By Stephen Gowans
May 9, 2022
[This is an excerpt from my new book, The Killer’s Henchman: Capitalism and the Covid-19 Disaster, officially released June 1.]
“To me, this feels honestly more about economics than about the science.” – Yonatan Grad, associate professor of immunology and infectious diseases, Harvard University[i]
“COVID-19 remains a global disaster. Worse it was a preventable disaster.” — WHO Independent Expert Panel[ii]
Pandemics are not inevitable.
To be sure, the emergence of new infectious diseases is a near certainty. Pathogenesis—the birth of a new disease—is a necessary condition of pandemics, but it is not a sufficient condition. That pandemics are optional and not inevitable is provable by reference to one word: China. By following a zero-Covid strategy of eliminating local transmission of the novel coronavirus, the Communist-led country avoided overwhelmed hospitals, limited fatalities to extraordinarily low levels, and escaped significant economic hardship. While the pandemic danced a macabre waltz around it, China, along with a handful of other countries that followed a similar strategy, failed to show up at the ball.
Public discourse outside China and other zero-Covid countries accepted the pandemic as an inevitability. The narrative was highly influenced by people such as billionaire Bill Gates, who advanced the view that pandemics are unavoidable, and that vaccines and drug therapies should be developed in anticipation of their ineluctable arrival. CEPI, the Center for Epidemic Preparedness and Innovation—a non-profit organization that played a leading role in the fight against Covid-19 among countries in the US orbit—was born as a vehicle for promoting Gates’ views and approach to emerging infectious diseases. Needless to say, the reality that the emergence of a novel pathogen is not a sufficient condition for a pandemic, and the fact that China demonstrated that a pandemic could be avoided by using mass testing, contact tracing, and isolation to break the chain of pathogenic transmission, refutes Gates’ view.
While Gates is a major funder of the World Health Organization, the organization’s director-general, Tedros Adhanom Ghebreyesus, rejected the erroneous Gates’ idea that vaccines ought to be the principal tool used to fight pandemics. “Vaccines are not the only tool,” Tedros announced. “Indeed, there is no single tool that will defeat the pandemic. We can only defeat it with a comprehensive approach of vaccines in combination with proven public health and social measures that we know work” (emphasis added.)[iii]
On the same day Tedros told the world it would need to combine vaccines with non-pharmaceutical public health measures to beat Covid-19, Eric Lander, at the time US president Joe Biden’s science adviser, promulgated a different view. He wrote in the Washington Post that “Coronavirus vaccines can end the current pandemic.” Lander made his prediction at a time vaccines were available to any US adult who wanted one, but when US case counts—already high by world standards—were climbing. The vaccine strategy clearly wasn’t working, though Lander appeared not to notice. Ignoring the reality that the United States’ own experience impugned the ability of vaccines alone to end the pandemic, Lander—a multimillionaire who has substantial investments in the pharmaceutical industry—announced that “the scientific community has been developing a bold plan to keep future viruses from becoming pandemics.” Would it involve the proven public health and social measures Tedros said we know work and that China had demonstrated do work? No. Instead, it would be based on vaccines—the tool wealthy US Americans with stakes in drug companies, like Gates and Lander, continued to tout as the pathway of escape from pandemics, current and future. In the United States, and the countries that orbit the imperial center, all belief was for vaccines as the main route out of the pandemic, and all evidence was against.
The US government, according to Lander’s plan, would see to it that vaccines were designed, tested, and approved within 100 days of detecting a new pandemic threat and would arrange to manufacture enough doses to supply the world within 200 days.[iv] The folly of the approach was evident. First, there is no guarantee that effective vaccines can be developed for every pathogen, let alone in 100 days. There is no vaccine for AIDS, for example, despite the decades of effort scientists have invested in trying to develop one. Second, it’s impossible to test a vaccine for safety in 100 days. Since the very short testing window allows scientists to follow test subjects only over a very brief period, it would be impossible to say whether the vaccine was free from any but immediate adverse side-effects. This would pose an enormous health risk to the billions of people who would be inoculated, perhaps greater than the risk of the novel pathogen itself. Third, even if the extraordinarily ambitious goal of manufacturing enough doses to supply the world within 200 days was met, the logistical difficulties of administering the vaccine to billions of people worldwide would take more than 200 days to overcome; it would likely take years. In the meantime, the only way to prevent the pandemic pathogen from running out of control, killing millions, collapsing healthcare systems, and devastating economies, would be to implement the proven public health and social measures we know work. It would seem, then, that the best way of meeting the challenge of future pandemics is, in the first instance, to figure out why most countries failed to implement the proven public health and social measures that could have prevented the Covid-19 pandemic, so that the impediments that blocked an effective response can be overcome the next time the world confronts a novel pathogen. Why was a strategy that worked in China, South Korea, and New Zealand, as well as in Vietnam and North Korea, rejected everywhere else? And why was it eventually rejected in South Korea and New Zealand as well?
