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Show Notes

Pandemics are political

Everything is political

It’s been easier to argue that “everything is political” – a traditionally academic argument that’s been difficult to transmit into the larger public sphere. People didn’t seem to bat much of an eye at “apolitical” public displays, like the anthem before a game or a Christmas tree in a store display, but these seemingly innocuous events have become political battlegrounds over the last few years.

I’ve written before about how sports have been intensely political since their inception and how the evolution of the modern political divide in the American two-party system has shaped and been shaped by the sports landscape. Even the “war on Christmas” has gone on for ages longer than you might originally think. Public Christmas displays have worked their way up court systems since the 1950s (becoming popular again in the 1980s), became part of antisemitic fearmongering in the 1920s and have been part of a larger argument about a “public religion” since before the founding of the country.

These realizations – or re-realizations – or really just the product of forcefully injecting social events into formal political avenues, like legislation, the judicial system or transparently “politicized” events like police shootings. But they were always political, whether or not they involved formal institutions.

We usually mean things have become “partisan” when say something is “political.” As a result, it’s difficult to convince many that these events were always political – at least until they hit institutions that we agree are political in nature. The definition of “political” and of “politics” has become distressingly narrow.

Ultimately, politics concerns the structure of society – how society is organized, how resources are distributed and how individual behavior is regulated. This of course means that the discussion of “what is political” is itself an act of politics, and therefore any actions tangential to these questions remain political.

More interestingly means that simple decisions like giving to charity or buying a sandwich are political. In the broad sense, they have to be – the exchange of money requires a fundamental shared belief in the value of a currency printed by the federal government and an agreement that the economic system the exchange takes place in will produce the desired outcome. Not only that, what you purchase or who you give to is a tacit acceptance of the methods by which they organize their charitable efforts or provide you with a good or service.

As I’ve said before, culture and politics are two sides of the same coin – because culture is an emergent product of how societies are organized while politics embody the negotiating process for that organization.

Once we’re attenuated with the understanding that every exchange carries political baggage under the surface and also, therefore, carries political meaning. That doesn’t mean every purchase of a product made under unethical means is an inherently unethical act – or if it is an unethical act, it doesn’t carry much weight.

The second dimension to the political nature of everyday interaction is that the questions of how societies are structured, organized and managed has more to do with values and priorities than it does banal questions like efficiency or optimized organizational structures.

Questions like “who society should serve”, “how many of our resources should go to the less fortunate or the well-off”,  “should the government should limit particular types of speech” – all of that depends on what societies value and which values they prioritize when they come in conflict, like security and liberty. In much the same way, determining if a purchase is unethical depends on value priorities – one has to eat to live, and purchasing food will inevitably reinforce a supply chain that is likely built on unethical grounds.

And if not, the commute to work, the use of electricity – even renewable – for communication, the use of coltan-heavy electronicized equipment; all of it forces us into ethical quandaries that can only be resolved by a value priority system that necessarily allows us to make exceptions for our own well-being.

“Natural events” are political

With all of this talk of community, it might seem that natural forces are immune to politics. No one controls earthquakes, tornadoes or the occasional asteroid. And what distinguishes a disaster caused by microbes from one caused by a large oceanic wave?

But most of these disasters carry political implications too, and not just because of the aftermath. How and where we set up our cities and centers of power are the product of political decisions. That doesn’t mean that anyone is necessarily “at fault” for a fault line shifting or a wave crashing in, but it is priced into the decision to live on a coast line or on top of an earthquake zone.

People have largely decided – correctly – that the benefits of living on the coast outweighs the costs of a potential hurricane. From there, it’s on local, regional and larger communities to make decisions that mitigate the impact of a potential disaster.

Pandemics are even more intimately political than any of that. Diseases don’t evolve in a vacuum – microbes respond to external pressure, and the history of disease bears that out. Because diseases spread through social vectors, they are primarily social events – and nothing makes that clearer than the homophobic and callous response to the HIV/AIDS epidemic throughout the 80s and 90s, initially referred to as GRID: gay-related immune deficiency.

For people unfamiliar with the way the media and the government handled the evolving AIDS epidemic, there’s a good media historiography here.

That obvious mismanagement continues even today, as the current vice president stalled legislation as governor that would inhibit the HIV epidemic in Indiana before undercutting the very legislation they ended up passing by essentially criminalizing the tools it created.

Because disease spreads through social vectors, it becomes easy to criminalize a population through disease, by implicating them in its spread — and those hit hardest are often blamed the most.

But even theoretically “neutral” diseases are political. Population density plays a big role in the spread of disease and the development of agriculture accelerated that very issue by encouraging high-density communities.

