Why healthcare workers are quitting in droves

‘About one in five health-care workers has left their job since the pandemic started. This is their story—and the story of those left behind...

‘Health-care workers aren't quitting because they can’t handle their jobs. They’re quitting because they can’t handle being unable to do their jobs. Even before COVID-19, many of them struggled to bridge the gap between the noble ideals of their profession and the realities of its business. The pandemic simply pushed them past the limits of that compromise...

‘Several health-care workers told me that, amid the most grueling working conditions of their careers, their hospitals cut salaries, reduced benefits, and canceled raises; forced staff to work more shifts with longer hours; offered trite wellness tips, such as keeping gratitude journals, while denying paid time off or reduced hours; failed to provide adequate personal protective equipment; and downplayed the severity of their experiences.’

Read here (The Atlantic, Nov 16, 2021)

Underfunded and under threat

‘At least 29 US states have passed laws, enacted other initiatives, or succeeded in lawsuits that permanently weaken state and local government authority to protect public health, and similar efforts are pending in multiple other states. The analysis was published by Kaiser Health News and the Associated Press as part of their ongoing series “Underfunded and Under Threat,” which examines how US public health systems were unprepared to confront the COVID-19 pandemic and face ongoing politicization, funding cuts, and other hindrances. Legislators in at least 16 states have limited public health authorities’ ability to issue mask mandates or quarantines or isolation orders, and in some cases, legislatures gave themselves that authority or shifted it to other elected officials. In at least 17 states, lawmakers passed legislation banning SARS-CoV-2 vaccine mandates or passports or facilitated opt-out options. And in at least 14 states, new laws, executive orders, or court rulings ban or limit mask mandates. 

‘Proponents of the new measures argue that they are a necessary check on executive powers, particularly for appointed officials, and give lawmakers a voice in public health emergencies. Public health officials and experts have expressed frustration with these efforts and warned that the consequences of these actions will extend far beyond the current pandemic. These new limits could also impact public health officials’ ability to prevent and contain future outbreaks for any number of communicable diseases. At least 303 state and local public health department leaders have resigned, retired, or been fired during the pandemic, according to the analysis.’ Johns Hopkins Center for Health Security e-newsletter 

• Public health officials face wave of threats, pressure amid coronavirus response (June 12, 2020). Read here
• Pandemic backlash jeopardises public health powers, leaders (Dec 15, 2020). Read here
• Hollowed-out public health system faces more cuts amid virus (July 1, 2020). Read here
• Politics slows flow of US pandemic relief funds to public health agencies (August 17, 2020). Read here

Read here (KHN & AP, as at Sept 17, 2021)  

Privatised health services worsen pandemic

‘Decades of public health cuts have quietly taken a huge human toll, now even more pronounced with the pandemic. Austerity programmes, by the International Monetary Fund (IMF) and World Bank, have forced countries to cut public spending, including health provisioning.’

This story is well argued and contains several relevant and informative links under the following subheadings:

• ‘Government is the problem’
• Neoliberal reforms worse
• Unhealthy reforms
• Austerity kills
• Government not main problem

Read here (IPS News, Aug 24, 2021) 

Prioritising profits reversed health progress

‘Instead of a health system striving to provide universal healthcare, a fragmented, profit-driven market ‘non-system’ has emerged. The 1980s’ neo-liberal counter-revolution against the historic 1978 Alma-Ata Declaration is responsible.’

This story is well argued and contains several relevant and informative links under the following subheadings:

• Alma-Ata a big step forward
• Primary healthcare
• Lalonde Report turning point
• Neo-liberal ascendance
• Healthcare financing key
• Philanthropy rules

Read here (IPS News, Aug 24, 2021)

Put people before profits for progress

‘Millions of people are expected to die due to delayed and unaffordable access to COVID-19 tests, treatment, personal protective equipment and vaccines. Urgent cooperation is desperately needed to save lives and livelihoods for all.’

