And here it becomes evident that the bourgeoisie is unfit any longer to be the ruling class in society. — Karl Marx
January 25, 2022
By Stephen Gowans
In the early days of the pandemic, UCLA economist Andrew Atkeson sat down to forecast what would happen if no measures were taken to curb the spread of the novel coronavirus. Plotting the course of the virus’s spread by day, Atkeson reckoned that in fairly quick order, the number of people infected would climb to 10 percent of the population. One in 10 workers would be off the job. Another set of workers would take time off to care for sick children and relatives. At the same time, a growing number of people would require medical attention, straining hospital capacity. The result would be an unbearable strain on the economy.
Two years later, newspapers are filled with stories of Covid-19-induced employee absenteeism disrupting supply chains, schools plunged into chaos because teachers, staff, and students are out sick, and hospitals groaning under the weight of record-high infections, as burned out doctors and nurses leave their posts.
According to The Wall Street Journal:
- Soaring virus cases have brought the U.S. economy to a near standstill.
- The U.S. food system is under renewed strain as Covid-19’s Omicron variant stretches workforces from processing plants to grocery stores, leaving gaps on supermarket shelves.
- Omicron has left many schools short of the essentials needed to operate, like teachers, substitutes, bus drivers, cafeteria workers—and sometimes students themselves.
- Omicron this month pushed Covid-19 hospital admissions among children to record levels.
- More than 1,000 hospitals have been reporting daily critical staffing shortages.
- The healthcare sector has lost nearly 500,000 workers since February 2020. [In response, the United States, along with Canada and the UK, are now looting the under-resourced health care systems of low-income countries of their doctors and nurses in order to replenish their own Covid-19-depleted health care systems at home.]
In the Canadian province in which I live, Ontario, the trend in the number of Covid-19 patients in the hospital, in an ICU, or on a ventilator, has been increasing almost vertically since Christmas, along with the number of deaths per day. Hospitalizations are at record levels.
It’s as if we’re back to where we were in the early days of the pandemic, under Atkeson’s uncontrolled transmission scenario, despite the fact that vaccines—heralded by Anthony Fauci as a cavalry that would recue humanity from a terrible affliction—arrived more than one year ago.
The rolling seven-day average of daily deaths as of January 23, was higher in the United States than it was in 77% of days since February 29, 2020, higher in Canada than in 89% of days since March 9, 2020, and higher in the UK that 83% of days since March 6, 2020.
No matter how you measure it, whether in number of deaths, infections, hospitalizations, or disruptions to the economy, the pandemic hasn’t been quashed, beaten, overcome, or even tamed into endemicity. Instead, in many respects, it’s worse than ever.
Nor does it seem that an exit is imminent. Despite hopeful prognostications that Omicron represents an “exit wave”, World Health Organization secretary-general Tedros Adhanom Ghebreyesus sounds a warning: “It’s dangerous to assume that Omicron will be the last variant or that we are in the endgame. On the contrary, globally, the conditions are ideal for more variants to emerge.”
How is this possible?
In the early days of the pandemic, Bill Gates—who saw himself as the encephalon of the global response to Covid-19—assured a fawning media that “a lot of the work here to stop this epidemic has to do with innovation in diagnostics, therapeutics and vaccines”—areas in which he claimed expertise. Gates’ brainchild, the Coalition for Epidemic Preparedness Innovations, or CEPI, which works to advance vaccines as the answer to epidemics, has been at the center of the response to Covid-19 in the West. Gates’ view that vaccines are—and continue to be—the solution to Covid-19, is shared by the White House, Big Pharma, and most journalists.
Joe Biden assured us that vaccines would give us “the upper hand against this virus” and announced in the summer of 2021 that owing to vaccines we “can live our lives, our kids can go back to school, our economy is roaring back.” Monica de Bolle, a senior fellow at the Peterson Institute for International Economics, averred that “You can’t have functioning economies without vaccines.” The Wall Street Journal described vaccines “as the only way out of” the pandemic, while Canada’s Globe and Mail announced that “Vaccines are the best weapon in the war on COVID-19” and “the most important tool for fighting the virus.” Jeremy Farrar, director of the drug company-endowed Wellcome Trust, and a scientific adviser to the British government, agreed. Vaccines, he said, have “always been the exit strategy from this horrendous pandemic.” Two officials of the American Civil Liberties Union, David Cole and Daniel Mach, opined that there “is no equally effective alternative [to vaccines] available to protect public health.” The New York Times’ Donald G. McNeil Jr. rhapsodized about US “pharmaceutical prowess” and predicted it would allow the country to “bring the virus to heel.” Nepal’s health secretary, Laxman Aryal, intoned that the only way to control the rate of infection—yes, the only way—was through vaccination. Meanwhile, French president Emmanuel Macron announced that vaccination was “the only path back to a normal life.” France’s “line is simple,” he said. “Vaccination, vaccination, vaccination.”