Despite China having every pandemic risk factor, it is one of the few countries that has escaped a Covid-19 catastrophe. It has the world’s largest population, close to one hundred cities with populations of one million or more, high-speed trains to whisk passengers from one part of the country to another, innumerable airline connections to the rest of the world, and yes, scientists who collect coronaviruses from the wild and study them in laboratories. All the same, China has not been struck by disaster. The numbers of infections and deaths per million have been held to astonishingly low levels, the healthcare system has not collapsed, and economic activity recovered quickly after an initial setback. What’s more, China may very well have been ground zero for the virus. It was the first country to identify the new infection—and while that doesn’t mean the virus originated there—there’s a good chance it did. And yet the Communist-led country has emerged mostly unscathed. If ever there were an answer to the question of whether pathogenic catastrophes are optional, China is it.
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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.[v] 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.” 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 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 averred. “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 irrupting into a pandemic, was lost to history. Governments tarried, and their foot-dragging plunged the world into the dark abyss of a pulmonary pandemic.
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, the panel reported, 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.”
While the panel failed to mention North Korea, the East Asian country also acted swiftly, sealing its borders on January 21, even before the WHO declared a global health emergency. The country’s leader, Kim Jong Un, called pandemic control North Korea’s “top priority” and “most important work.”[vi] The Washington Post noted that Pyongyang had taken the pandemic “hyper-seriously,”[vii] while the New York Times observed that “North Korea has taken some of the most drastic actions of any country against the virus.”[viii] These reports accorded with the country’s claim to have experienced not a single Covid-19 case. Howard Waitzkin, a physician with a Ph.D. in sociology, critically examined North Korea’s Covid-19 claims, concluding that Pyongyang’s report of zero cases and zero deaths “is plausible” and the DPRK may, in fact, lead the world in the fight against COVID-19.[ix]
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.
“Countries with the poorest results,” the panel found, “had uncoordinated approaches that devalued science, denied the potential impact of the pandemic, delayed comprehensive action, and allowed distrust to undermine efforts. Many had health systems beset by long-standing problems of fragmentation, undervaluing of health workers and underfunding.”
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, according to best selling author Michael Lewis’s study of the US response to the Covid-19 pandemic, The Premonition: A Pandemic Story, 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.”[x]
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.[xi] “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.[xii] 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.”[xiii]
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China’s success in protecting the health of its citizens from the ravages of Covid-19 is perhaps the greatest public health accomplishment in human history. By contrast, the United States’ dismal Covid-19 performance 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 would continue 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. When it came to pandemic control, China and the United States inhabited different planets.
Was China the anomaly or was the United States? In fact, both were, though compared to the world at large, China performed 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.[xiv]
The United States’ utter failure by comparison with China, and failure even by comparison with the world at large, was a taboo subject, judging by the virtual absence of discussion of the numbers, despite the fact that the figures were readily available for inspection by anyone with access to the Internet. Our World in Data, a collaborative effort between researchers at the University of Oxford and the non-profit organization Global Change Data Lab, assembled a vast storehouse of Covid-19 information by country, from morbidity and mortality figures, to vaccine uptake statistics, and more. The yawning chasm between Washington and Beijing in pandemic performance was immediately evident to anyone who cared to inspect the data. No country or jurisdiction, with the exception of a handful of sparsely populated nations, had accumulated fewer cases or deaths per million than China. By comparison, the United States’ record was among the worst in the world. All the same, journalists and academics in the US orbit mainly avoided Sino-US comparisons, and, on the rare occasions they did make comparisons, grossly understated the disparity. By avoiding quantitative comparisons, or obscuring them when they were made, the Western media prevented important questions from being asked. Why had China performed so much better, not only in comparison to the United States, but relative to virtually every other country in the world? Why hadn’t China’s approach, a manifest success, been emulated except by a few other countries? How many lives might have been saved had governments learned from the experience of the East Asian colossus?
