Contact tracing and capitalism’s response to the pandemic
27 June 2020
Less than three months ago, on April 2, the world marked one million cases of COVID-19. Before the end of June, the globe will have surpassed ten million cases of COVID-19. The World Health Organization repeated their warnings this week that the pandemic is accelerating, and it is time “to double down” on the basic tenets of public health measure—test broadly, trace every contact of those infected, isolate and treat every infected individual, and protect the most vulnerable. This requires initiative on the part of every level of government to work closely with all communities to engage everyone in the fight to contain the spread of the infection.
Dr. Anthony Fauci, during a House committee hearing last Tuesday, explained that the United States is experiencing a “disturbing” rise in cases in states that rushed to reopen quickly with little foresight into how they would provide adequate testing of infected individuals and trace their contacts in a concerted effort to take advantage of the gains made by the shutdowns this spring. In response to questions from the panel, Dr. Fauci said, “The next couple of weeks are going to be critical in our ability to address those surges we see in Florida, Texas, Arizona, and other states.” He also added that deaths usually lag, and it would be essential to watch this trend.
In the United States, there has never been a serious attempt to contain the pandemic. This has characterized every step, from the abysmal false starts in testing, the chronic shortage of PPE, the trillion-dollar CARES Act and other initiatives that enriched corporations, the launching of a phased intervention to open the economy, all accompanied by the cartoonish clowning and brazen lying of a bad circus show. All the while, the daily number of COVID-19 cases continued to rise unabated.
Last weekend on “Meet the Press,” Dr. Michael Osterholm, the director of the Center of Infectious Disease Research and Policy at the University of Minnesota, said succinctly, “I don’t think this is going to slow down. I’m not sure the influenza analogy applies anymore. I don’t think we’re going to see one, two, and three waves—I think we’re just going to see one very, very difficult forest fire of cases.”
New York City, the epicenter of the pandemic in the US in April and May, is attempting to proceed into the next phase of reopening. However, the city has hired only 3,000 contact tracers to facilitate the necessary public health measures to guard against the coronavirus’ resurgence. According to the New York Times, “only 35 percent of the 5,347 city residents who tested positive or were presumed positive for the coronavirus in the program’s first two weeks gave information about close contacts to tracers.” Despite the strides made by the city to reduce its daily case numbers, more than 300,000 people have returned to work this week while the city is very far from achieving World Health Organization standards on contact tracing and other public health measures.
Massachusetts was one of the first states in the US to begin a “comprehensive” contact tracing program. Yet, it continues to have difficulty reaching a substantial number of contacts by phone. The chief medical officer of Partners in Health, Dr. Joia Mukherjee, told Boston25 News, “We’d like to have a higher rate. We’re still missing 30 to 40 percent of the people who aren’t picking up the phone.” They have only hired about 1,000 contact tracers to supplement their public health department.
Louisiana has spent millions on contact tracing but is unable to get people to answer their phones, reaching less than 50 percent of infected people. Figures are similar in other states.
Austin, Texas, has seen hospital admissions increase by 90 percent since the end of May. According to the Austin Public Health department, admissions for COVID-19 to Travis county hospitals have nearly tripled averaging 25 to 30 per day. The ICU bed occupancy has risen 150 percent, and ventilator use is up 75 percent.
Dr. Mark Escott, Travis County’s Health Authority, explained to the local news media, KXAN, affiliated with NBC, that contact tracing efforts are proving to be ineffective. “When we look at the efficacy of contact tracing in other countries where it worked, that contact tracing happened when the places generally were shut down, when people weren’t moving around. That’s not what we’re doing here. Things have still opened, and we’re trying to contact trace at the same time we’re getting hundreds, or perhaps a thousand cases a day being reported. I’m not sure that’s going to give us what we need.”
Tom Frieden, the former director of the Centers for Disease Control and Prevention, told STAT News back in April, that once the US is passed the surge and in the suppression phase, using the usual military parlance, it would need an army of 300,000 people to battle and suppress the transmission of the virus effectively. Assuredly skeptical, he said, “until the federal response is more coherent, each state is going to be on its own.” Dr. Robert Redfield, Director of the CDC, told Congress on Tuesday, as of June 23, 2020, the United States has about 28,000 contact tracers. This is an increase from only 6,000 in January, but far short of the number cited by Frieden.
Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, said about contact tracing, “This is going to test the capacity of the existing public health system. I don’t know if we have enough staff in the public health department to do that.”
It should be clear that the lack of a large cadre of contact tracers is not an oversight. With massive funding available to police departments and free cash infused into the markets, this is part and parcel of the herd immunity policy.
Comparing countries that have adopted more stringent public health measures and those that chose a policy of herd immunity is instructive. South Korea and Germany (very belatedly) have carried out extensive testing of their population, as the ratio of number tested to positive cases detected is above 100. Meanwhile, Sweden and the United States have, despite claims by the Trump administration, been running near or below ten tests per positive case. The implication here is that there is insufficient testing being conducted.
Without a robust, comprehensive strategy, both Sweden and the United States have suffered staggering daily new confirmed cases per capita, higher case fatality rates, and atrocious per capita daily confirmed deaths. Fundamentally, behind Sweden’s strategy of herdiImmunity is not the well-being of its nursing home populations nor concerns for the mental health of the children but concerns over its gross domestic product, which is expected to decline 5 percent this year, according to the Financial Times. Last week, Reuters announced that truck and construction equipment maker, Volvo, “plans to cut its white-collar workforce by around 4,100 positions.” Unemployment is estimated to reach 12 percent.
CNBC reported that Germany’s industrial production fell 17.9 percent in April during the peak of the pandemic in Europe, “the largest decline since the beginning of the time series in January 1991”, and this despite a less severe epidemic than in Italy, France, and the United Kingdom. Carsten Brzeski, global head of macroeconomics at ING, was, however, optimistic about a strong rebound when the lockdowns were lifted, while admitting, “the period after the imminent rebound does not look too promising.” Germany’s woes may be compounded by recent reports that the rates of infections have been rising since opening with the reproduction rate (R0) jumping to 2.88 this week. A number under 1.0 indicates declining numbers. Last week, 1,300 workers at a meat processing house in North-Rhine Westphalia tested positive.
South Korea faces similar economic hardships despite its massive mobilization to flatten the outbreak that emerged in February. Asia’s fourth-largest economy recorded its most severe contraction since the global financial crisis of 2008. The first quarter saw its economy shrink 1.4 percent. Exports had decreased by two percent, and consumer spending fell more than six percent. Economists have forecasted their economy will contract six percent in the second quarter. The World Bank projects that advanced economies overall will decline by seven percent.
The United States also saw real GDP decline by 5.0 percent in the first quarter of 2020, according to estimates released by the Bureau of Economic Research. Over 40 million Americans filed for unemployment. This must be placed in the context that the bottom 90 percent, due to chronic wage stagnation, have for nearly four decades spent more than they earn to get by. The pandemic has only exposed the massive poverty that underlies the astronomical wealth possessed by the financial oligarchs, exemplified by the miles of cars waiting at food distribution centers throughout the country.
Nations pursuing a policy of herd immunity will not escape the impact and devastation on their national economies as every market is deeply entrenched in an integrated network of interconnected economies that span every square inch of the planet. Fundamentally, the “herd immunity” policy highlights the utter disregard for life and prosperity of working people as they attempt to forestall the collapse of the financial markets while culling the excess population to ensure production lines stay in motion.
Every nation faces the pressures imposed by capitalism to quicken the forced contamination. As the pandemic accelerates, the term used by the Director-General of the WHO “a dangerous phase” acquires a more significant meaning.