By Mike Shane
The COVID-19 pandemic threatens to kill 100,000 to 250,000 people or more in the U.S. As it sweeps across the country, exposing stark inequalities in many areas of social life, the deficiencies in the healthcare system and the Federal government’s lack of preparation in dealing with this crisis are exposed for all to see.
Recent news reports have revealed that African Americans experience a much higher COVID-19 infection and fatality rate than the general population. According to the Washington Post, as of April 6, 2020:
“African Americans made up 27 percent of the population in Milwaukee County, Wis., but 70 percent of its covid-19 deaths. In Chicago: 30 percent of the population but 69 percent of deaths. And in Louisiana, the disparity is 32 percent and 70 percent. A similar divide can be seen in Michigan, where African Americans make up 14 percent of the population and, as of last Friday, accounted for 40 percent of covid-19 deaths.”
There are several reasons for this disparity. African Americans are twice as likely as white counterparts to be uncovered by health insurance and have experienced a legacy of poverty, food insecurity, environmental racism and racism in general that leads to higher rates of pre-existing adverse health conditions. These pre-existing conditions include high blood pressure, obesity, chronic lung disease, asthma, heart disease and diabetes and increase the risk of serious illness and death from COVID-19.
Trump’s response is to refuse to reopen the enrollment period for Obamacare and to continue its efforts to repeal the Affordable Care Act in its entirety. As criticism over the failure of the Federal government to prepare for and respond to the novel coronavirus pandemic grows, the Trump administration is attempting to blame the government of China. First, he and his racist minions incorrectly described the virus as a “China” or “Wuhan” virus, using an unscientific term that has been rejected by the World Health Organization and other scientists and doctors. This racist verbiage spewing from the White House has resulted in over 1000 reports of racist incidents directed towards Asians in the Bay Area alone, according to the Facebook group, Crimes Against Asians. This was followed by a coordinated campaign accusing China of organizing cover-up and creating the global pandemic.
A cable from the U.S. National Security Council to the State Department on March 20, 2020, directed U.S. officials to accuse China of a cover-up and failure to act in a timely fashion. In a press conference that day U.S. Secretary of State Mike Pomeo stated,
“The Chinese government was the first to know of this risk to the world. And that puts a special obligation to make sure that data gets to our scientists, our professionals,”
This line of attack has been picked up by various U.S. based publications, with The Atlantic magazine accusing China of playing “a particularly harmful role in the current crisis, which began on its soil.” U.S. intelligence accuses China of underreporting the number of people infected and the number of deaths from COVID-19.
The correct reporting of the number of people infected and the number of fatalities is difficult to do and every country is struggling to get sufficient testing done in a timely manner. Diagnostic tests must be developed and mass produced so that people can be tested en masse. In a Feb. 24, 2020 article in JAMA, the Journal of the American Medical Association, two scientists from the Chinese Center for Disease Control and Prevention, Beijing, China, admitted:
“The total number of COVID-19 cases is likely higher due to inherent difficulties in identifying and counting mild and asymptomatic cases. Furthermore, the still-insufficient testing capacity for COVID-19 in China means that many suspected and clinically diagnosed cases are not yet counted.”
The article also discusses the CFR or case fatality rate, which is the ratio the number of deaths (numerator) to the total number of people infected (denominator). With insufficient testing, which is a problem across the world, the CFR denominator is uncertain. The Chinese CDC scientists continue,
“This uncertainty in the CFR may be reflected by the important difference between the CFR in Hubei (2.9%) compared with outside Hubei (0.4%). Nevertheless, all CFRs still need to be interpreted with caution and more research is required.”
In the U.S., in addition to huge uncertainty in the number of people infected (CFR denominator), reports have emerged of serious undercounting of the COVID-19 death toll (CFR numerator). According to an article in the New York Times, reporting on the undercounting of the death toll in the U.S,
“Hospital officials, doctors, public health experts and medical examiners say that official counts have failed to capture the true number of Americans dying in this pandemic. The undercount is a result of inconsistent protocols, limited resources and a patchwork of decision making from one state or county to the next.
“In many rural areas, coroners say they don’t have the tests they need to detect the disease. Doctors now believe that some deaths in February and early March, before the coronavirus reached epidemic levels in the United States, were likely misidentified as influenza or only described as pneumonia.
“In infectious outbreaks, public health experts say that under typical circumstances it takes months or years to compile data that is as accurate as possible on deaths. The reporting system during an epidemic of this scale is particularly strained.”
The incomplete reporting is not just a problem in the U.S. A website that tracks COVID-19 cases globally asserts,
“For many countries however, available data on testing is either incomplete or else completely unavailable. This makes it impossible for their citizens and for researchers to assess the extent and significance of their testing efforts.
“Our current knowledge of COVID-19 testing – and more importantly of the pandemic itself – would be greatly improved if all countries were able to report all the testing data available to them in the way shown by the best examples.”
Incredibly, the U.S. Department of Health and Human Services announced that effective April 10, 2020, the federal government will discontinue funding for coronavirus testing sites.