This story is well argued and contains several relevant and informative links under the following subheadings:

• Vaccine apartheid
• Pfizer profits
• What the pandemic demands
• Technology transfer needed
• What the world needs now

Read here (IPS News, May 18, 2021)

Covid in India: Missing facts, misdirected discourse

‘The current stentorian discourse sans facts, which shifts the blame on to the government for the supply chain failures of hospitals, misses a more critical fact. Anticipating a contingency like this, the Modi government had ordered 162 PSA plants at a cost of over Rs 200 crore in October last for government hospitals all over India. This could have produced 80,500 litres of medical oxygen per minute. This translates approximately to one ton of liquid oxygen per day per plant. 

‘But out of plants ordered for 162 hospitals, only 33 got installed. Why? Even state government hospitals thwarted the Centre’s plan for on-the-spot oxygen production facilities. The Print says, orders were placed in December but when vendors reached the hospitals for installation, many “faced resistance” from them, pretending “no space” — the real reason being vested interest to procure oxygen rather than generating the entire requirement onsite. This showed how advance planning for on-the-spot oxygen supply by the Centre was thwarted by even the state-run hospitals. In the contemporary shouting and counter shouting in the media and social media, has anyone heard about this farsighted move of the government, beyond the feeble voice of The Print?’

Read here (New Indian Express, Apr 27, 2021) 

‘We are witnessing a crime against humanity’: Arundhati Roy on India’s Covid catastrophe

‘As this epic catastrophe plays out on our Modi-aligned Indian television channels, you’ll notice how they all speak in one tutored voice. The “system” has collapsed, they say, again and again. The virus has overwhelmed India’s health care “system”.

‘The system has not collapsed. The “system” barely existed. The government – this one, as well as the Congress government that preceded it – deliberately dismantled what little medical infrastructure there was. This is what happens when a pandemic hits a country with an almost nonexistent public healthcare system. India spends about 1.25% of its gross domestic product on health, far lower than most countries in the world, even the poorest ones. Even that figure is thought to be inflated, because things that are important but do not strictly qualify as healthcare have been slipped into it. So the real figure is estimated to be more like 0.34%. The tragedy is that in this devastatingly poor country, as a 2016 Lancet study shows, 78% of the healthcare in urban areas and 71% in rural areas is now handled by the private sector. The resources that remain in the public sector are systematically siphoned into the private sector by a nexus of corrupt administrators and medical practitioners, corrupt referrals and insurance rackets.

‘Healthcare is a fundamental right. The private sector will not cater to starving, sick, dying people who don’t have money. This massive privatisation of India’s healthcare is a crime.’ 

Read here (The Guardian, Apr 28, 2021)

Covid-19 in India—profits before people

...‘In the interim, in a uniquely cynical strategy, the Modi government has passed the buck on vaccination to the states, without providing any funding—indeed making them pay higher prices. It has agreed with the private producers a pricing system whereby state governments already desperately short of finances and facing hard budget constraints will have to pay up to four times what the central government pays for the same vaccines...

Disaster capitalism: ‘The latest sign of this active encouragement of disaster capitalism by the Indian state is even more egregious. In the proposed opening up of vaccination to the 18-45 age group from May 1st, access is to be limited to private hospitals and clinics, and only on payment—with prices ranging from ₹1,200 to ₹2,400 (€13.25-€26.5) per dose! Obviously, the poor will be unable to afford the vaccines, and so the pandemic will rage on, the massive human suffering will continue and countless lives will be lost.’

Read here (Social Europe, Apr 27, 2021)

How do faithless people like me make sense of this past year of Covid?

‘Many of us yearn for meaning. But in our individualistic, secular society we lack even the flimsiest of narratives to guide us...

‘Long before Covid’s arrival, it was clear this was something too many people were losing touch with. Through decades of secularisation, cheered on by irreligious liberals, not nearly enough thought was ever given to what might take on the social roles of a church. The demise of the factory and the collectivised lives that went with it marked another loss. And now, long years of cuts have obliterated many of the shared spaces we had left, from libraries and Sure Starts to community centres.