Even bigger than population density, however, came opportunities for new pathogens to mutate and develop the ability to jump species. As domestication increased and the density of domesticated animals increased, the number, deadliness and contagiousness of pathogens threatening to humans has correspondingly increased.

This has long been a concern of epidemiologists when it comes to the nature of modern agriculture, featuring “concentrated animal feeding operations,” or CAFOs colloquially referred to as factory farms — particularly where it concerns strains of influenza.

How seriously did we interrogate the swine flu as it jumped from swine CAFOs — concentrated animal feeding operations in the United States? There’s no incredible proof that it originated from the United States and there’s similar accusations that a CAFO in Mexico — owned by an American agribusiness — and more speculation that we just don’t have the evidence that the specific swine flu epidemic in 2008 was started at a CAFO at all — but the first known case was in a town dominated by a local CAFO. Not only that we also independently know that CAFOs are known as reservoirs of swine flu and are unique vectors for the disease in a way other farming operations are not.

There’s a couple of reasons for this — the concentration and density increases the vectors for transmission among the animals, increasing the net number of mutations by increasing the population of virus and they also store massive amounts of waste in fecal lagoons, which often pollute local watersheds. They also emit enormous amounts of ammonia-laced pollution, which presents as a piercing odor that can impact quality of life severely even six miles away – “the ammonia-laden airborne emissions released by CAFOs are also linked to asthma, mucous membrane irritation, and other respiratory sysmptoms.”

Not only that, zoonotic transmission isn’t covered by OSHA, even in response to some new regulations put into place in 2009 except solely in the case of bloodborne pathogens. Those workers often end up operating as bridge populations that transfer those pathogens to the population at large.

In the 30 May 2007 issue of Vaccine, Gregory Gray, director of the Center for Emerging Infectious Diseases at the University of Iowa College of Public Health, estimated the current U.S. swine and poultry CAFO workforce at about 54,000 workers.

Building on a growing body of evidence, Gray’s research strongly suggests that CAFO workers and veterinarians can infect other people with H1N1 viruses. In a 2-year prospective study of 803 rural Iowans, published in Emerging Infectious Diseases in December 2007, he found that CAFO workers were 50 times more likely to have elevated H1N1 antibodies than nonexposed controls. Equally important, their spouses were 25 times more likely to harbor these antibodies, reflecting how the viruses can jump from farm workers to their intimate contacts. Similarly, in work published 15 May 2009 in the Journal of the American Veterinary Medical Association, Gray and coauthor Whitney S. Baker reported that 84% of 44 seroepidemiologic studies reviewed identified an increased risk of zoonotic pathogen infection among veterinarians.

By concentrating so many viruses in one place, he explains, CAFOs increase the frequency at which more dangerous strains might appear. Andrew Pekosz, an associate professor of microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health: “This is all a numbers game,” he says. “The more variants you’re exposed to, the more likely it is that you’ll be exposed to one with altered properties that allows for infection of a new host.”

Meanwhile, Robert Martin, senior officer with the Pew Environment Group in Washington, DC, is concerned that competing financial interests may be partly to blame for the current lack of data and regulation. “Even the best scientists seem loathe to say anything against the industry,” he says. “With the decline in public research funding, it’s industrial animal agriculture that pays for virtually all the animal sciences research going on at land-grant universities today.”

Even if the genesis of a pandemic – or the conditions that lead to a virus becoming a pandemic – aren’t inherently political, the response afterward necessarily is. Almost every state initiated some kind of social restriction, whether that’s the quarantine in effect in New York or the stay-at-home order put in place in states like Minnesota, effectively sacrificing economic activity for another type of well-being: generalized health.

If the response to the pandemic’s economic effect is to find a way to bolster those businesses or care for those laborers by replacing some or all of their lost wages, that will have a marked impact on the community – but the decision to have a response at all is a political decision, one that governs the use of collective resources and the ability to gather those resources.

And how that response is carried out is inevitably political as well. Will they be confined to lost wages through a one-time federal stipend? What about incentives – in the form of subsidies, tax credits or infrastructural support – to get businesses back up and running? Will workers receive in-kind contributions from the community at large, will they receive narrow income streams like food stamps and energy credits?

How liquid is the relief — freezing mortgage and rent might seem to be an illiquid form of relief because you can’t eat with a voucher, but they are probably more liquid than an expanded food stamp program; you can direct the money that would go to rent to whatever you need, whether that’s medicine, food, furniture, etc.

We’ve made partisan the “plan to reopen” economies — to the extent that an economy closed off to the value of labor is open — but these plans were going to be “political” even if completely designed by nonpartisan health experts and executed faithfully by a faceless bureaucracy without politicians injecting their naked ambitions into the project. Where were the health experts educated? How were they selected? What are their blind spots? What blind spots do they have that are a direct result of their background? Do they know how the pandemic is impacting immigrant populations, black populations, indigenous populations, homeless populations, queer populations, etc.? Are populations more reliant on intercommunity support more vulnerable than populations rigidly defined by a nuclear family structure? How does the placement of hospitals, availability of resources and ability to easily access food, water and energy impact a plan to reopen? Neutral decisions made by neutral experts are never neutral or apolitical.

