Several of you asked what my take was on the latest Jacobin interview on
COVID-19. I haven't read it thoroughly. But here's the first of two
critiques I'll share. Tim Lacy is Director of the Medical Student
Learning Environment at the University of Illinois College of Medicine.
I will say that a couple weeks ago I noted the development of a leftist
mirror stage. Whatever the switch in political chirality, the
interviewees here (and others) may be miming Trumpist command (and the
Democrats' staged infirmity) as if the natural order of things.
The gesticulation matches a political impotence with biomedical magical
thinking. Because we are unable to get the bourgeoisie to pay for a
community health response that matches COVID's scale, including, as in
other countries, paying everyone to huddle down and ride out the
outbreak, the *virus* must not be as dangerous as it seems.
_______________________________
Glad to see Jacobin engaging this topic. Here is my 13-Point Response
and Criticism. Please read to the bottom, when I get to the
complications faced by the CTU:
1. Kulldorff, early on in the interview, emphasizes age-specific
responses to COVID-19 and references a piece by him from April 2020.
What we know now, and didn't know then, were the after-effects on young
people who catch the virus, and the effects on so-called long-haulers.
These effects argue for the existing, cautious stay-at-home orders for
all, including young students, college-aged people, and those in their
twenties and thirties. We are still learning the parameters of this
disease. It may be true that those under 50 and without underlying
conditions are unlikely to die from COVID-19, but widespread, long-term
health effects from those "recovered" may be just as damaging to the
populace and the economy. Katherine Yih refers to these long-term
effects in her responses. Kulldorff is wrong to emphasize that children
and young adults have "minimal risks." He should say unknown but fewer
risks (i.e., non-mortal) than those over 60 who contract this.
2. The answer to Yih's point about being locked down is testing and
contact tracing, not focusing on the potential unreliability of
vaccines. We now possess fast-turnaround tests (the IL and Yale saliva
tests), which enable quick quarantines for individuals. Those tests
should be made widespread. That is a medically-oriented approach that is
historically tested and proven (i.e., contact tracing and isolation).
3. The answer to the effects on the working-class is a generous,
pandemic-focused Universal Basic Income. That enables people to stay
home, and minimizes the massive inequalities that have continued
unabated through the pandemic. That extra income would enable
flexibilities to see young children through the pandemic with one or
more parents available.
4. Kulldorff's advocacy for herd immunity is absolutely dangerous. It
should not be a medical focus, but rather a "happy" accident that occurs
when viable, equitable medical interventions fail or run out. What has
happened in Sweden should be a cautionary tale for all who think the
herd immunity strategy is viable in countries with significant
populations over the age of 60. Yes, the article addresses Sweden, but
not in as detailed a fashion as it deserves. Lots of elderly people died
in Sweden. Kulldorff is right, however, when Kulldorff says the question
is how to get there with minimal casualties. The answers are testing,
contact tracing, universal health insurance, and pandemic-related UBI
until a viable vaccine is ready for all.
5. This article, strangely for Jacobin, actually concedes too much to
our current landscape and conditions---meaning of authoritarian,
unchecked, and minimally-regulated capitalism in the United States
versus the science of medicine and public health. I can't believe UBI
and universal healthcare are not emphasized herein!
6. Neither Yih nor Kulldorff address the very real and ethical question
of how many people they are willing to sacrifice, or to let be subject
to long-term complications, to reach herd immunity. 1? 100? 1000? 10000?
100000? How many aged people were sacrificed in Sweden?
7. Regarding Sweden generally, you must look at those mortality and
casualty numbers per capita, not absolutely. You also have to look at
Sweden's healthcare infrastructure, general mental health incoming to
the pandemic, and culture of mutual support. One must extrapolate very
cautiously from Sweden. Kulldorff eventually gets to this point when the
conversation turns to Denmark, Finland, and Norway.
8. In relation to secondary and tertiary effects in terms of
non-COVID-19 illnesses (cancer, heart disease, immunizations, dental
care, etc.), the answer again is universal healthcare and UBI. Young
people need and benefit from quick, early treatment---enabled by a
robust testing and contact tracing regime. A solid universal healthcare
system would enable, perhaps, the prevention of young from a severity of
infection that would cause the emerging long-term health risks.