While Macron’s commitment to “vaccination, vaccination, vaccination” may be emblematic of the thinking in drug company executive suites and the halls of power, in the public health community the thinking has been a good deal more skeptical.
The WHO director-general counselled that “vaccines alone will not get any country out of this crisis” and “vaccines alone cannot solve the pandemic.” He added that “there is no silver bullet at the moment and there might never be. For now, stopping outbreaks comes down to the basics of public health and disease control; testing, isolating and treating patients and tracing and quarantining their contacts.”
Dr. Leana Wen, an emergency physician and public health professor at George Washington University, echoed Tedros. “We should not be thinking of the vaccine as a silver bullet,” she warned.
Emer Cooke, the Executive Director of the European Medicines Agency—the EU’s drug regulatory body—said the same. “Vaccines alone will not be the silver bullet that will allow us to return to normal life.”
Dr. Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine, joined the chorus. Vaccines, he said, “are not magic solutions.”
Simon Clarke, a professor of cellular microbiology at the University of Reading observed that “There’s been an attitude in some quarters that a vaccine is our automatic savior.” While vaccines are “really important,” he said, “they’re not a silver bullet.”
Martin McKee, a professor of public health at the London School of Hygiene and Tropical Medicine, put it bluntly” “Anyone who says that vaccines alone can end the pandemic is wrong.” Experience has proved him right.
Pundits and world leaders who anointed vaccines as the only solution, the only way out of the pandemic, and the only effective alternative, were dishonest. Even before Pfizer, Moderna, and AstraZeneca sought emergency use authorization for their fast-tracked vaccines, China, along with a handful of other countries, had months earlier taken the exit out of the pandemic. And they had done so by simple, old-school public health measures—measures the World Health Organization kept pointing out were proven and demonstrated to work, but which, unfortunately, much of the world, ensorcelled by vaccines, chose to ignore, with tragic consequences for the lives of millions.
China’s success in using these measures to protect the health of its citizens is perhaps one of the greatest public health achievements in human history. By contrast, the United States’ dismal Covid-19 performance—predicated on the hope that a vaccine would be a silver bullet—is perhaps one of the greatest public health failures of all time.
Despite the fact that the first Covid-19 cases were identified in China, and the country’s population is over four times the size of that of the United States, the number of confirmed Covid-19 cases in the United States surpassed China as early as March 26, 2020, only two weeks after the World Health Organization declared a pandemic. By March 29, US deaths due to Covid-19 had already inched past China’s, and have continued to climb, with the gap between the two countries unremittingly increasing. The disparity between the US and Chinese figures—little mentioned in Western public discourse—is astonishing. By December 31, 2021, some 23 months after Chinese authorities reported a cluster of unusual pneumonia cases in Wuhan, there were nearly 55 million confirmed cases of Covid-19 in the United States, compared to slightly over 100,000 in the far more populous China. The number of people that had tested positive for Covid-19 was over 164,000 per million in the United States compared to only 71 per million in China. Incredibly, deaths per million in the United States were over 770 times greater than in China. Over 800,000 US Americans had died from Covid-19, making the outbreak the greatest death event, measured in absolute numbers of deaths, in US history, exceeding fatalities from World War I, World War II, the Korean War, the Vietnam War, the Great Influenza of 1918-1920, and even the Civil War. Meanwhile, in China, fewer than 5,000 had died, less than six-tenths of one percent of the US figure. At 3.2 people per million, Covid-19 deaths in China were less than two-tenths of one percent of the United States’ 2,480 deaths per million.
Is China the anomaly or is the United States? In fact, both are, though compared to the world at large, China performs anomalously better and the United States anomalously worse. On December 31, 2021, confirmed cases per million were over 500 times better in China than the world average and over four times worse than the world average in the United States. Confirmed deaths per million were over 200 times better in China but over three and a half times worse in the United States. The United States, with only four percent of the world’s population, accounted for 19 percent of cases and 15 percent of deaths, while China, comprising 18 percent of the world’s population, accounted for less than one-tenth of one percent of the world’s cases and a similarly infinitesimal fraction of the world’s deaths.
What has China done to outperform the United States and the rest of the world? Beijing takes Covid-elimination seriously—perhaps more seriously than any other country, with the possible exception of North Korea. “China,” according to New York Times’ reporters Rebecca Tan and Alicia Chen, “always set zero as their goal.”