I think people can understand the idea that diseases are social when they think of vectors, but they certainly don’t think of it that way when it comes to the cause of the disease. For most people, diseases are caused by viruses or bacteria. That’s both true and irrelevant in the same way a shooting death is caused by a bullet or a car crash is caused by metal enclosures coming in at a high speed. Certainly to solve these problems, one needs an understanding the forces involved — but even more important than the physical proximate factors are the social factors. Think about removing lead from gasoline and which communities were most impacted.

On the podcast, I brought up Richard Lewontin and his book Biology as Ideology. No one puts this better than Richard Lewontin, a geneticist, mathematician, paleontologist and evolutionary biologist. Here’s that chapter I quoted:

An examination of the causes of death, first systematically recorded in the 1830s in Britain and a bit later in North America, show that most people did, indeed, die of infectious disease and in particular of respiratory diseases. As the nineteenth century progressed, the death rate from all these diseases decreased continuously. The death rates from the major killers like bronchitis, pneumonia, and tuberculosis fell rather regularly during the nineteenth century, with no obvious cause. There was no observable effect on the death rate after the germ theory of disease was announced. The death rate from these infectious diseases simply continued to decline as if Koch had never lived. By the time chemical therapy was introduced for tuberculosis in the earlier part of this century, more than 90 percent ·of the decrease in the death rate from that disease had already occurred.

The progressive reductions in the death rate were not a consequence, for example, of modern sanitation, because the diseases that were the major killers in the nineteenth century were respiratory and not waterborne. It is unclear whether simple crowding had much to do with the process, since some parts of our cities are quite as crowded as they were in the 1850s. As far as we can tell, the decrease in death rates from the infectious killers of the nineteenth century is a consequence of the general improvement in nutrition and is related to an increase in the real wage.

In countries like Brazil today, infant mortality rises and falls with decreases and increases in the minimum wage. The immense betterment of nutrition also explains the drop in the higher rate of tuberculosis among women than among men. In the nineteenth century, and even long into the twentieth in Britain, working men were far better nourished than home-bound women. Often if meat could be afforded for the table in an urban working-class family in Britain, it was saved for the man. So there have been complex social changes, resulting in increases in the real earnings of the great mass of people, reflected in part in their far better nutrition, that really lie at the basis of our increased longevity and our decreased death rate from infectious disease. Although one may say that the tubercle bacillus causes tuberculosis, we are much closer to the truth when we say that it was the conditions of unregulated nineteenth­ century competitive capitalism, unmodulated by the demands of labor unions and the state, that was the cause of tuberculosis. But social causes are not in the ambit of biological science, so medical students continue to be taught that the cause of tuberculosis is a bacillus.

In the past 20 years, precisely because of the decline in infectious disease as an important cause of ill health, other single causes have been raised as the culprits in disease. It is undoubtedly true that pollutants and industrial wastes are the immediate physiological causes of cancers, miners’ black lung, textile workers’ brown lung, and a host of other disorders. Moreover, it is undoubtedly true that there are trace amounts of cancer-causing substances even in the best of our food and water unpolluted by  pesticides and herbicides that make farm workers sick. But to say that pesticides cause the death of farm workers or that cotton fibers cause brown lung in textile workers is to make a fetish out of inanimate objects. We must distinguish between agents and causes. Asbestos fibers and pesticides are the agents of disease and disability, but it is illusory to suppose that if we eliminate these particular irritants that the diseases will go away, for other similar irritants will take their place. So long as efficiency, the maximization of profit from production or the filling of centrally planned norms of production without reference to the means remain the motivating forces of productive enterprises the world over, so long as people are trapped by economic need or state regulation into production and consumption of certain things, then one pollutant will replace another. Regulatory agencies or central planning departments will calculate cost and benefit ratios where human misery is costed out at a dollar value. Asbestos and cotton lint fibers are not the causes of cancer. They are the agents of social causes, of social formations that determine the nature of our productive and consumptive lives, and in the end it is only through changes in those social forces that we can get to the root of problems of health. The transfer of causal power from social relations into inanimate agents that then seem to have a power and life of their own is one of the major mystifications of science and its ideologies.

