As much of the world faces the threat of a massive spread of Covid-19 that threatens to overwhelm even the most advanced healthcare systems, the US stands out as especially unprepared for the crisis. This relates to both long-term issues in the US regarding healthcare and sick leave as well a much more recent mismanaging of the response to this crisis.

The virus was first identified as cases of pneumonia in China in December 2019. In early January, the virus was identified by Chinese authorities as a new version of the Coronavirus, later named Covid-19. As China initially did little to prevent the spread both inside and outside of the country, waiting nearly three weeks to do anything, the virus spread quickly to many parts of the world. Later, once the severity of the crisis was evident, China announced draconian measures to keep the virus contained. It appears that these measures have had significant success, however, it is difficult to gage with absolute certainty whether current reports coming out of China are accurate given the secretive and authoritarian nature of its political system which worked hard to ensure that information on the virus was not made public in the early days of the crisis including targeting Wuhan doctor Li Wenliang who warned of the dangers of the virus.

The first case in the US was reported in Washington on January 21 and the federal government was slow to respond with the Trump Administration denying entry to individuals who had travelled to China in the last 14 days on January 31. While the Chinese example should have triggered a strong response by federal officials to begin significant preparation for countering an epidemic such as finding supply chains for protective masks, respirators, gloves, ventilators, etc. there is little evidence that this happened. In fact, much has been made of the 2018 decision of Trump to fire the federal pandemic response team. This decision, very much in keeping with his anti-science rhetoric certainly had the effect of weakening the federal response.

Recently Trump has made the claim that the federal government has no responsibility to assist in supplying goods that would help in fighting the pandemic: “the federal government’s not supposed to be out there buying vast amounts of items and then shipping them, you know, we’re not a shipping clerk.”[1] It seems as though Trump sees this only from the perspective of government as a business which has no real responsibility to its customers.

But perhaps more troubling than the clearly botched and inept federal response, are the long-term factors that make this crisis particularly acute for the US. The Census Bureau reports that in 2018, about 27.5 million did not have health insurance. This number is likely to rise as the US healthcare system primarily relies on employers to provide coverage. As more and more states and localities restrict the operation of businesses and the number of people that can gather to prevent a rapid spread of the virus, more people will find themselves out of work, low on cash and without health insurance. While Trump has been able to negotiate a deal with private insurers to forego co-pays on Coronavirus testing, many will still be reluctant to seek treatment fearing the out-of-pocket costs that come with it. This is even true for many with insurance as many plans have high deductibles. The end result of this will likely be more deaths and sicker patients seeking treatment that will require greater levels of intervention than if patients sought treatment earlier.

The spread of infection is also likely to be exacerbated by a lack of a federal policy on sick leave in the US. While a number of states require businesses provide employees with sick leave, the federal government has no such policy. Even the most recent legislation passed in the House of Representatives has glaring omissions that will leave most low-waged workers without a choice but to go to work when sick. While touted as a solution to the sick leave problem, in fact, only about 20% of workers would see its benefits. Small companies with under 50 workers (26% of the workforce) can seek hardship exemptions and many large corporations like McDonald’s and Amazon have lobbied for their own exemption. With just these large employers that have 500 or more employees we find about 54% of all workers in the US.[2] Thus, we are likely to see the usual pattern: those making the least will be forced to continue to work while sick, whereas those with higher wages who may be better able to take unpaid leave, will continue to receive paychecks. In fact, 90% of those in the top quarter for income have paid leave while only 47% of those in the bottom quarter do.[3] Moreover, sick leave has been shown to have a positive effect on the spread of an influenza epidemic by reducing it up to 40%.[4] This seems like more than enough to at least initiate new discussion on this important topic, despite the negative effect it would have on profit margins.

