THINGS WE ARE LEARNING
“The question today is whether we can learn something from coronavirus that might not only help us mitigate the harm of this pandemic, but build a new infrastructure of care that allows us to better protect the most vulnerable — and us all.”
Gregg Gonsalves, Yale epidemiology professor and Amy Kapczynski, Yale Law School professor.
We are learning – or should be learning – some important lessons from the pandemic sweeping the country. This tragedy shows how fragile and vulnerable we are as a society. We are finding out that many of our social structures are inadequate, broken, or not structured to meet the needs of people. Despite our national obsession with “security,” we are learning we were very unprepared to handle a predictable crisis.
Because we were not prepared and did not have the necessary, adequately funded, public infrastructures, our reaction to this medical emergency has been slow and chaotic. There needed to be robust testing, tracking, and effective quarantine actions. There needed be consistent, accurate information and coordinated measures taken to contain the spread of the disease. We need a better healthcare system focused on care and not profit. We have multiple federal, state, and local health authorities, but many are understaffed and underfunded. We have a maze of private, public, for profit, non-profit, good quality, mediocre, and non-existent healthcare. So, while other countries moved forward with sensible containment efforts, we debated who was going to pay for what, who was responsible, who’s information was correct, and what needed be done. While confusion spread so did the virus.
The most important defense against a pandemic is for everyone to have access to healthcare. But 27 million Americans have no health insurance. Four out of 10 people have insurance with very high deductibles. Many of the 30 million people laid off because pandemic lost their health insurance. Connecting healthcare to employment is stupid. As a result, many people who got sick did not get the care they needed. Nor were they tested or quarantined effectively. Many “essential” workers went to work sick spreading the disease. Add to this the many healthy, asymptomatic disease carriers and you have a mess. Having a good, universal healthcare system doesn’t make a country immune to pandemics. But it does provide the needed infrastructure – in place and ready to go – to slow the spread of the disease.
Paid sick leave is another critical need for combating a pandemic. But in America 25% of private sector employees have NO paid sick leave. Seventy percent of lower wage workers lack this essential benefit. There is no consistency in these programs nor are many adequate for people’s needs. This means 32 million people must go to work sick or lose much needed income. Many jobs can’t be done online and do require public contact or travel. So, working sick increases risk to the public and to co-workers. Not having a modern system of universal paid sick leave or family medical leave helped the virus to spread.
We are learning there are many “essential” workers. All the talk about “closing” the economy is misleading. Much of the economy had to stay open. It wasn’t just the medical professionals and grocery clerks that had to continue working. Nor was it the CEO’s and hedge fund managers that were essential. We have learned again that it is the unseen, often poorly paid, grunt work that actually keeps society and the economy functioning. It is the delivery drivers, food factory food workers, store clerks, utility maintenance workers, mechanics, garbage collectors, unemployment processors, and postal employees and snow plow operators – to list just a few — that really matter. These folks don’t have the luxury to work from home. Nor are they appreciated or adequately compensated for the risks they face so the rest of us can “shelter-in-place.”
The pandemic is exposing the vulnerabilities of our economic system. The supposedly more “efficient” free market has exacerbated rather than solved many problems. Production and distribution decisions were based on profit rather than public health needs. We are learning that the just-in-time, worldwide supply chain leaves no flexibility to react quickly to increased needs. There is no inventory for essential goods. We are learning again that pharmaceutical companies are only driven by profit. We are learning that without good oversight, scammers and profiteers will take advantage of any disaster. Once again, the gambling casino called the stock market is destroying people’s savings. The first non-essential business to be closed should have been the speculative “markets.”
We are finding out that medical care is not a commodity like other consumer gadgets. A telling example is the lack of hospital beds needed to handle a pandemic. For-profit hospitals have cut capacity for more “efficiency” and to save costs. In 1975 the U.S. had 7,200 hospitals with 1.5 million beds. Now, with 100 million more people, we have 1700 fewer hospitals with 600,000 fewer beds. Again, there was no back up inventory because profit decisions trumped public health or emergency preparedness. Ironically, even during a medical emergency, for-profit hospitals and healthcare providers are laying off healthcare professionals. They are losing money from reductions in the highly lucrative business of non-essential procedures. Health care should be a public good and not a business.
The result of all this is some people overreacted while others denied the problems. Some heeded the warnings and calls for social distancing while others called it a hoax. The politicians reacted with poorly thought-out, but hugely expensive, emergency measures. Everyone with a lobbyist maneuvered to get a slice of the action. But the people who really needed help didn’t get what they needed. In attempting to “flatten the curve” some governors ordered a massive shut down of “non-essential” businesses, schools and social gatherings. This economically painful, sledge hammer approach may not have been necessary if testing, tracking, and effective quarantining had been in place. But lacking a coordinated, effective public health system in desperate times required desperate actions.
As the professors quoted above point out, we need to create a modern, sensible program of universal healthcare and economic safety nets. Will we learn from this pandemic? Or will we prematurely return to “normal,” exacerbate the problems, and fail to be prepared for the next disaster?