by Jai Chavis
As COVID-19 cases and hospitalizations continue to increase and hospitals continue to be understaffed and overwhelmed by patients with coronavirus complications, it is clear that the pandemic is far from over. The recent flurry of reports says that at least three major pharmaceutical companies based in the US and UK have highly effective COVID-19 vaccines. While this is promising, we should have no illusions that the pandemic will be “solved” as soon as effective vaccines are mass-produced. Decades of cutbacks of hospital staff, consolidation of hospital conglomerates, lack of consistent and safe patient-to-staff ratios, and privatization and deregulation has left our healthcare infrastructure severely weakened and vulnerable to a major health crisis such as the COVID-19 pandemic.
It is not news to anyone that the Trump administration has failed to handle the crisis, for months pretending like it was nothing more than a bad flu that would go away on its own. But make no mistake, a Democratic president wouldn’t have done much better. Biden has finally revealed his plan for fighting the pandemic and it is limited to four main points: a 100 days long federal mask mandate, vaccinating 50 million Americans in his first 100 days of office, pushing for the majority of public schools to return to in-person learning, and convincing Congress to pass the $900 billion stimulus bill—which is less than half of the woefully inadequate CARES Act that went into effect in late March.
While we of course support vaccination, mask mandates, and economic relief for working people, the Biden administration’s proposed measures are not game-changing and will hardly make a dent in fighting the crisis triggered by COVID-19. None of this solves massive medical bills, the systemic lack of paid sick leave, understaffed hospitals and overworked healthcare workers, unemployment and underemployment, housing insecurity, and so many more systemic inequalities that this pandemic has exacerbated and laid bare. Biden’s push to reopen public schools further showcases that freeing up parents to go back to work is a higher priority than preventing the spread of COVID-19.
The issue at the heart of the COVID-19 crisis in the U.S. is not Trump, but capitalism, and its unwillingness and inability to plan beyond the shortsighted aims of profit. “Herd immunity,” presented by some politicians as a solution to the pandemic, is the peak of this profit over people ideology. The idea? Allow COVID-19 to spread freely until enough people have the virus—and presumably developed immunity to it—that it can no longer effectively spread throughout the population.
This is a pseudoscientific distortion of the concept of herd immunity, the idea that widespread vaccination (and therefore immunity) to a disease will prevent it from spreading to those who are unable to be vaccinated. Prior to the entry of effective vaccines, some politicians were seriously putting forward this “strategy” of allowing free spread of COVID-19 which—as we saw in Sweden—concedes that the death of millions of more people due to coronavirus are acceptable casualties in the eyes of the capitalist class.
This pandemic exposes more than ever the need for working people to break free from the logic of the capitalist free market, which has only mismanaged the crisis and allowed capitalists to continue to profit while millions of workers are losing friends and family members, facing exorbitant medical bills, unemployment and wage cuts, food insecurity, and foreclosure or eviction, among other social and economic problems. Instead of market “solutions” that have been and will remain woefully inadequate, we need democratic planning to contain COVID-19 and prepare ourselves for future pandemics.
The Vaccine Race
Pfizer, the first pharmaceutical company to get their vaccine approved for distribution, announced their preliminary vaccine results. They reported that their vaccine is approximately 90-95% effective at preventing acquisition of COVID-19. That may seem promising, but the vaccine has to be stored at -94o F (-70o C), which severely limits the extent it can be distributed since it requires far more planning and coordination to ensure vaccine doses don’t spoil.
For the most part, only research universities and university hospitals will be able to store the vaccine at such ultracold temperatures. Without a thorough plan for distribution, the Pfizer vaccine will be inaccessible to huge sections of the American population, especially those who live far from the institutions that can appropriately and efficiently store vaccine doses and those who do not have the time or resources to travel to those places. Pfizer claims to have a distribution plan, but they have already shown that they put profits over people’s lives. In 1996, Pfizer performed an illegal clinical trial on children during a meningitis outbreak in Nigeria, and in 2009, Pfizer and one of its subsidiaries received a $2.3 billion fine from the US government for fraudulent marketing of one of their drugs despite the FDA’s clearly stated safety concerns. This merely scratches the surface of an industry rife with examples of hyper-exploitation and extortionary policies.