There’s a few points to be made here. Disease most significantly impacts vulnerable populations. Which populations are vulnerable are in some part a product of the decisions we make — where we’ve placed hospitals, what the capacity of those hospitals are, what they’re stocked with and so on. Not only that, things like access to nutrition, the ability to pay for medicine, the ability to avoid strenuous labor, the ability to avoid pollution, etc. all impact our susceptibility to disease — think about the risk factors for COVID-19 — they all impact minority and lower-income populations much more than richer and whiter populations. Even age is less of a factor with more access to capital and power.

Black people are dying of COVID-19 more than any other group (there is a lot of data on this), and are subsequently getting blamed for it. Brookings, more liberal than progressive, broke down a host of the structural reasons that black people are dying at a much higher rate than the white population. Even when blame isn’t explicit, who gets arrested for violating emergency rules during a lockdown? The data suggests it’s black and brown people.

Who gets it in the first place is a product of class as well. The people who socially distance are the ones who get to. Larger, single-family homes with the ability to work from home. Spending 15 minutes in a grocery store to pick up groceries exposes one to the virus much less than spending 8 hours there working. Asking someone to pick up your deliveries is also easier if you can pay them and they need the money.

Late last month, a photo circulated of delivery drivers crowding around Carbone, a Michelin-starred Greenwich Village restaurant, waiting to pick up $32 rigatoni and bring it to people who were safely ensconced in their apartment. A police officer, attempting to spread out the crowd, reportedly said, “I know you guys are just out here trying to make money. I personally don’t give a shit!” The poor got socially close, it seems, so that the rich could socially distance.

The past few weeks have exposed just how much a person’s risk of infection hinges on class. Though people of all incomes are at risk of being laid off, those who can work from home are at least less likely to get sick. The low-income workers who do still have jobs, meanwhile, are likely to be stuck in close quarters with other humans. For example, grocery-store clerks face some of the greatest exposure to the coronavirus, aside from health-care workers. “Essential” businesses—grocery stores, pharmacies—are about the only places Americans are still permitted to go, and their cashiers stand less than an arm’s length from hundreds of people a day.

. . .

“Self-isolation is an economic luxury,” says Justin Gest, a public-policy professor at George Mason University and the author of The New Minority. For those working-class people who do still have jobs, “it probably requires a physical presence somewhere that exposes them to the virus.”

Sinophobia

To start things off, it’s important to note that American spread of SARS-CoV-2 comes from multiple sources, but seems to have primarily come from Europe, as Ben noted. Europe had cases as early as November, per chest scans that identify glasslike opacities in lungs somewhat unique to COVID-19. That November case comes a day earlier than the first known case in China, unofficially November 16 per documents seen by the South China Morning Post.

This isn’t to suggest that the Virus originated in France — the genetic data on SARS-CoV-2 still most closely resembles that of a coronavirus found in horseshoe bats found in China and cases exploded there first — but rather that our response was unnecessarily specific to China. Given a constant rate of mutation, there’s inferential evidence that the virus was in New York for months before lockdowns began, primarily from viruses transmitted from travelers arriving from Europe.

Wet markets in China, which are not all that distinct from farmer’s markets in the United States, persisted in selling wildlife not because of some ignorance as to the agents involved — China tried phasing them out in 2003 in response to SARS, and they did indeed successfully ban selling live poultry to be slaughtered on the spot — but because the forces of capital are comfortable with the risk involved in pathogen spread, there persisted a wildlife market, generally for the upper class who use them

There’s this perception that wet markets are for some underclass when the fact of the matter is that they are very similar to farmer’s markets, with some differentiation to sell to a broader public. Papers on wet markets from before the pandemic don’t treat them as a gross novelty but as a vendor system that provides a service that western-style supermarkets do not — fresh food.

“Wet” here refers to a translation from Cantonese that distinguishes them from “dry goods” like preserved foods or things like flour, etc. Stuff that goes into your pantry — as opposed to produce, which is not a dry good and therefore wet. If we called them fresh markets it would be a lot more difficult to drive fear about them.

I mentioned a few YouTube videos on wet markets in China from expats living in China. The first comes from a channel I’ve been following for years just because of its cooking advice, Chinese Cooking Demystified. They also have an unlisted video from before the pandemic where they just walked through a market.

Most wet markets don’t even sell wildlife. Wildlife is considered exotic in the way that you would imagine — there’s more diversity in the protein supply in China, things like frogs, rabbit, snake, turtle, etc. but those do exist in western cuisine as well, think French frog legs or turtle soup or rabbit in paella — but things like pangolins aren’t common. And again, they’re primarily the purview of the well-off.

We may not know where the virus actually came from for a decade — that’s how long it took to track down SARS — but the theory that it jumped from bats to a pangolin sold in a wet market has been used like a cudgel to inflame racist fears about China. Regardless, think about it in other terms — for example, we’re comfortable buying wild salmon, wild deer, wild elk, wild boar, wild duck, wild pheasant, bison, rattlesnakes, alligator, etc. Sometimes we celebrate wildlife cooking in the United States as uniquely Southern or uniquely self-sufficient. Of course, we don’t call it wildlife.