There is no particular genius in China’s approach to stamping out Covid-19. Beijing’s strategy is based on an axiom. As author Michael Lewis explained in his book The Premonition, “One thing that is inarguably true is that if you got everyone and locked each of them in their own room and didn’t let them out to talk to anyone, you would not have any disease.” China’s approach is based on this core truth.
Beijing’s initial response to the outbreak was to lock down Wuhan, the city in which the disease was first identified. Only one member of each household was permitted to leave their place of residence every few days to gather provisions. This was a variation on Lewis’s “lock everyone into their room and don’t let them out until the disease is gone” approach. Within a matter of weeks, the city’s 11 million people were tested for SARS-CoV-2. Sixteen temporary hospitals were rapidly built to isolate people with mild to moderate symptoms. Because patients were quarantined in a hospital and not at home, family residences did not become petri dishes for the growth and transmission of the virus. If a patient’s condition worsened, they were transferred to a regular hospital. By March 10, the outbreak had been brought under control, and the temporary hospitals were no longer needed. After 76 days, infections had been driven to zero, and the city was reopened.
At the same time, Beijing rapidly set up a country-wide contact tracing system, eventually developing a highly stringent definition of contact. Anyone who has been in a building four days before or after a person who develops Covid-19 symptoms or tests positive for the disease is deemed a contact and quarantined. While this may appear to be draconian, and a measure guaranteed to gather large numbers of people in its net, it should be remembered that case numbers are exceedingly low. In fact, they’re so low that the odds of encountering an infected person are less than the odds of being struck by lightning. As a result, only a small fraction of the population ever gets caught up in the net.
Having eliminated the disease within its borders by severing the chains of transmission, China implemented additional measures to minimize the chances the virus would seep into the country from outside. Travelers require special government approval to enter the country, and those who receive visas are required to quarantine for weeks. Quarantine is required for all travellers, including those who are fully vaccinated. These controls are not infallible. Occasionally, the virus evades border restrictions and slips into the country. When it does, public health authorities act quickly and decisively. When nine airport cleaners at the Nanjing Lukou International Airport tested positive for Covid-19 during routine testing, the city immediately imposed lockdowns and tested its 9.3 million residents in just two weeks.
Zeng Guang, the former chief epidemiologist of the Chinese Center for Disease Control and Prevention, describes China’s strategy as on one that doesn’t “simply treat infected patients but cut[s] off the disease infection routes by screening out and quarantining every close contact or potential virus carrier through prompt epidemiological investigations.” In others words, China simply follows the tenets of epidemiology 101. As the British Medical Journal explained:
“China mobilised quickly and within two months had contained the epidemic and eliminated local infections in the country. There were no magic bullets in the tools it used: the methods were old school public health strategies, which are often called non-pharmacological interventions. Other countries also successfully eliminated local infections, showing that elimination of an emerging disease with pandemic potential is possible by using non-pharmaceutical interventions alone. Public health methods such as mask wearing, hand washing, social distancing, and restriction of public events and travel played an important part. Identifying and quarantining people with covid-19 and their close contacts was also critical.”
China’s success, then, has been due, not to vaccines—the lodestone of the West’s pandemic response—but to old school pubic health strategies—strategies the World Health Organization describe as proven and known to work.
Had the world reached for known and proven old school public health methods in early 2020, as China did, it’s likely that the embryonic pandemic would have been aborted, sparing humanity two years (and counting) worth of clogged hospitals, cancelled surgeries, burned out nurses and doctors, supply chain disruptions, closed businesses and schools, millions afflicted by long-Covid and its enduring health impairments, and possibly as many as 20 million deaths to date, according to excess death estimates.
In May 2021, more than a year into the pandemic, the World Health Organization released a report by an independent panel on the performance of the world’s governments in responding to the Covid-19 health emergency. The panel arrived at a stunning conclusion. The pandemic could have been avoided. It wasn’t inevitable, even as late as January 30, 2020, the day the WHO declared a public health emergency of international concern, and two to three months after the virus likely first began to circulate. Even at this late date it was “still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts and promote social distancing measures commensurate with the risk”—in other words, to do what China did.
But that didn’t happen. By March 11, 2020, the virus had spread far enough that the global health organization declared a pandemic. How had an avoidable pandemic become a catastrophe—and a continuing one—on a world scale?
