Global Endemics

One way we fight fascism is by challenging the underlying logic which has opened the door to the global rise of Right-wing authoritarianism. On CNBC, a (controversial) venture capitalist opines, of billionaires: “Who cares? Let them get wiped out.” And goes very viral. In a blog post entitled “Capitalists or Cronyists?” – shared with me by my friend Scott – an NYU professor makes a similar case. The Financial Times features Arundhati Roy.

Clearly, the shock of this crisis is shaking (rich) people up. Data on death tolls leave no doubt that the pandemic is not “the great equalizer,” but neither are the rich sheltered from this as, largely, they are from other global scourges. Imagine, every day since March 28th, more than 3,000 confirmed COVID-19-related deaths per day have been recorded globally. That’s nearly three consecutive weeks of 3,000+ daily deaths caused by this pandemic (with the highest single-day global death toll coming on April 8th when it was recorded that nearly 7,500 people died of COVID-19). Okay, now imagine, more than 3,000 people have been dying, on average, per day globally every day from tuberculosis for years. Does anyone you know seem to care?

In my case, I can say yes – in part because I have many friends who are public health professionals and global health workers – but it should be clear to anyone paying attention that while pandemic disease – even this relatively mild one with which we are currently grappling – is a major cause of concern for the rich and powerful (if only belatedly), endemic disease, largely, is not. Certainly, the Gates Foundation pours a great deal of money into confronting tuberculosis, AIDS, malaria, and other major infectious causes of death to the poor, and through USAID and PEPFAR, the US government also supports some of these efforts, but relative to shutting down the entire global economy, have we ever really seen proportionate steps taken to address these leading global, infectious causes of mortality? Of course we haven’t – at least not since they stopped afflicting the parts of the world that are now rich.

And, yet, we’re told that the only way to build “affordable housing” is through “mandatory inclusionary zoning” – that is, by incentivizing private developers to build a small number of apartments for poor/er people and then giving those same developers tax breaks and the like while they build mostly new luxury condos. We’re told that the only way to “save” the US economy is by giving ~$5 trillion to major corporations, with no strings attached (not even one), while giving small one-time checks and a little additional unemployment insurance to working people, but that there is no money to save the United States Postal Service. We’ve been kept so desperate and afraid for so long that the possibility of an alternative feels almost impossible, so it’s always inspiring to see organizations, like the Rosa Luxemburg Stiftung, tell the truth about the sources of that fear and desperation in outlining the structural barriers to change that are the key accelerants of this crisis.

Short piece today. In an India stricken by “Fear of mass destruction and causality,” elders Anand Teltumbde and Gautam Navlakha face imprisonment – along with “nine other respected human rights activists and lawyers” – at the hands of Modi’s fascist Hindu-nationalist government. I encourage you to read their letters, linked above.

In New York, two recent reports make clear that a significant percentage of people giving birth at NYC hospitals in recent week have tested positive for COVID-19, and that, of those, a significant percentage were totally asymptomatic upon presentation (with most of those remaining asymptomatic throughout their time in the hospital). While the New York Times chose to highlight the feel-good story of one COVID-positive pregnant person who did not require an early emergency C-section, both its article and this letter to the New England Journal of Medicine from doctors at Columbia University’s medical center suggest that ~15% of birthing people at Brooklyn Hospital and Columbia’s affiliated institutions respectively have tested positive in recent weeks. While the Times is largely silent on the nuances, the doctors’ letter makes clear that of the ~15% of birthing people who tested positive, ~9/10 of them were asymptomatic. Almost 90%! Their conclusion was that universal screening is necessary, with which I agree, but I’d go further and say this makes very strongly the case that, in addition to screening, Alternative Birthing Sites are necessary under such circumstances to protect COVID-negative pregnant people, their partners/birth companions, and their care providers – a case that my partner has worked tirelessly to advance since mid-March in the face of political indifference in New York City and State.

Interestingly, one other potential inference from these two data points is that predictions from late March suggesting a solid double-digit percentage of New Yorkers were already infected with SARS-CoV-2 were likely correct. Excepting the fact that pregnant people are obliged to have more regular interaction with the healthcare system than are most individuals, there’s no clear reason why they would be infected at significantly higher rates than the rest of the population, but there is one very clear reason (birth!) why they would be tested at much higher rates under our current circumstances. I’ve been guessing that somewhere from 10-50% of New Yorkers have already, at some point, been infected, with a best guess putting the number at ~20%, and these ~15% figures seem to validate that guess to some extent.

My friend Frank – the adopted Brit – points out that there are some concerns with the reliability of serological testing, especially given that those who have been asymptomatically infected with SARS-CoV-2 may not build up enough antibodies to be detected by such tests. Guess we’re all now into the higher level classes at COVID University! Here’s hoping that we soon have a reliable way to determine at scale how many of us have already been infected as we chart a path forward.

Finally, both Rossana Rodríguez- Sánchez – on this episode of Doug Henwood’s Behind the News – and Daniel Aldana Cohen – on this episode of the Hot & Bothered podcast that he co-hosts with Kate Aronoff – pointed to the threat of natural disasters (in particular, Caribbean hurricanes) striking already pandemic-stricken populations, while this article – “COVID-19 and dengue fever: A dangerous combination for the health system in Brazil” – points to another of the potential catastrophic convergences which menace, disproportionately, the global poor.