We need a fighting movement to demand democratic public control over the distribution of vaccines! Otherwise, workers in rural and poor areas will face even more barriers to accessing the vaccine. To make matters worse, the rushed rollout of the Pfizer vaccine is shaping up to be a chaotic patchwork with huge differences in planning from state to state, lack of national, centralized coordination, and uncertainties about how many doses will actually be delivered and when. Simply having a vaccine that is easier to store in no way solves the crisis of vaccine distribution under capitalism.
Moderna and Oxford/AstraZeneca have announced more stable and more effective vaccines, but simply having the technology necessary to “end” the pandemic in no way ensures that it will be used effectively and distributed equitably throughout the world. In fact, this is certain to not be the case; the European Union, the U.S., and other high-income countries are already reserving billions of doses of COVID-19 vaccines for themselves, leaving poorer countries struggling to deal with the coronavirus in the lurch. The Duke Global Health Innovation Center has predicted that many low-income countries won’t have adequate access to COVID-19 vaccines until 2023 or 2024!
Several pharmaceutical companies have claimed that they will set aside their usual profit-driven mindset until the COVID-19 pandemic subsides—but it is intentionally left vague how much the situation has to improve before these corporations revert to their profiteering ways. We should in no way take corporations at their word about this. These companies could demand further government subsidies to move forward with production (effectively holding the vaccine hostage), refuse to sell the vaccine doses at a loss (or even just at cost), or decide that the pandemic has “ended” when only a fraction of the population has been vaccinated. As of now, Moderna and Pfizer have made absolutely no promises to keep prices low if and when COVID-19 resurges in the future. Some pharmaceutical executives have hinted at their real intentions, such as Albert Bourla, Pfizer’s CEO, who admitted the company “will make a very, very marginal profit at this stage.”
Vaccines Are Not Enough
The complications of the vaccine roll out extend beyond just distribution and profit, though. It could in fact exacerbate the crisis if not handled with care. The side effects of the Pfizer vaccine, and likely other vaccines as well, are not major but they are certainly significant and could even result in lost days of work due to fatigue and mild to moderate muscle aches. The CDC, NIH, and other governmental institutions will need to develop clear explanations of side effects, the effectiveness of the vaccine, and the potential need for booster shot(s).
Equally important, to our knowledge, none of the COVID-19 vaccines have been tested for their ability to prevent a vaccinated individual from spreading the disease if they happen to come into contact with it, only for preventing the vaccinated person from getting sick. It is entirely possible that you can remain an asymptomatic carrier even if vaccinated—a fact which many of the enthusiastic press releases leave out. Clear, evidence-based guidance around vaccines is absolutely crucial to prepare people for the mild to moderate flu-like symptoms that the COVID-19 vaccines could cause and pre-empt the further confusion and fear that this could cause. It is crucial for the public to understand that vaccination does not necessarily mean an immediate end to pandemic-related restrictions. The past few months, however, give little confidence that the U.S. government is remotely prepared to handle these crucial public health tasks.
Now more than ever, we as working people must ask ourselves why life-saving pharmaceuticals, medical technologies, health insurance, hospitals, and healthcare in general are overwhelmingly run by for-profit companies. These companies, especially the pharmaceutical industry, have massive amounts of influence over politics and effectively decide which diseases are worth researching and developing drugs for, all on the basis of maximizing profit. These corporations routinely walk all over toothless “regulatory” bodies like the Food and Drug Administration (FDA), which has to approve new drugs before they are allowed to go to market, and they extort millions of dollars from governmental funding bodies like the National Institutes of Health (NIH), which dump money into the private sector to fund medical advancements that are then owned privately.
