle. But it’s not necessarily a rational world. So there could be a lot of demonisation and calls for isolation. Which will mean more deaths and more suffering worldwide.”

Some populist and demagogue politicians have blamed foreigners for COVIS-19 and have embarked upon unilateral nationalist policies rather than coordinated with neighbouring nations. In a 2008 report on the legal aspects of pandemic response, prompted by the increase in pandemic flu outbreaks, a team of historians and medical ethicists assembled by the American Civil Liberties Union suggested that  “People, rather than the disease, become the enemy.”

However there is another way of responding to a global pandemic.

Long before COVID-19, people died of diseases we knew how to prevent and treat. People lived precarious lives in societies awash with wealth. Experts told us about catastrophic threats on the horizon, such as climate change, and we did next to nothing to prepare for them. We are now aware of the extent of that can be accomplished (and quickly!) when we understand the urgency of the threat and risk. We have learned that the market cannot provide solutions to protect the public good. 

The task today is not to fight the pandemic in order to return to business as usual, because business as usual was already a disaster. The goal, instead, is to fight the virus – and in doing so transform business as usual into something more humane. 

“We’ve been trying for years to get people out of normal mode and into emergency mode,” said Margaret Klein Salamon, a former psychologist who now heads the advocacy group The Climate Mobilization. “What is possible politically is fundamentally different when lots of people get into emergency mode – when they fundamentally accept that there’s danger, and that if we want to be safe we need to do everything we can. And it’s been interesting to see that theory validated by the response to the coronavirus. Now the challenge is to keep emergency mode activated about climate, where the dangers are orders of magnitude greater. We can’t think we’re going to go ‘back to normal’, because things weren’t normal.” Salamon believes that one lesson of the coronavirus crisis is the power of shared emotion, which has helped make possible radical action to slow the pandemic. “I’m not talking about people giving each other medical expertise. I’m talking about people calling each other up and saying: ‘How are you doing? Are you scared? I’m scared. I want you to be OK, I want us to be OK.’ And that’s what we want for climate, too. We need to learn to be scared together, to agree on what we’re terrified about. It’s good that we’re entering emergency mode about the pandemic,” she said.

“The political outcome of the epidemic,” said Mike Davis, “will, like all political outcomes, be decided by struggle, by battles over interpretation, by pointing out what causes problems and what solves them. And we need to get that analysis out in the world any way we can.”

Rebecca Solnit, author of  "A Paradise Built in Hell", a study of disaters, said she was taking heart from all the new ways people were finding to connect and help each other around the world, ranging from the neighbourhood delivery networks that had sprung up to bring groceries to people who couldn’t get out, to more symbolic interventions, such as kids playing music on an older neighbour’s porch.

 The Italian political scientist Alessandro Delfanti said he was finding hope from a post-outbreak wave of strikes roiling Amazon warehouses in the US and Europe, and also the steps that workers across different sectors of the Italian economy were taking to help each other secure equipment they needed to stay safe.

The world feels strange right now because –it is changing so fast and any one of us could fall ill at any time, or could already be carrying the virus and not know it. It feels strange because the past few weeks have exposed the fact that one of the biggest things which can change is ourselves.

The pandemic reveals that people are not selfish and self-centred but possess the capacity to share and act in solidarity with one another, even in the midst of a disaster.

Adapted from here

Key Workers

National Interest or Common Interest?

Many rich countries are invoking the ‘national interest’, by banning exports of vital medical supplies. 

The EU has  announced export restrictions on medical supplies needed for the COVID-19 pandemic to countries outside the European single market, ignoring earlier pledges.

France, Germany, the Czech Republic and Poland now want to ban the export of certain types of protective equipment and gear, prompting Stella Kyriakides, the EU Health Commissioner, to contradict them, insisting instead that “Solidarity is key”.

Dr Hans Kluge, WHO Regional Director for Europe, also appealed to EU governments to reconsider their export restrictions on medical supplies, including personal protective equipment for frontline health workers.

Such moves are politically attractive, with Trump’s approval ratings hitting an all-time high. Much of the US public agrees with Trump blaming China for the COVID-19 outbreak, with some senior UK Tory politicians joining the chorus, warning that China will face ‘a reckoning’ over it.