The answer was simple. Inaction. “On 30 January 2020, it should have been clear to all countries from the declaration of the” public health emergency of international concern “that COVID-19 represented a serious threat,” the panel concluded. “Even so,” it continued, “only a minority of countries set in motion comprehensive and coordinated Covid-19 protection and response measures.” The result was that February 2020, a month “when steps could and should have been taken to” prevent a controllable outbreak from morphing into a pandemic, was lost to history. Governments tarried, and their foot-dragging plunged the world into the dark abyss of a viral nightmare.
Not all governments were content to sit tight until it was absolutely certain they were staring disaster in the face. “China, New Zealand, Republic of Korea, Singapore and Thailand and Viet Nam,” the panel noted, all acted quickly and decisively to contain the emergency, and all with exemplary success. These countries pursued an aggressive containment strategy that involved mass testing, robust contact tracing, and quarantine, with “social and economic support to promote widespread uptake of public health measures.”
Most other countries, by contrast, waited far too long to act. And when they did act, they failed to do enough, never fully implementing the measures needed to bring their outbreaks under control. What’s more, they almost invariably dialed back measures too soon, with catastrophic consequences for the health of their citizens.
So, why did most countries do too little, too late? The panel pointed to cost. Most governments judged concerted public health action—the aggressive test, trace, and isolate measures implemented by China and a handful of other countries—as too expensive. Three costs were central to their concerns:
- The direct expense of testing, contact tracing, the construction of isolation facilities, coordinating quarantine, and providing financial support to the quarantined.
- The indirect cost of business disruptions.
- The impact on the stock market.
Concerning the first cost, the “people inside the American government who would be charged with executing various aspects of any pandemic strategy … believed none of these so-called non-pharmaceutical interventions”—the kind China pursued to great effect—”would contribute anything but economic loss,” according to Michael Lewis.
Concerning the cost of business disruption, the Great Influenza offered an anticipatory model. Studies of how the United States responded to the 1918-1920 flu pandemic found that government decision-makers were under incessant pressure from businesses to lift public health measures. Now, as then, capitalist governments were highly influenced by business communities and finely attuned to their needs. Minimizing the cost to business was the top priority of governments working out how to deal with a global health crisis.
Finally, US president Donald Trump deliberately downplayed the public health emergency, repeatedly declaring that it would magically resolve itself, because he feared that acknowledging the danger would result in untold stock market losses. “Trump grew concerned that any [strong] action by his administration would hurt the economy, and … told advisers that he [did] not want the administration to do or say anything that would … spook the markets,” reported the Washington Post. What the WHO panel perceived as “a wait and see” attitude on the part of many governments was actually a “take no strong action to avoid spooking the markets” attitude. The contrast between China’s aggressive response and the United States’ “see, hear, and speak no evil” approach, is revealingly summarized in the comments of the countries’ respective leaders: China’s Xi Jinping: “Infectious disease control is not merely a matter of public health and hygiene; it’s an all-encompassing issue and a total war.” The United States’ Donald Trump: “One day — it’s like a miracle — it will disappear.”
Why did the United States, and most countries in its orbit, embrace vaccines as a silver bullet, when the World Health Organization urged countries to adopt the proven public health and social measures that were known to work and that China had confirmed did, indeed, work—and what’s more, worked remarkably well?
One driver of Washington’s predilection for vaccines was the ability of billionaires, such as Bill Gates, to set the public health agenda to favor pharmaceutical solutions. Owing to their great wealth, billionaires, foundations supported by the wealthy and large corporations, and the pharmaceutical industry, were able to strongly influence public discourse on healthcare issues and to set the public policy agenda on matters related to health, including pandemic preparedness. They had long ago used their influence to push vaccines—a potential cornucopia of profits—to the top of the agenda on how to meet the challenge of future pandemics. As a result, when the pandemic hit, governments followed the path capitalist influencers had already set, eschewing the proven public health measures which, though unquestionably effective, offered no opportunities for amassing profits.
Additionally, Washington had long been planning for how to meet the threat of a biological attack, or warfare carried out with germs. Always, the response had been seen to depend mainly on developing and stockpiling two things: vaccines and personal protective equipment, or PPE.
Vaccines and PPE, however, are not the only ways to address germ threats, but the idea is so ingrained in public discourse, that when asked how humanity ought to prepare for another pandemic, the answer is almost invariably: make sure we have enough N-95 masks and build vaccine manufacturing infrastructure. But there is another model of pandemic preparation that is almost always overlooked: develop the infrastructure to trace, test, and isolate. Few people—and no one in senior positions in government—ever talk about developing the infrastructure for an elimination strategy as the means to meet the next pandemic threat. Instead, the chorus only ever has two notes: vaccines and PPE.