‘The pandemic has shone unforgiving light on the consequences. A British Academy report on “the long-term societal impacts of Covid-19” found that the age group most likely to experience loneliness during the first lockdown was 16- to 24-year-olds. In the past decade, spending in England and Wales on youth services has been cut by 70%. As life after Covid unfolds, such choices will look not just reckless but downright cruel.

‘Three years ago, Anthony Costello – a former director of maternal and child health at the World Health Organization – published a book titled The Social Edge, focused on the so-called “sympathy groups” that sit between the state and the individual. “Religious or therapy groups have always offered solace and peace and relaxation and friendship,” he wrote. “They help us in our spiritual quest for meaning and wellbeing.” Church groups, choirs, sport and dance clubs, he went on, “bring harmony and relaxation to tired minds” and give people “a greater sense of being alive”.

‘Costello proposed using similar structures to tackle loneliness in old age, prisoner recidivism, “stress in motherhood” and much more. Now, in the context of Covid and its long-term social effects, this sounds like something millions of us might sooner or later need. Whatever our experiences, what we have all been through is huge. And as an act of post-pandemic healing, encouraging the growth of such initiatives would surely not be too hard. Fund and create public spaces – parks, halls, arts venues, meeting rooms – and revive the most grassroots aspects of local government, and you would create roughly the right conditions.’

Read here (The Guardian, Mar 28, 2021)

Cuban socialist internationalist medicine puts capitalist countries to shame: Black Agenda Radio with Margaret Kimberley and Glen Ford

‘So few of its own citizens have [died from] Covid-19 – less than 300 — that Cuba must test its vaccines in other countries, said Dr Layla Brown-Vincent, professor of Africana Studies at the University of Massachusetts at Boston and author of “The Pandemic of Racial Capitalism: Another World is Possible.” Cuba “is helping control this global pandemic in ways that none of the capitalist countries attempt to do,” said Brown-Vincent.’

Listen here (Defend Democracy Press, Mar 22, 2021)

Fighting the medical monopoly: Mobilising for Zero-Covid and decommodified healthcare

‘As I have discussed in an article on Interferon 2b and Cuba’s other treatments for COVID-19, decommodified universal healthcare is the alternative to monopoly-driven healthcare ravaging countries around the globe. Not for profit production and delivery of all health related goods responding to general and specific human needs of the majority of any given country is the only means to assure quality health for all, in pandemic as well as non-pandemic times.

‘More concretely, decommodified universal healthcare is ecologically sound, public sector production of everything from food to psychological support, medicines to medical technology, and medical care. Rather than results based management and other corporate models adopted by most state owned enterprises globally in the past four decades, such public production would be designed and managed democratically by citizens, health professionals, scientists, and the range of other workers involved.

‘Taxation of corporations and rich individuals would be the primary means of financing decommodified universal healthcare. Due to the social importance of health related goods, and high employment potential given the extent of need in most countries around the globe, decommodified universal healthcare would constitute a significant segment of needs based, ecologically sound, nationally focused economies.’

Read here (The Bullet, Mar 4, 2021)

Neoliberal finance undermines poor countries’ recovery

‘After being undermined by decades of financial liberalisation, developing countries now are not only victims of vaccine imperialism, but also cannot count on much financial support as their COVID-19 recessions drag on due to global vaccine apartheid...

‘Undoubtedly, distressed developing countries desperately need foreign exchange to cope. But IMF Managing Director Kristalina Georgieva’s call to boost global liquidity with “a sizeable SDR” (Special Drawing Right) allocation was blocked by the Trump administration, who objected that it would give China, Iran, Russia, Syria and Venezuela access to new funds.