Washington failed in multiple ways.
- To avoid spooking the markets and to preserve investor wealth, it refused to acknowledge the seriousness of the threat.
- It refused to emulate the successful approach of China to stop the outbreak, rejecting non-pharmaceutical pandemic control measures as too costly.
- It eschewed successful non-pharmaceutical pandemic control measures, even after it became unavoidably clear that China’s approach was the most effective way to safeguard the health of US citizens.
These failures precipitated a pandemic and produced avoidable death on a scale never before seen in US history. How many lives were needlessly sacrificed to the stock market and Washington’s desire to spare the business community the expense and inconveniences of public health measures?
It’s possible to answer this question. Had Washington emulated China’s approach, an estimated 1,067 US Americans would have died from Covid-19 by December 31, 2021 (equivalent to the number of Covid-19 deaths per million China experienced, adjusted to the size of the US population.) That is 823,173 fewer deaths than the actual US Covid-19 death toll to that date. In other words, to protect the stock market and avoid the costs of implementing stringent non-pharmaceutical public health measures, the lives of more than 800,000 US Americans were sacrificed. Had Canada emulated the Chinese approach, an estimated 122 Canadians would have died from Covid-19, compared to over 30,000 that actually did die. In the United Kingdom, 216 would have died compared to more than 146,000 whose lives were cut short by London’s failed pandemic response.
What if the world as a whole had followed China’s lead? Had that happened, an estimated 25,239 people would have died from Covid-19 by December 31, 2021, compared to over 5,428,000 that actually did perish, a difference of over 5,402,000 people. The failure of the world’s governments to act in a manner that China, early on, had demonstrated was an effective means of controlling the outbreak, created in excess of 5.4 million preventable deaths, some two years after the world became aware of the novel coronavirus.
[i] Benjamin Mueller, “Will shortened isolation periods spread the virus?”, The New York Times, December 28, 2021.
[ii] Grant Robertson, “The world’s ‘lost month’ in fight against COVID-19,” The Globe and Mail, May 12, 2021.
[iii] WHO Press Conference on Covid-19, August 4, 2021.
[iv] Eric Lander, “As bad as covid-19 has been, a future pandemic could be even worse — unless we act now,” The Washington Post, August 4, 2021.
[v] “COVID-19: Make it the Last Pandemic, The Independent Panel for Pandemic Preparedness & Response,” Word Health Organization, May, 2021, COVID-19: Make it the Last Pandemic (theindependentpanel.org).
[vi] “5 key terms for parsing Kim Jong un’s vision for N. Korea, in 2022,” The Hankyoreh, January 3, 2021.
[vii] Michelle Ye Hee Lee, “What’s happening inside North Korea? Since the pandemic, the window has slammed shut,” The Washington Post, September 9, 2021.
[viii] Choe Sang-Hun, “North Korea Declares Emergency After Suspected Covid-19 Case,” The New York Times, July 25, 2020.
[ix] Howard Waitzkin, “COVID-19 in the Two Koreas,” Monthly Review, September, 2021.
[x] Michael Lewis, The Premonition: A Pandemic Story, W.W. Norton & Company, 2021, p. 99.
[xi] Amber Phillips, “Was the stock market the object of Trump’s ‘don’t create a panic’ coronavirus approach?” The Washington Post, September 10, 2020.
[xii] Yasmeen Abutaleb and Josh Dawsey, “Trump’s soft touch with China’s Xi worries advisers who say more is needed to combat coronavirus outbreak,” The Washington Post, February 16, 2020.
[xiii] “What did leaders of US, Japan and China say about COVID-19?” The Hankyoreh, March 14, 2021.
[xiv] The source for all confirmed case and death figures is Our World in Data.
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