We call it game. See if you can find your favorite wild game recipe in this Pinterest list of the best Wild Game Recipes from the Wisconsin Department of Natural Resources.

What I quoted from that piece in the Conversation about the genealogy of the wildlife markets in China and their roots in local farming’s competition with industrial agriculture:

“In western media, “wet markets” are portrayed as emblems of Chinese otherness: chaotic versions of oriental bazaars, lawless areas where animals that should not be eaten are sold as food, and where what should not be mingled comes together (seafood and poultry, serpents and cattle). This fuels Sinophobia and anxieties of what anthropologists have long identified as “matter out of place”: a symbolic system of pollution through which proscriptions and prescriptions of what foods or foodstuffs may be combined is held up.

This image is highly flawed, not only because it relies on western sensitivities of what is eatable and what is not, and which portrays a modern form of Chinese food trade and consumption as “traditional”, but more practically, because it misrepresents the material and economic reality of these markets.”

. . .

“What is perhaps most omitted in the discussion of Chinese wet markets is the perspective of farmers, producers, and vendors. Although media reports often marvel at the consumption of wild animals, little is said about why farmers produce them. As Lyle Fearnley learned during fieldwork research with wild swan goose (dayan) farmers in Jiangxi Province, two factors brought most farmers into the breeding of wild geese during the late 1990s: an opportunity to meet consumer demand without illegal poaching from the wild, and as a path toward higher-value production, at a time when rural smallholder farmers faced increasing economic pressure from large-scale industrial food producers.”

In the 1990s, China embarked on a “second leap” to expand the scale of agricultural production. Heavily capitalised “dragonhead enterprises”(longtou qiye) – industrial food production conglomerates – built integrated supply chains, often centred on slaughterhouses and processing facilities, and contracted livestock out to household-scale farmers.

An enormous consolidation followed, as independent smallholders were progressively driven out of livestock farming, especially in sectors such as pork or poultry, because prices dropped too low and the cost of inputs went up. Livestock diseases, such as Newcastle disease and Porcine reproductive and respiratory syndrome, also played a role in driving smallholders out of these sectors. Unable to survive as independent smallholders, many farmers faced a drastic choice: take up farming under contract to an industrial food conglomerate, or get out of farming pork or poultry altogether.

Some farmers discovered a third way, opting to raise local breeds and wild animals that could be sold for higher returns in niche markets. Many of these species were less afflicted with diseases than mainstream livestock, often simply an effect of the smaller number being farmed. Although the higher price of wild animals compared to domesticated has led to the belief that its consumption “is a dietary choice and not driven by low income”, for farmers the story is different: breeding wild animals can be a path toward a steady income when it remains a struggle to live off the land in rural China.

Ben brought up a potentially scuttled trade deal, one secured in January. Looks like that’s happening.

Ideology and structure matter

Socialist responses

There have still been no deaths in Vietnam, though a British expat may be the first victim in the country — they’ve been attempting to secure a lung to transplant and save his life. 26 people came forward, but medical practice — both globally and in Vietnam — prevent live donors of lung transplants.

They’ve tested an enormous portion of their population and have excess tests at the ready, enough that they are providing for other countries (along with additional PPE).

There have been no shortage of pieces using Vietnam’s success as evidence that Vietnam is bad. It’s remarkable that they even point to abuses of power by other states in the region as evidence that Vietnam is somehow analogous, like using an example of the dictatorial Duterte’s regime in the Phillippines and their regular abuse of power as an example of how Vietnam is oppressive.

The quarantine measures described in the piece are clearly meant for public health but described in insidious ways; “the authorities closed off part of the Hanoi suburb of Gia Lam, quarantining 120 households because one person was showing symptoms that could have been COVID-19. So-called district functional forces—uniformed police and militia—were pictured erecting barricades. Media photos also showed the men without uniforms who hold the real power in these situations. They work for the Ministry of Public Security: shadowy enforcers in polo shirts and slacks who can, depending on the situation, dish out orders to local officials or summon up the heavy mob with a phone call.”

They are describing Vietnam but this can happen nearly anywhere in the world. Uniformed police — the “so-called precinct” will erect barricades at the behest of shadowy men wearing slacks (like the mayor, city council or federally, an official from the FBI or Department of Homeland Security), who can dish out orders to local officials, like anytime a federal agency takes over a local investigation or declares something a national emergency. They too can summon a mob (law enforcement) with a phone call. That’s what being a civilian in a leadership position in law enforcement is, and it’s true worldwide.