‘The Financial Times (FT) argues that the proposed new SDR1tn (US$1.37tn) issuance – almost five times the US$283bn issued in 2009 – is justified by the scale of the crisis. For the FT, it would be “the simplest and most effective way to get additional purchasing power into the hands of the countries that need it”...

‘With 85% of IMF votes required to issue new SDRs, and the US holding veto power with 16.5%, Biden administration support is vital. For SDR issuance under US$650 billion, the White House only needs to consult, rather than get approval from the US Congress.’

Read here (IPS News, Mar 1, 2021)

The pandemic has unmasked America’s deepest inequities: Covid’s disparate racial impacts, by the numbers

‘Covid-19 doesn’t discriminate, but the havoc wrought by the virus—the deaths, economic devastation, and intergenerational trauma—has disproportionately affected Black, Latino, and Native American communities. The Trump administration’s feckless response didn’t help, yet even proactive steps have reinforced preexisting inequities: Stay-at-home orders protected people with the privilege to work remotely while frontline workers, disproportionately Black and Latino, took on greater risk of exposure. People of color have also experienced more unemployment and financial insecurity. As Mary Bassett, director of Harvard’s François-Xavier Bagnoud Center for Health and Human Rights, explains, none of this is caused by the virus itself: “It’s because of the social consequences of race in our society, which has been reinforced by decades, centuries of bad practices and policies.”

Read here (Mother Jones, Feb 12, 2021) 

Lancet editor says inequality and Covid-19 have converged to create a ‘syndemic’

‘In his new book "The COVID-19 Catastrophe: What's Gone Wrong and How to Stop It Happening Again," Dr. Richard Horton does more than trace the history of the COVID-19 pandemic and explain how we should listen to scientific experts in confronting this global scourge.

‘He does this, of course, but Horton is more ambitious than that. As editor-in-chief of "The Lancet" — one of the world's oldest, most famous and most prestigious medical journals — Horton has overseen the publication of countless articles on a variety of medical subjects. Hence, one can sense in his book a desire to apply the full breadth of his knowledge and experience to this problem. His conclusion is both fascinating and extremely relevant, even urgent.

‘As Horton explains, the COVID-19 pandemic was unnecessarily worsened by deeper social problems, from economic policies that left millions upon millions of people especially vulnerable to Western governments who made political assumptions about the virus that proved to be gravely mistaken. Speaking with Salon, Horton discussed everything from President Donald Trump's failure to address the pandemic (as well as President Joe Biden's early successes) to an intriguing thought experiment on what would have happened if the governments the world could have simply paid people to stay home.’

Read here (Salon, Feb 6, 2021)

The governance of Covid-19: Anthropogenic risk, evolutionary learning, and the future of the social state

‘We consider the implications of the Covid-19 crisis for the theory and practice of governance. We define ‘governance’ as the process through which, in the case of a given entity or polity, resources are allocated, decisions made and policies implemented, with a view to ensuring the effectiveness of its operations in the face of risks in its environment. Core to this, we argue, is the organisation of knowledge through public institutions, including the legal system. Covid-19 poses a particular type of ‘Anthropogenic’ risk, which arises when organised human activity triggers feedback effects from the natural environment. As such it requires the concerted mobilisation of knowledge and a directed response from governments and international agencies. 

‘In this context, neoliberal theories and practices, which emphasise the self-adjusting properties of systems of governance in response to external shocks, are going to be put to the test. In states’ varied responses to Covid-19 to date, it is already possible to observe some trends. One of them is the widespread mischaracterisation of the measures taken to address the epidemic at the point of its emergence in the Chinese city of Wuhan in January and February 2020. 

‘Public health measures of this kind, rather than constituting a ‘state of exception’ in which legality is set aside, are informed by practices which originated in the welfare or social states of industrialised countries, and which were successful in achieving a ‘mortality revolution’ in the course of the nineteenth and twentieth centuries. Relearning this history would seem to be essential for the future control of pandemics and other Anthropogenic risks.’