9. The disproportionate burden of COVID-19 has fallen on people of color
and the aged. The article is right to hammer this home. The Professional
Managerial Class has focused on protecting its assets (homes, families,
retirement accounts) rather than enabling universal services that would
enable a softer lockdown. The conservatism of the PMC has hurt our
disadvantaged communities. The PMC is the entity that doesn't want
extended health, welfare, and unemployment benefits. The selfishness of
healthy aged white people has helped enable the disproportionate burden.
10. The politicization of this crisis by our president has created and
fostered a COVID-19 culture war. This has dissolved any viable middle
way that would've given thought to at least temporary UBI and universal
healthcare measures, and undermined the testing and tracing regime. It's
not the Left-Right divide so much as a divide manufactured by our
autocratically-inclined president.
11. I agree that an age-targeted strategy can be viable, but only when
the young are well-protected as well from any kind of potential
widespread infection. We don't want to create a high-maintenance cohort
of recovered youth with potentially expensive, not-fully-known long-term
side-effects. Some medical "conservatism" on behalf of youth--even when
they don't want to be protected---is warranted.
12. Yih suggests that "progressives need to reject the unquestioning
lockdown approach." I would agree if I saw progressives accepting the
lockdown unquestioningly. I see by contrast, for instance, the centrist
yet mildly progressive IL Governor Pritzker talking about phases,
regions, and best-available science. This has enabled some (imperfect)
flexibility around the state. It is true that some businesses could've
been given more flexibility earlier, but the state also seems to want to
ramp up the rapid testing possibilities and contact tracing.
13. The two medical professionals interviewed here seem to underestimate
the complications of youthful asymptomatic spreaders, and the
difficulties of age separation in relation to social interactions.
Schools, for instance, are often led by older people who are susceptible
to more intense consequences from child super spreaders. Those teachers
then return to homes with their kids and maybe a susceptible relative.
There is a reason why Chicago's CTU, a champion of working-class parents
and social responsibility, has advocated for remote learning. It's
trying to protect its middle-class teachers as well as its working class
students and their parents. What of multi-generational homes, where aged
family members receive better care from family than they would at any
elder-care facility? The CTU operates in a diverse milieu, balancing
numerous interests for the good of all. It has been an advocate for
stay-at-home education and supported conservative, medically-informed
stay-at-home orders. I also feel certain that the CTU would champion UBI
and universal healthcare for all, to ease the pandemic-related burdens
of all.
We Need a Radically Different Approach to the Pandemic and Our Economy
as a Whole
<https://l.facebook.com/l.php?u=https%3A%2F%2Fjacobinmag.com%2F2020%2F09%2Fcovid-19-pandemic-economy-us-response-inequality%3Ffbclid%3DIwAR00BDoI03nLygDXr8JhyHKJy_Kz_2Y4uNRCdT_UhC3x_30E0XGgInvyk0s&h=AT3mm1gwsQYutmEjWaiXkgFKrM1Q1MjhZJCIvkGXZbFvczTks38QEt4k1EhMQBJs5qbBUz7z7Bcp2At-ya48Zh8INz0ESKaXYQc7WQwIfImsVovyzyAunnNDfWREn3Rd7G4bmeE&__tn__=H-R&c[0]=AT00LCsoCJ3YPheDvr7eYraNDggV4z6Ll32c-bS3nIRgiGHkAEhQdPcB7EJAvIeT9CwgB7HmtehVHF39_AIeZbEVb-Sihe9-3WOONlpAYQ9eYRr6pBlMoFqvwjHv_zv0k0zkcSXhsbqBXd6UG7Mumg>
JACOBINMAG.COM
We Need a Radically Different Approach to the Pandemic and Our Economy
as a Whole
We talk to two public health experts about America's COVID-19 response
and how poor households have borne a disproportionate share of the
pandemic's hardship. We need to urgently fight for a more just society.
<https://jacobinmag.com/2020/09/covid-19-pandemic-economy-us-response-inequality?fbclid=IwAR3EeRgHTgED2KKKe8nImtalb5IgjuIgnQ00x5f3nIRAiU2GNy-rg-cfB6U>
30Jay Arena, Thomas Weytsand28 others
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