The FDA decides whether drugs can go to market, but has no say in drug prices. This effectively allows corporations to fully exercise their short-term monopoly over the new drug and set the price at whatever they think they can get away with. While the NIH, and the broader U.S. Department of Health and Human Services (HHS) that the NIH falls under, does perform some independent research, its primary purpose is to funnel money into research of universities and corporations. For COVID-19 vaccine and antibody research alone, HHS has funneled over $11 billion of tax-payer funds into just 8 pharmaceutical companies, all of which are billion-dollar institutions that routinely profit off of workers’ suffering.
Contrary to the conventional wisdom of capitalism, the model of for-profit, competitive research actually holds back technological innovation all the time. When leading U.S. infectious disease experts recommended doing one big “master protocol” clinical trial that could test each of the emerging COVID-19 vaccines against each other to pool resources and determine which is actually the most effective, the major U.S. vaccine making companies rejected this idea in favor of separate trials that cannot test which vaccine is the most effective. Why? Because the “master protocol” is a massive business risk that could reveal the fact that their vaccine is just not as effective as another company’s, putting their profits in jeopardy. Even during a pandemic, the logic of capitalism continues to undermine innovation of the best possible drug purely so corporate executives can further line their own pockets.
The Need for Socialist Planning
Capitalism’s chaotic and short-sighted focus on the profits of a privileged few—maintained even while a historic pandemic rages on—perfectly showcases the need to abolish the entire capitalist system. We must take major pharmaceutical corporations, hospital conglomerates, health insurance companies, and medical manufacturing companies into public ownership. However, public ownership is not enough. These companies need to be run democratically by working people in the interest of the majority of society rather than in the interest of the profits of the ultra-rich.
A publicly owned, collective, and democratic approach to biomedical research would facilitate widespread cooperation and pooling of resources, the ability to perform comprehensive clinical trials that can determine the most effective version of treatments, and allow for the sharing of ideas and expertise across research teams throughout the country—all things that are constantly thwarted by capitalism’s competitive, profit-driven model of biomedical research. At the same time, we could develop a national and international public infrastructure for mass manufacturing of medical technology, including the mass distribution of vaccines. Free from austerity and hoarded wealth, a democratically controlled and planned healthcare system could control drug prices and make the vast majority of medical procedures and healthcare free! This must be paid for by increased taxation on the corporations and the rich and cutting the bloated defense budget that is utterly wasted on researching new means of mass destruction while workers are dying prematurely of preventable and treatable diseases.
The Need for Socialism
Under a socialist planned economy, all implemented plans and decisions would be open to public scrutiny and allow for democratic participation by working people. Together, we could develop a coherent plan to defeat the virus using vaccination, universal free healthcare, reinstating laid off healthcare workers and ending understaffing of hospitals, programs that pay people to stay home to prevent spread, contact tracing, robust quarantine and isolation protocols, full compensation of lost wages due to vaccine side effects or quarantine, creating jobs programs and increasing unemployment benefits, extending the moratorium on evictions and foreclosures, effective and consistent public health messaging, and establishing genuine trust and goodwill in the government’s response because it is made by the democratic decision-making of workers and their accountable representatives rather than by rich bureaucrats and elites seeking to enrich themselves.
As our co-thinkers in the Committee for a Worker’s International put it so eloquently:
Instead of giant pharmaceutical corporations researching copycat drugs of existing money-spinners, treatments to cure many illnesses that afflict the poorest of the world could be found.
Instead of squandering huge sums of money and scientific talent on researching agribusiness and food products that damage our health, similar efforts could be used to grow and produce sustainable and nutritious food for all.
And instead of pouring billions into researching armaments that destroy life, the money and skills could be redirected to mitigating and reversing pollution and [Climate Change].
Socialism, with democratic, working-class control of publicly owned industries, would enable planning of resources for need, not profit. The rapid development of Covid-19 vaccines gives a glimpse of the possibilities of planning to meet needs.