Vietnam is subject to a heavy degree of human rights violations, of course. The header at the top of that linked article comes from a protest against capitalization of land resources that resulted in protestors getting beaten by cops. And it’s not as if the Hmong population were well-treated by the Vietnamese government. The description I provided from NPR has its clear benefits and worrisome drawbacks.

Some perspective on the “surveillance state” from people living in Vietnam –

The BBC attempted a balanced take, acknowledging the objectionable limits of free speech in Vietnam while pointing out the successes of their approach and somewhat vouching for the accuracy of their data.

Surveillance is a weird thing to place as uniquely Communist. The West has suffered from a security corporate state for just as long (if not longer) but has a layer of abstraction that makes it easy to swallow. Who cares if Apple has your data?

Well, a great discussion of this concept was had by Olly Thorn at Philosophy Tube in a video called Data. It’s well worth watching. We’re all being surveilled, and for what and by who might matter. Are corporations any more benevolent than the state? Even when they work with the state to intentionally compromise your privacy?

Ben also mentioned the communist state of Kerala and their success handling the pandemic.

Even though Kerala was the first state in the country to report a coronavirus case in late January, the number of new cases in the first week of April dropped 30 percent from the previous week. With just two deaths, 52 percent of positive patients have recovered in the state, higher than elsewhere in India.

. . .

Kerala’s approach was effective because it was “both strict and humane,” said Shahid Jameel, a virologist and infectious-disease expert.

“Aggressive testing, isolating, tracing and treating — those are ways of containing an outbreak,” said Jameel, who is also the CEO of the Wellcome Trust/DBT India Alliance, a foundation with offices in Hyderabad and New Delhi.

. . .

The state, where communists have held power for more than 30 years in several different governments since the 1950s, has invested heavily in public education and universal health care. Kerala has the highest literacy rate and benefits from the best-performing public health system in the country. It tops India’s rankings on neonatal mortality, birth immunizations and the availability of specialists at primary-care facilities.

The strength of its health-care system allowed it to follow the WHO’s recommendation on aggressive testing, even as central agencies maintained that mass testing was not feasible in a country like India. Through the first week of April, Kerala had conducted more than 15,000 tests. By comparison, Andhra Pradesh, a more populous state with a similar number of cases, had carried out nearly 8,000 tests, while Tamil Nadu, with more than double the number of cases, had done more than 12,700 tests.

An even better piece than that Washington Post article, from Tribune Mag, covers it even more in depth. They go further into the history of Kerala and its socialist democracy. They even won the ability to engage in land reforms despite elite and national resistance.

Land was redistributed under the slogan “land for the tillers,” swiftly bringing an end to the agrarian feudal system that had held back the majority of people. A subsequent focus on education empowered the population to develop important sectors of society, including health and education. Reading rooms, village libraries, and debating groups were established in villages throughout Kerala, providing political education, albeit predominantly for men. These institutions formed an integral part of the way of life for many in Kerala’s villages.

. . .

The ease with which the means of production can be redeployed by local governing bodies has proven a structural advantage to a socialist democracy like Kerala, when compared to the difficulties faced by some Western governments. Kerala police, supervised by health officials, are also performing temperature screening at interstate and district borders, as well as at railway stations, airports, and bus stations – another pandemic management tactic that has seen little application in the West.

. . .

The DYFI has created a pool of volunteers who are helping these local panchayats and municipalities with food deliveries, sourced from community kitchens that have been set up by Kudumbasheree across the state. The Chief Minister has been adamant that no-one in Kerala should go hungry, a sentiment echoed by the Health Minister in parliament.

To that end, the state has pledged a 20,000 crores INR (£2.24 billion) relief package including loans and food rations. Two months’ worth of social security pension payments will be paid in advance to the elderly in early April, with the Treasury gearing itself up to ensure that the payments can be made while maintaining physical distancing, relying on co-operative networks for much of the distribution, and with volunteers stepping in to deliver the payments to those unable to leave their houses.

The informal labour sector, typically migrant workers who form a large fraction of the labour force in Kerala, have not been left behind. In an era of growing xenophobia the government has urged its people to treat these workers as guests, referring to them as athithi thozhhilalikal, meaning “guest labourers.”

And Capitalism?

How have capitalist economies responded? A 2019 survey of pandemic preparedness found that the United States — by far and away — was the most prepared country in the world to deal with a pandemic.

Of course, that didn’t materialize in genuine preparedness. There’s probably a larger point to be made here to be made about how cataloguing the material capability of a region or country doesn’t tell you much about its quality of life or ability to handle challenges — see things like the Human Development Index — without a clear understanding of how materials and resources are deployed and distributed, but for now let’s just marvel at how the US and the UK were best prepared for a pandemic.