At a more general level, these types of policies have the effect of exacerbating the virus for those in the lower rungs of society. In part due to a lack of access to preventative care, among other factors, those in poorer socioeconomic groups are more likely to have chronic health conditions like diabetes and heart disease. Moreover, they are likely to get these health problems earlier than other wealthier groups, meaning younger people are at a greater risk for complications from the Coronavirus among this group. Moreover, those that are poor and have these preexisting conditions may be up to twice as likely to have deadly complications.[5]

Since compassion is unlikely to be a motivating factor for capital, which views its supply of labor as vast and interchangeable, the above may not be enough to rethink public health policies. There is evidence, however, that inequality can also increase the spread of infection to other socioeconomic groups.[6] Since viruses do not respect neighborhood boundaries and since many of the poor work alongside the wealthy, increased spread among the poor means increased transmission for all. More cases also means that health resources are stretched thinner, perhaps to a breaking point—something that is hoped to be prevented by social distancing. The success of that policy will be tested by those who are economically forced to work while sick.

As the example of the Brooklyn Nets getting tested regardless of symptoms illustrates, the wealthy and influential will not suffer these shortages, however, a mass contagion like Coronavirus has the potential for a mass disruption of the workforce, the blocking of the production process, the profits of capital and above all the reproduction of capitalist production relations. While the federal government under Trump seems content to reopen businesses and society in general, mayors and governors are much more cautious either due to genuine concern, or the knowledge of what a mass contagion would mean for capitalism with its shortage of healthy workers and consumers without jobs and disposable income.

In addition, the federal government and the business community show little altruism and appear to be taking what they can. The latest attempt to provide an economic stimulus package from the Senate includes $500 billion in a slush fund for loans and loan guarantees to businesses that the Treasury Department would have full control over, plus the names of companies receiving this largesse would not be revealed for six months. Moreover, there has been concern expressed about who would benefit from the funding overall. The current bill does provide payments to individuals to help pay the bills, but the overall approach is a top-down model providing relief to corporations who will then pass it down to their workers.[7] This certainly wasn’t true of the 2008 bailout and there is little reason to think that things will change this time.

Finally, we have seen significant elements of opportunism from the pharmaceutical industry. While Democrats have at least engaged in rhetoric to try to protect the public interest through support for policies that protect the public’s right to low-cost treatment and vaccines for the Coronavirus, the same has not been true of the Trump Administration. It is clear that the interests of the industry are much more important than the lives of individuals. For example, the federal Biomedical Advanced Research and Development Authority has agreed to pay Regeneron Pharmaceuticals up to 80% of the cost for developing and manufacturing Coronavirus treatments with no guarantee that these treatments would be affordable.[8] Taxpayers foot the bill and capital reaps huge profits from those that are able to pay.

In another similar example, on March 23, the Food and Drug Administration granted Gilead Sciences “orphan” drug status for its antiviral drug, Remdesivir, which has had some positive effects in the treatment of Coronavirus. This will allow the company to profit from this drug exclusively for seven years, limiting the potential for production of cost-saving generics. This is a particularly odd move as Coronavirus hardly meets orphan status—a very rare disease that is unlikely to get investments in treatment due to lack of profitability.[9] Thus, this federally protected status that acknowledges that capital only cares about treating disease when it makes it more money, is being used in such a way as to potentially limit the numbers of people that have the effective demand to get treatment. If it works, millions will need it, but have no power to get it in a world where wealth and worth are synonymous.

All of the above lays bare the crassness of contemporary capitalism. Trump is simply its most recent and clearest messenger. Human beings are commodities that are to serve capital as either employees or consumers. On March 23, Trump called for a return to normalcy after a 15-day quarantine. The message was clear. We must all serve the needs of valorizing capital, regardless of personal consequences. The stock market must recover. People need to go back to work to “earn” their continued space on this planet. The appearances of a strong economy must be maintained, even though it may be built on a house of cards. Profits come before human needs.