The facts regarding China show the opposite
The epidemic started on December 12, 2019 when the first patient was hospitalized in Wuhan, Hubei Province in central China with a pneumonia of unknown origins. Epidemiological investigations by Chinese experts have suggested that the outbreak was associated with a seafood market in Wuhan. The onset date of symptoms of the first patient, who did not visit the seafood market, was determined to be Dec. 1, 2019. “None of his family members developed fever or any respiratory symptoms. No epidemiological link was found between the first patient and later cases.” Additional research by scientists from China suggests that the SARS-CoV-2 may have originated in November 2019.
On the evening of Dec. 30, 2019, the Wuhan Municipal Health Commission issued an “urgent notice on the treatment of pneumonia of unknown cause” broadly over the internet. According to the International Society for Infectious Diseases website ProMED, the notice stated:
“All medical institutions should strengthen the management of outpatient and emergency departments, strictly implement the first-in-patient responsibility system, and find patients with unknown cause of pneumonia.”
Wuhan health officials announced that they were investigating the cause of an apparent pneumonia outbreak in the city of Wuhan that had sickened 27 people, and that 7 were in serious condition and the others were stable. They stated that the pneumonia appeared to be viral and the patients were in isolation.
WHO was notified on Dec. 31, 2019, “a pneumonia of unknown cause” had been detected in Wuhan and an announcement in English was posted online on Jan.5, 2020. On Jan. 1, 2020, WHO “set up the IMST (Incident Management Support Team) across the three levels of the organization: headquarters, regional headquarters and country level, putting the organization on an emergency footing for dealing with the outbreak.” (WHO Timeline – COVID-19)
Immediately, health officials in Hong Kong and Taiwan took note, and announced that they were closely monitoring the situation. Hong Kong officials went further and urged their people to wash hands frequently, wear a surgical mask if experiencing respiratory symptoms, and avoid work, school, or crowded spaces. On January 1, 2020, local authorities shutdown the Wuhan seafood market.
On Jan. 10, China shared the SAR-CoV-2 genetic sequence with scientists worldwide, a key step in developing a vaccine.
Scientists in the U.S. and around the world also took note and initiated research into the novel coronavirus. In an interview in the Texas Tribune, Associate Professor Jason McLellan at the University of Texas at Austin, described how his lab immediately began research on the novel coronavirus, “as soon as we knew that this virus was in China at the end of last December.” He described the importance of WHO’s call for international solidarity among researchers worldwide, including the sharing of data, findings, and materials, and the importance of collaboration.
McLellan’s lab was the first to produce a 3-D map the SARS-CoV-2 spike protein, which is very helpful to scientists researching vaccines against that virus.
Instead of responding in a scientific manner to the spread of SARS-CoV-2 in a collaborative manner as many countries have chosen to do, the U.S. government and big business media chose to weaponize the health crisis in order to attack China. The U.S. media charged that the Chinese government was silencing whistleblowers and focused on Dr. Li Wenlia, an ophthalmologist. He tragically died from Covid-19. The U.S. media maintained that he had been arrested for alerting the public about the novel coronavirus.
However, an article in the online news site, FAIR, pointed out that
“Li didn’t consider himself to be [a whistleblower], and didn’t want his December 30 posting in a private WeChat group to be shared with anyone else. Neither were Li and his colleagues “arrested,” as several sensationalist reports falsely claimed without issuing retractions, as the Wall Street Journal (2/7/20) did:
‘Dr. Li Wenliang was taken in by police and questioned after telling former classmates about a cluster of pneumonia cases. An earlier version of this article mistakenly said Dr. Li Wenliang had been arrested.’
“Li was told by the police on January 3 not to spread unverifiable rumors—after a screenshot was leaked on December 31—because false information could set off unnecessary panic during the Spring Festival (one of the busiest and most important holidays of the year), as at the time there had been no fatalities and no clear evidence of human-to-human transmission.”
Meanwhile in the U.S., Kenisa Barkai, a nurse at DMC Sinai-Grace Hospital in Detroit, was fired for sharing a 10-second video on her Facebook page showing the precautions she was taking to treat the first COVID-19 patient at the hospital. Medical workers on the frontline across the U.S. have been threatened with firing and actually fired for publicly discussing working conditions.
On Jan. 28, 2020, a senior WHO delegation led by the Director-General, Dr Tedros Adhanom Ghebreyesus, travelled to Beijing to meet President Xi Jinping and China’s leadership, in order to learn more about China’s response, and to offer any technical assistance. A WHO press release stated,
“The two sides agreed that WHO will send international experts to visit China as soon as possible to work with Chinese counterparts on increasing understanding of the outbreak to guide global response efforts.
“’Stopping the spread of this virus both in China and globally is WHO’s highest priority,’ said Dr Tedros. ‘We appreciate the seriousness with which China is taking this outbreak, especially the commitment from top leadership, and the transparency they have demonstrated, including sharing data and genetic sequence of the virus. WHO is working closely with the government on measures to understand the virus and limit transmission. WHO will keep working side-by-side with China and all other countries to protect health and keep people safe.’”