Ben mentioned early on in the episode his issues with how governor Cuomo handled it. The New York Times has a timeline of all the missteps, while continuing to avoid canceling rent. And that’s one example, but crisis response is a skillset that prioritizes immediacy. Capitalism is structurally unable to respond to these crises.

Aside from the fact that profit takes priority over human lives in the crisis response playbook, capitalism disables pre-pandemic capacity. Ben brought up the fact that hospitals throughout New York have shut down as a result of private equity firms.

In 2006, the Wall Street Journal noted that “just in time” inventory strategy, a dominant business strategy designed to reduce overhead and warehousing space, makes the United States uniquely incapable of dealing with a pandemic. In 2006! The problem deepened in 2015, as Health Care Finance News pointed out. Hmmm

“Just in time is a bit of unicorn when it comes to the healthcare supply chain.,” said Hellmann. “While used effectively in industries such as automotive, where demand and production scheduling is highly predictable, most health care providers don’t have that luxury of extreme predictability when it comes to the services they provide,” she said.  “Frankly, hospitals need some cushion in their inventories to absorb this variation.”

This was easily predictable, and not just from someone at the Wall Street Journal. It’s in the very construction of health care as a concept that one be filled with contingency inventory (either physical in the form of goods or technological in the form of expertise). From resilience.org, written in February.

JIT systems are designed to minimize inventories in order to free up cash for other useful and profitable purposes. If you no longer have to store large inventories, you don’t need to build and maintain substantial rooms and storage areas for that purpose. And, the money actually invested in those inventories, whether for auto parts or for medical supplies, can be deployed elsewhere to make a profit. With JIT, supplies arrive at your door as you need them. The “storage room,” if it can be called that, is a delivery truck on its way to your loading dock.

And of course:

The trouble is, a wave of corona virus victims showing up at hospitals could quickly exhaust lean inventories of medical supplies. And, the supplier providing those supplies may quickly run out as demand surges. After all, a smart supplier will be practicing JIT as well.

This has impacted the chemical reagents needed for testing and treatment, the medicine needed for treatment, the number of ventilators available, the additional sanitation equipment needed to keep the hospital clean during a surge in usage, the personal protective gear needed for hospital workers and the number of beds available for patients. To name a few.

What happens when the government does contract out necessary supplies ahead of time, like they did in 2014 when they put in an order for a stockpile of ventilators? The company making those ventilators gets acquired — by, no shit, a corporation called Covidien — and cancels the order.

Curious.

Government officials and executives at rival ventilator companies said they suspected that Covidien had acquired Newport to prevent it from building a cheaper product that would undermine Covidien’s profits from its existing ventilator business.

What happens when administrations attempt to act outside of federally capitalized control of medical supply? Seizures of medical equipment, apparently.

In Massachusetts, state leaders said they had confirmed a vast order of personal protective equipment for their health workers; then the Trump administration took control of the shipments.

In Kentucky, the head of a hospital system told members of Congress that his broker had pulled out of an agreement to deliver four shipments of desperately needed medical gear after the supplies were commandeered by the Federal Emergency Management Agency.

Gov. Jared Polis of Colorado thought his state had secured 500 ventilators before they were “swept up by FEMA.”

For weeks, the Trump administration pushed states to procure their own ventilators and protective gear, like masks, gloves and face shields. But a new effort by the administration to create a hybrid system of distribution — divided between the federal government, local officials and private health care companies — has led to new confusion, bordering on disarray, and charges of confiscation.

FEMA officially denies it, but there are a preponderance of individually confirmed cases, like this one in Massachusetts.

As the number of coronavirus cases surged in Massachusetts, nurses at a hospital in Milford were desperate. They held up cardboard signs outside the hospital asking for donations of protective gear to wear while treating infected patients.

William Touhey Jr. thought he could help. Touhey is the fire chief and emergency management director in this small town outside of Boston. He did some legwork, and placed an order for 30,000 protective gowns from overseas.

“We were hearing good things that it was coming,” Touhey said.

Then he got a phone call from the distributor last week.

“The order had been redirected, as they put it, from us to FEMA,” Touhey said.

And this other one in Massachusetts.

Massachusetts Governor Charlie Baker, a Republican, says his state placed an order for millions of N-95 respirator masks — but never got them. “We had our 3 million masks that we had ordered … confiscated in the port in New York,” Baker said at a press conference this month.

After federal officials took those masks, Baker says Massachusetts scrambled to arrange a new shipment from China. But this time, state officials used a private plane that belongs to the New England Patriots.

So where did that first order of masks end up?

“I don’t have any specific information on that,” said Captain W. Russell Webster, who is in charge of FEMA’s coronavirus response in New England, in an interview with member station WBUR.

It’s been happening all over the country. The response has been to increase bidding, meaning states are competing with each other for supplies and increasing the price with no benefit to people suffering. Of course, it does benefit the companies that fill the orders. FEMA’s even signing the letters that they send to medical suppliers during seizure.