This might reflect borrowed thinking from the military. The standard ways of defending military forces from weaponized pathogens are to equip troops with biohazard suits and respirators and to vaccinate them in advance against the bacteria, viruses, and other pathogens the enemy might employ. Test, trace, and isolate is absent from the military doctrine on defense against biological threats because it is ill-suited to the military environment. Blindly importing military anti-biological threat doctrine into public health practice omits an effective technique that, while ill-suited for military purposes, works very well in the civilian realm.
Moreover, vaccines and PPE comport with the United States’ techno-fix culture. “Techno-fixes,” according to the late Howard P. Segal, who was an historian of science and technology at the University of Maine, “are short-term, avowedly practical proposed solutions to hitherto unsolvable economic and social problems” that “reflect an almost blind faith in the power of technology as panacea.” Techno-fix culture biases people enmeshed in its web to overlook social and economic solutions, in favor of what seem like quick technological fixes. Techno-fix culture is a religion based on faith. Its votaries believe that the god of technology will save humanity from all problems, even in cases where the evidence shows that proposed techno-fix solutions have failed. If techno-fix religion has a pope, it is surely Bill Gates.
But the technofix religion has other grand figures, as well. “Google,” wrote historian Jill Lepore,” opened an R&D division called X, whose aim is ‘to solve some of the world’s hardest problems.’” Elon Musk, one of the world’s richest people, if not, the wealthiest, promotes “a capitalism in which companies worry…about all manner of world-ending disasters”—disasters, notes Lepore “from which only techno-billionaires, apparently, can save us.”
Techno-billionaires promote techno-fix faith because the religion stimulates interest in their products. Techno-fix enterprises are the perfect distillation of their view that the combination of technology and private enterprise can save the world. Technology and free enterprise are also the foundations of the techno-billionaires’ fortunes and instruments of their continued expansion.
A number of other mutually reinforcing factors led Washington’s to favor vaccination as “the key to getting the pandemic under control and keeping the economy strong,” as Joe Biden put it.
First, non-pharmaceutical public health measures are contraindicated under capitalism. Rather than spending billions of dollars on vaccines, billions could have been spent on a robust public health response. The Rockefeller Foundation proposed a test-trace-isolate program to the Trump administration, which was immediately rejected. The problem, from a capitalist perspective, is that a public sector program to hire hundreds of thousands of public servants to carry out old-school public health measures, offers few, if any, profit-making opportunities for the private sector. Shoe leather epidemiology—the basic, hard labor of tracking down infected individuals, tracing their contacts, and herding them into quarantine—is the unsung labor of public servants. On the other hand, vaccine production can be quickly and easily made a private sector activity, one offering a rich banquet of profits on which investors—Washington’s principal clients—can gorge.
Additionally, Washington—always a bastion of free enterprise and private sector boosterism—has no desire to promote the public sector. The capitalist class, the US state, and individual billionaires such as Gates, agree that free enterprise must be the main vehicle through which the world’s problems are addressed. There is no room in this view for the public sector, except as a host for private enterprise parasitism and source of the private sector’s new products (such as mRNA vaccines.)
Writer and journalist Nina Burleigh observed that the White House’s focus was “on its conviction that private enterprise was the way out of the disaster.” Not only would vaccines be the exit from the calamity, but vaccines produced by the private sector (generously funded by the public sector) would be presented as the only possible escape.
Burleigh also argued that Washington’s incompetence, evidenced in its failure to prevent hundreds of thousands of US citizens from dying, is deliberate. The White House could seize the levers of public power to bring the pandemic under control by dint of old-school public health measures, following China’s path, but chooses not to in order to avoid giving hope to US citizens that government, unhinged from its service role to the bourgeoisie, can be a force for good.
The vaccine strategy—the notion that vaccines alone can protect public health and return the world to the status quo ante—has failed. Vaccines were approved under emergency use authorization after an unconscionably short period of testing (only two months into planned two-year-long phase 3 clinical trials) because the FDA declared falsely that there were “no adequate, approved, and available alternatives” to address a (self-inflicted) medical emergency, as if China’s success had never occurred. The reality is that there existed then, as there does now, a safe and demonstrably effective alternative to the failed silver bullet vaccine strategy. China has shown the way. Unfortunately, capitalism holds us back.
*The title is adapted from André Picard, “’I’m done with COVID’ is easier said than done,” The Globe and Mail, January 24, 2022.
Coming soon. The Killer’s Henchman: Capitalism and the Covid-19 Disaster. Available for pre-order from Baraka Books.