On Jan. 30, 2020, the WHO Director-General declared that the outbreak constituted a Public Health Emergency of International Concern.
From February 11-12, WHO convened a Research and Innovation Forum on COVID-19, attended by more than 300 scientists, public health agencies, ministries of health and research funders from around the world. Presentations were made by George Gao, Director General of China CDC, and Zunyou Wu, China CDC’s chief epidemiologist.
“This is not a meeting about politics or money. This is a meeting about science,” Dr Tedros Adhanom Ghebreyesus stated.
“There is still so much we don’t know….We need your collective knowledge, insight and experience to answer the questions we don’t have answers to, and to identify the questions we may not even realize we need to ask.”
China’s early warning system
In 1949, when the People’s Republic of China was established, infectious disease was the second most common cause of death. In response, a system for disease surveillance and monitoring, now known as the National Notifiable Disease Surveillance System (NNDSS) was developed over time and the Chinese government invested heavily to control and prevent infectious diseases.
The novel coronavirus that causes COVID-19 is also known as SARS-CoV-2. It is the seventh coronavirus known to infect humans. SARS-CoV, MERS-CoV and SARS-CoV-2 can cause severe disease and death, while the other four are associated with mild symptoms and the common cold. Two large-scale coronavirus epidemics occurred over the past two decades, SARS in 2002-2003, initiated in Guangdong Province, China, and Middle East respiratory syndrome (MERS) in 2012, initiated in Saudi Arabia. The MERS epidemic is considered ongoing.
In response to the SARS epidemic of 2002-2003, China improved its capacity to respond to epidemics by moving to an internet-based real-time reporting, among other improvements. The figure below illustrates the improvement since 2003:
While critics claim that the Chinese government did not follow its own policy for epidemic response, such charges serve to distract attention from the U.S. failure to have any policy at all. In 2018, the White House office responsible for coordinating a pandemic response was shut down by the Trump administration.
There has been over 30 years of collaboration between the U.S. CDC and the China CDC, where China permitted the U.S. CDC to embed scientific experts in its CDC. In July 2019, after a funding cut, Dr. Linda Quick, an epidemiologist embedded in China CDC returned to the U.S. The funding cut was due in part to the trade war that Trump initiated against China. Since 2017, the U.S. CDC delegation shrunk from 47 people down to 14 today. Losses included epidemiologists and other health professionals.
In addition, the National Science Foundation (NSF), the U.S. Agency for International Development (USAID), a global relief program which had a role in helping China monitor and respond to outbreaks, and the U.S. Department of Agriculture (USDA) animal disease monitoring program representatives were also removed from China.
It gets worse. In 2017, the Department of Homeland Security stopped maintaining pandemic computer models. These are the models that are run on a network of supercomputers at several national laboratories and simulate a pandemic and pandemic responses under varying scenarios. Impacts of a pandemic on infrastructure such as hospitals are studied.
According to a recent investigation by Politico magazine,
“One 2015 DHS report, based partly on data produced by NISAC, warned that America’s public and private health systems might ‘experience significant shortages in vaccines, antivirals, pharmaceuticals needed to treat secondary infections and complications, personal protective equipment (PPE), and medical equipment, including ventilators.’”
Computer models that simulate pandemics need data. And some of this data is obtained from Covid-19 tests which are in very short supply.
U.S. attacks China’s and also Cuba’s solidarity with the world
China is helping more than 100 countries worldwide to combat the epidemic. Shipments include personal protective equipment, ventilators, testing kits and medications. Aid to Cuba from China, however, was blocked by the unjust, arbitrary, and illegal blockade of Cuba.
China’s Alibaba Group, a huge capitalist organization based in China, has set up an online site, International Medical Expert Communication Center. The website states “We welcome more medical professionals and medical institutions around the globe to join us and share invaluable real work experience. Let us work together to win this battle.” The website has published a guide, “Handbook of COVID-19 Prevention and Treatment” which is currently available in Chinese, English, Italian, French, Spanish, Japanese, German, Persian and Bahasa Indonesia and Arabic, with more translations becoming available on an ongoing basis.
Cuba, known across the world for providing medical assistance and training, has sent doctors and medics from the Henry Reeve International Medical Brigade to 16 countries thus far to assist in the fight against the pandemic. More than 850 Cuba medical workers have been sent abroad. This is in addition to the 28,000 medical professionals who were already in 60 countries.
Santiago Badia, general secretary of Cuba’s Health Workers Union, said 45 countries have so far asked the Caribbean nation for support in the face of the coronavirus epidemic. “Over half a million Cuban health professionals have expressed their readiness to assist, if necessary, nations hit by COVID-19,” he said.
The answer to the global pandemic is not the weaponization of the COVID-19 disease response as U.S. imperialism seeks to achieve. The answer lies in the solidarity among frontline and essential workers, and solidarity between nations as exemplified by China and Cuba, as working and oppressed people around the world unite to contain and ultimately defeat the novel coronavirus.