Not only that, there’s been federal subsidizing of all of this, but without the concordant public benefit — ie taxpayers are paying for shipping and companies charge the same price for masks.

A secretive Trump administration project that enlists private companies to bring masks and other medical equipment to the U.S. to fight the coronavirus outbreak has provided tens of millions of dollars in taxpayer subsidies to the nation’s largest medical-supply companies with little public accounting.

Over the last three weeks, taxpayers have paid to fly the companies’ supplies to the U.S. from Asia on government-chartered cargo flights, while the firms have been free to sell the material to hospitals, clinics and others at prices they choose.

That has saved the companies more than $25 million in shipping costs, savings they are not required to pass on to the medical systems, state governments and others who buy their products. The supply companies’ profits topped $2 billion last year, financial statements show.

You know what happens if you’re not one of the six or so companies party to these subsidies? Your shipments get seized.

In addition to missing out on subsidies, suppliers not selected for Air Bridge also risk having supplies they import seized at ports of entry by the federal government without explanation. Medical systems across the country have reported shipments being expropriated in recent weeks, as previously reported by The Times.

On the testing side, there’s a remarkable — but long — inside look at the failures of the CDC test, the inability of the federal government to work with other countries on expanding testing capacity and the inability to design a regulatory scheme that balanced safety and responsiveness. It should be noted that the piece defines the failure not in the science of the process but in the manufacture of the test.

The Washington Post takes it as a matter of course that the issue is the existence of regulations and the relative lack of freedom private companies have to innovate within the space, but never questions what capacity the CDC would have if they had the budget to command the wide range of facilities and expertise that exist outside of itself. The CDC itself has been undercut.

Of course, it’s clear that the baseline regulations put in place by the FDA have magnified problems — being forced to burn a CD and send that in because an email won’t be accepted is absurd — but certainly the article is written with the idea that regulations are inherently problematic. The workaround on the CDC tests that states proposed — essentially eliminating one of the components of the test — was initially barred by the FDA and that deserves scrutiny as well, though

Democrats have attempted to claim that Trump has cut funding for the CDC — which is something he’s attempted, but has not been actualized in actual budgetary proposals passed by Congress — but don’t go on the attack with regards to the actual staffing of the CDC, which has been gutted, especially in pandemic response.

And now that we’ve gotten around that regulatory hurdle? Bad private tests, with enormous false positive rates at three times the bare minimum rate of acceptability. It’s not just the Abbot ID Now tests that have received the bulk of the attention for inaccurate tests. Private serological tests aren’t doing as hot, either. The UK bought 3.5 million antibody tests from a private company that also failed.

We mentioned the capitalist conception of liberty and freedom. For a broader discussion on that, check out our episode on neoliberalism.

Ben mentioned the State of Exception from Carl Schmitt, a term that hadn’t seen much use outside of academia until the Patriot Act. Giorgio Agamben’s breakdown post-2005 has been one of the most important philosophical discussions of the subject, some of which is referenced in this piece. While Agamben might have taken a bit of blow in credibility on the subject when criticizing Italy’s lockdown, his philosophy remains intact and is worth analyzing in the context of COVID-19, as Al-Jazeera does in an essay titled, “COVID-19 and the neoliberal state of exception”.

The truth is that in the current neoliberal global economy – which is a strange mix of economic nationalism, the dominance of the stock market and transnational corporations, and oft-disavowed economic interdependence – any large-scale restriction that hinders the movement of capital, labour, and commodities is seen as “counter-growth” and hence undesirable by governments and corporations.

Caught in its own plague-like state of exception, Italy is also not immune to a severe economic fallout. While giving extraordinary powers to local and state governments, lockdowns in Italy have also triggered fears of a looming recession.

According to the investment firm Goldman Sachs, the sectors most affected by the lockdown – including tourism, travel, hospitality, and retail – account for about 23 percent of the Italian gross domestic product (GDP).

For many critics of the European Union’s neoliberal austerity measures, the lockdowns in Italy and Spain are, in fact, glaring revelations of the weaknesses of a free market economy, the overreliance on the private sector, and overwhelmed healthcare systems.

On March 16, the same day that the Spanish government decided to nationalise all private hospitals, the whole world watched the footage of a woman crying inconsolably outside a hospital in Madrid. Her husband had just died from COVID-19 and she herself had also tested positive. But the woman had been turned away from the hospital because she was reportedly “not sick enough” to be treated under these emergency circumstances.

The state of exception decides which citizens’ lives are worth saving and which ones are not. Paradoxically, the moment at which that decision is taken lays bare the neoliberal state’s incapacity to save and care for most of its citizens.