Read here (NCBI, Dec 4, 2020)

Designing vaccines for people, not profits

‘The Covid-19 crisis is a perfect test of whether a more public-health-oriented approach to innovation and production will prevail in the years ahead. While Pfizer is sticking with the model of maximising shareholder value, AstraZeneca has at least pledged not to profit from its vaccine ‘during the pandemic.’ Yet, despite all the public investment that underwrote these innovations, the process will remain opaque, leaving one to wonder if AstraZeneca is actually ready to prioritise public health over profit and offer its vaccine at cost.

‘While the recent vaccine news has brought hope, it also has exposed the pharmaceutical industry’s broken business model, casting doubt on the prospects of delivering a people’s vaccine and achieving health for all. Business as usual may allow us to scrape by in this crisis. But there is a better way to do things. Before the next pandemic arrives, we must recognise vaccines as global health commons, and start to reorient the innovation system toward symbiotic public-private partnerships governed in the public interest.’

Read here (Social Europe, Dec 2, 2020)

Pandemic, ‘Great Reset’ and resistance

‘The Covid pandemic is a turning point, an opportunity to change. The reset we need now is not the creation of a ‘post-human, post-nature’ world defined by unregulated corporate-led growth of artificial intelligence and biotechnology. We need to balance digitalization and commoditization with an ecological reset, a way of living that respects the environment, promotes agroecology, bioregionalism and local communities. We need to raise our consciousness and understanding of humanity as a species in nature, our connectedness to each other and the rest of planetary life.’

Read here (IPS News, Dec 1, 2020)

United States: Beyond the wasteland -- New strategies for pivoting from the pandemic crisis to a recovery built on economic justice

‘Decades of falling wage shares mean that millions of households are ready to spend more if only they could earn more income. A well-calibrated recovery strategy that combines public spending on goods and services with regulation of predatory corporate behavior and effective redistribution can unleash a virtuous growth circle that improves living standards for the vast majority and strengthens government finances even as it generates resources to boost public services and tackle the environmental catastrophe.

‘Such a strategy would consist of the following elements:

• A prolonged fiscal expansion with immediate support to employment creation and social services, including a strong component in the care economy;
• Public-infrastructure investment to accelerate the energy transition by combining policies to encourage investments in renewables and discourage fossil fuel extraction;
• Policies to improve industrial capacity based on raising productivity and greater energy efficiency;
• Progressive tax reforms shifting the burden from indirect taxes such as sales and value-added taxes (which are regressive and discourage spending) to direct taxation, especially on high-income earners (whose consumption is relatively unaffected by taxation) and on corporate earnings and rents (with exemptions depending on employment creation).

Read here (The American Prospect, Nov 27, 2020)

Covid-19 has exposed the catastrophic impact of privatising vital services

‘The Covid-19 pandemic has exposed the catastrophic fallout of decades of global privatisation and market competition. When the pandemic hit, we saw hospitals being overwhelmed, caregivers forced to work with virtually no protective equipment, nursing homes turned into morgues, long queues to access tests, and schools struggling to connect with children confined to their homes. People were being urged to stay at home when many had no decent roof over their heads, no access to water and sanitation, and no social protection. 

‘For many years, vital public goods and services have been steadily outsourced to private companies. This has often resulted in inefficiency, corruption, dwindling quality, increasing costs and subsequent household debt, further marginalising poorer people and undermining the social value of basic needs like housing and water. We need a radical change in direction.’

Read here (The Guardian, Oct 19, 2020)

How the coronavirus pandemic exposed the dark side of Western democracy

‘A Lowy Institute report reviewing such trends [the systematic dismantling of science, expertise and rule of law] concluded that “the concept of a rules-based international order has been stripped of meaning, while liberalism faces its greatest crisis in decades”. If these writers and many more are correct that Western “democracies” have trashed core components of democracy, it is only fair to ask what Western statesmen mean when they castigate others for failing to adopt democracy...’

Read here (South China Morning Post, Oct 4, 2020)