U.S. situation

U.S. system in shudders

Print edition : April 24, 2020

President Donald Trump holding a five-minute test for COVID-19 from Abbott Laboratories during the daily briefing on the novel coronavirus, in the Rose Garden of the White House on March 30. Photo: MANDEL NGAN/AFP

The U.S. Navy’s hospital ship Mercy arriving at the Port of Los Angeles in Los Angeles, California, on March 27. The ship will provide an overflow facility for LA County hospitals and will treat urgent care patients, although not COVID-19 victims. Photo: Tim Rue/Bloomberg

People receiving food at My Brother’s Table soup kitchen in Lynn, Massachusetts, on March 30. The kitchen, which serves an average of 600 meals a day, helps the homeless and anyone in need. It is serving bagged meals as people are not allowed to inside the premises because of the pandemic. Photo: Joseph Prezioso/AFP

The U.S. now has the highest number of people infected with the coronavirus, and its mostly privatised health care system is struggling to cope, but there is no appetite in the Trump administration to set up an international cooperative process to come up with a cure.

ON March 28, the United States declared that the number of people who tested positive for the novel coronavirus infection was above 100,000. In that moment, it became the country with the highest number of cases. What this means is that a large number of people with symptoms for the virus are going to their doctors or to hospitals, being tested and then being put into either self-isolation or into hospital isolation (depending on the severity of the symptoms). Many others are likely to have been infected with the virus; they are either asymptomatic or have not been able to get tested. As the protocols for getting a test done in the U.S. are not easy to understand, it is doubtful if enough number of tests are done.

Preparation

New York City is the epicentre of the pandemic in the U.S. About half of the cases in the country have been detected in the city, which is, after all, a crossroads for the world. Hospitals in there are beginning to find that they do not have the capacity to deal with the onrush of cases, which is why emergency hospitals, such as the converted Jacob K. Javits Convention Centre, have been built and why New York Governor Andrew Cuomo has called upon city hospitals to increase capacity by 50 per cent. Comfort, the U.S. Navy’s hospital ship, will be docked in New York to provide additional hospital beds, while Mercy, its hospital ship, will be docked in Los Angeles harbour. A lack of basic medical supplies (masks for medical workers) and ventilators has sent the government scurrying to increase production. The lack of surge capacity has shocked the public, who now see that the country’s medical system was simply not prepared for the pandemic.

The U.S. government did not declare a national emergency until mid-March even though it had become clear by early February that this pandemic was serious and would impact the U.S. in a big way. President Donald Trump belittled the danger and suggested repeatedly that the country could not fall victim to the virus. When it did strike, he suggested that it would be over quickly. This lack of leadership in terms of preparation and in terms of education of the public produced uncertainty and worry. It was left to State Governors to begin preparations, although they simply did not have the resources available to them to tackle the scale of the pandemic. Nonetheless, over half the population told Gallup that they approved of Trump’s handling of the crisis.

What disturbed Trump far more than the threat of deaths was the casualty of the stock markets. In March, all the markets began to tumble as the virus crossed the Atlantic and the Pacific oceans. Hasty injections of capital from the government did not stop the fall. Already, U.S. stock markets have been grossly inflated, largely by government action to provide liquidity to investment banks and financial firms. Trump has long believed that the health of the stock market is a sufficient indicator of the fortunes of the economy. That is why he has over the years urged the Federal Reserve, the U.S. central bank, to unleash liquidity into the market and allow stocks to overvalue. A stock market correction has long been on the cards, although no one expected the drop to be so dramatic.

As the coronavirus went global, a series of unfortunate events took place damaging the confidence of money managers: the lack of an oil deal between Saudi Arabia and Russia, the massive shutdown of economic activity due to the coronavirus, and the uncertainty about when the coronavirus will come under control. Central banks, led by the Federal Reserve, dropped interest rates, while governments pledged massive amounts of money to mitigate the effects of the slowdown of economic activity. The U.S. Congress led the way with a $2.2 trillion package, which provided funds for companies in short-term distress and cash transfers to unemployed workers. The number of people who filed for unemployment in the U.S. rose to record levels (over three million in one week). The downward slide in the markets slowed, with some recovery.

Trump sent an envoy, Victoria Coates, to Riyadh, in a bid to push the Saudis to make a deal with the Russians and allow oil prices to either stabilise or to rise. This would remove one of the uncertainties in the world of finance. It is easier to fix the oil prices than it is to develop a vaccine for coronavirus or to know when to sound the “all clear” siren. Trump threatened to end the lockdown by Easter, as if an American resurrection would be possible so swiftly. Until the number of cases levels off, it is unlikely that medical experts will tolerate a loosening of the guidelines. But the class of money seems far more interested in getting the sinews of economic activity back again than in overcoming the virus.

Resources

In Italy, the medical sector warned that as resources were overrun by patients, medical institutions would have to start making decisions about who to treat and who to let die. This was a shocking revelation from an advanced industrial society. The debate around “rationing” moved to the U.S., where the number of intensive care beds (96,000) and ventilators (62,000 with 12,700 in the Strategic National Stockpile) are far fewer than the anticipated requirements. An official in New York City said that as a consequence of shortages of intensive care beds and ventilators, city institutions might have to make “some very serious, difficult decisions”. In the U.S., where the health system is almost entirely privatised, hospitals are designed so that they do not have much surge capacity. Every bed must be full at any time so that each bed, considered a piece of real estate, is making money for the private investor in the hospital. There is no way to plan for an emergency such as a global pandemic in this sort of private-sector-driven health care system. That is why the question of “difficult decisions” arises. Trump hastily invoked an archaic law that allows him to compel private industrial firms to make specific equipment; in this case, he demanded that General Motors mass produce ventilators.

No let-up in sanctions & bombing

By habit, in the midst of the global pandemic, the U.S. government hardened sanctions against Iran and Venezuela, forced the International Monetary Fund to not assist Iran and Venezuela with emergency funds, and indicted many leaders of the Venezuelan government for narco-trafficking. The Trump administration scoffed at the United Nations Secretary-General’s call for a global ceasefire on war; its aircraft bombed Iraq.

Routines of profit-seeking that look at solutions to problems through the private sector have driven the U.S. administration, and its European allies, in the hunt for a vaccine. That China used various older remedies and the 39-year-old Cuban drug Interferon Alpha-2B to treat its infected population was of no consequence. The U.S. administration egged on its private pharmaceutical sector, and even tried to bribe a German company, to find a “cure”; this cure will then be patented and sold for large profits around the world or, at least, that is the dream. An alternative to this approach would be to set up an international cooperative process to use the experience in East Asia, the medical innovations in China and Cuba, and the expertise of corporate pharmaceutical companies and universities to come up with an international cure to a global pandemic. But there is no appetite in the Trump administration, given as it is to the old ways of belligerence and domination, for such a humane and necessary approach. The corona shock continues to manifest itself in every corner of the planet; the old system shudders before it.

A letter from the Editor


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