 Covid-19 is already challenging our assumptions about humanity, about society, about greed and selfishness, about the need to cooperate. he pandemic has exposed fault lines in trust among humans, among groups, among countries, between citizens and governments, and faith in many of our assumptions about the world around us. Many of us recoil in disbelief, shock and despair when we learn of those already infected who put others at risk, who ruin, destroy and compromise society’s already modest, inadequate existing health capacities through their selfish behaviour.

We are beginning to doubt social media and many other previously trusted sources of information and knowledge, as we slowly realize that we are inundated with fake news, information and advice. We are doubting those leaders and others who see the COVID-19 crisis as a minor blip, a temporary interruption before returning to ‘business as usual’, following a V-shaped recovery. Such proposals  come from those with agendas of their own, of self-interested business opportunities.

After we get past the lockdowns and other ‘inconveniences’ imposed by COVID-19 things must be different, really different. We caannot - we will not - return to ‘business as usual’ after we get over this crisis.

Re-Imagining Society

In 2009, Dr. Margaret Chan, Director-General of the World Health Organization stated in, “All countries should immediately activate their pandemic preparedness plans and must remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.”

In the richest country on the face of the earth, doctors and nurses have no guarantees about having enough two dollar masks or other personal protective equipment (PPE) when they care for patients. The inadequate supply of PPE has already killed patients and providers. It is shameful. Covid19 provide ample reasons for anger—towards the  healthcare corporations and the media purposefully oblivious to exploitation. As usual in times of crisis, those most affected are generally those with the least economic resources. Millions of employees worldwide have been left without work given the widespread cessation of all kinds of activities, except the essential ones. As a result, those workers who depend exclusively on their wages and savings are unable to meet their needs and those of their families. Some governments have promised financial aid to those most in need but that aid is insufficient or it will take time to arrive, making it less effective. What workers need right now is not good-will, but will-power.

We’re living in a different world now. Schools, workplaces, and restaurants are shut down, adding to that already desperate situation of workers living pay-check to pay-check. The COVID-19 pandemic exposes the huge cracks in capitalist society. The longer the coronavirus emergency goes on, however, the clearer it is that people require to start rethinking our whole society. Is a “return to normalcy” possible when we may never see normal again. It is time for a revolution in our politics, pushing the idea of a more sane, more humane type of system.  Squeezing a few concessions from the government is hardly revolutionary and no amount hyping it up as a revolution will make it one. We need to back radical change in the fundamentals of this economic system. The COVID-19 pandemic is leading to major changes in people’s behaviour. It will also bring a new way of thinking. The majority of people are acting with a great sense of responsibility and expressing a great amount of generosity, offer their assistance at the risk of their lives. The pandemic, economic collapse will define the future. What we need to do is to develop solidarity and reciprocity between people around the world, to cooperate and collaborate and to provide mutual aid. To create change, people must demand it. Technology allows us to educate and organise online. People are showing they can be innovative to get our message across to our brothers and sisters. COVID-19 has shown that essential workers are among the lowest-paid workers and that it is they who make our society function.  Understanding this gives a new understanding of the power of the people. We are all connected and share a common humanity. If we act in solidarity during this time of crisis we can create the future we want to see for ourselves. We are all in this together.

America's Failing Private Healthcare

More than 80 million people in the U.S. are currently uninsured or underinsured and millions more are losing their employer-provided insurance as the jobless rate spikes due to the coronavirus crisis.

Research conducted by Covered California is warning that U.S. health insurance companies could hike already exorbitant premiums by 40 percent or more next year.

America's healthcare system is driven first and foremost by the profit motive and it is ill-equipped to provide necessary care for all, particularly in a time of nationwide crisis.

Covered California found (pdf) that "if carriers must recoup 2020 costs, price for the same level of costs next year, and protect their solvency, 2021 premium increases to individuals and employers from COVID-19 alone could range from 4 percent to more than 40 percent."

It could result in even more "consumers and employers no longer being able to afford coverage, leading to employer groups dropping coverage or individuals deciding to go uninsured."

Peter V. Lee, executive director of Covered California said in a statement. "Consumers will feel these costs through higher out-of-pocket expenses and premiums, as well as the potential of employers dropping coverage or shifting more costs to employees."

"These increased costs could mean that many of the 170 million Americans in the commercial market may lose their coverage and go without needed care as we battle a global health crisis," 

Last week, a 17-year-old boy in Los Angeles County died from complications believed to have been caused by COVID-19 after he was denied treatment at an urgent care center. The reason: he was uninsured.

"He didn't have insurance, so they did not treat him," said R. Rex Parris, the mayor of Lancaster, California.