Luxemburg, writing in the aftermath of a volcanic eruption on Martinique, contrasted the response to this natural disaster to the violence of colonialism. People will be compassionate in a natural disaster and help those in need with monetary contributions and volunteering time, because they see fellow human beings in the crisis: “And now in the ruins of the annihilated city on Martinique a new guest arrives, unknown, never seen before—the human being. Not lords and bondsmen, not blacks and whites, not rich and poor, not plantation owners and wage slaves—human beings have appeared on the tiny shattered island, human beings who feel only the pain and see only the disaster, who only want to help and succor… A brotherhood of peoples against nature’s burning hatred, a resurrection of humanism on the ruins of human culture.”[10] The same is not true of colonialism, which was naturalized. Violence was fine because “they” were not like “us.” “They” had to face violence and destruction of their humanity to serve the needs of capital.

The crisis today evokes a similar dichotomy. While there has been a mass outpouring of support nationally and internationally which treats human life as valuable, capital, by its very nature seeks to overturn this for its own purposes. This is evident in the words of the Lt. Governor of Texas. Looking at the balance sheet between saving lives and returning to work and restarting the economy now, Lt. Governor Dan Patrick said: “Those of us who are 70 plus, we’ll take care of ourselves. But don’t sacrifice the country… No one reached out to me and said, ‘As a senior citizen, are you willing to take a chance on your survival in exchange for keeping the America that America loves for its children and grandchildren?’ And if that is the exchange, I’m all in.”[11] It is difficult to find a clearer case of the fetishization of market relations. The economy must go on even if it kills grandma and grandpa.[12] Each passing day illustrates the need to uproot a vicious and vile capitalism that places value on human life only as far as it can profit from it and replace it with a society that values all of its members as living embodiments of our species being regardless of race, class, gender, sexuality, gender identity or ability.

[1] Michelle Goldberg. 2020. “Of Course Trump Deserves Blame for the Coronavirus Crisis. New York Times. March 19.

[2] “There’s a Giant Hole in Pelosi’s Coronavirus Bill,” New York Times. March 14, 2020.

[3] Max Fisher and Emma Bubola. 2020. “As Coronavirus Deepens Inequality, Inequality Worsens its Spread. New York Times. March 15.

[4] Fisher and Bubola, 2020.

[5] Fisher and Bubola, 2020.

[6] Fisher and Bubola, 2020.

[7] Erica Werner, Paul Kane, Rachael Bade and Mike DeBonis. 2020. “Senate negotiators cite progress on coronavirus bill after day of drama and rancor.” The Washington Post. March 24. https://www.washingtonpost.com/us-policy/2020/03/23/trump-coronavirus-senate-economic-stimulus/

[8] Mariana Mazzucato and Azzi Momenghalibaf. 2020. “Drug Companies Will Make a Killing from Coronavirus.” New York Times. March 18.

[9] Sharon Lerner and Lee Fang. 2020. “Coronavirus Treatment Developed by Gilead Sciences Granted “Rare Disease” Status, Potentially Limiting Affordability,” The Intercept. March 23. https://theintercept.com/2020/03/23/gilead-sciences-coronavirus-treatment-orphan-drug-status/

[10] Luxemburg 2004, “Martinique,” in Hudis and Anderson, eds. The Rosa Luxemburg Reader. New York: Monthly Review Press, 124.

[11] Jamie Knodel. 2020. “Texas Lt. Gov. Dan Patrick suggests he, other seniors willing to die to get economy going again.” March 24. https://www.nbcnews.com/news/us-news/texas-lt-gov-dan-patrick-suggests-he-other-seniors-willing-n1167341

[12] It is worth noting as well that Texas is one of the states that has banned abortion procedures due to the Coronavirus threat. Kate Smith. 2020. “Texas becomes latest state to halt abortion services amid coronavirus outbreak.” March 23. https://www.cbsnews.com/news/texas-governor-greg-abbott-stop-abortion-services-coronavirus-outbreak/ It seems as though their “pro-life” rhetoric only applies to controlling women’s bodies and not protecting all life.