Talk politics.

Writing about the politics of public health whilst we are the midst of a major global pandemic is a peculiar combination of churlishness and critical necessity. At the time of writing, there are 425,000 confirmed cases, and 19,000 deaths, and in a few days that number will double, and then double again, and then double again. It is worth remembering that the first 100,000 diagnoses took from December to March, the second from March 5 to 17, and the third from March 18 to 21, and the fourth from March 22 to 24. It is the single greatest health risk of this century, in part due to the relatively high rate of fatalities (approximately 4.1% of diagnosed cases), and significantly due to the relative ease of transmission. Most of all, however, the greatest risk is the effects of the ease of transmission and fatality rate combined, that is, how it overwhelms our health-care systems, which are woefully unprepared for an event such as this.

But it is not as if that the knowledge was not there. There have been plenty of warning signs, such the previous outbreaks of Severe Acute Respiratory Syndrome (SARS) in late 2002 to mid-2003, which is related to COVID-19, to the extent that academics warned of SARS as "an agent of emerging and reemerging infection". SARS had a fatality rate of 9.6% across 17 countries, with approximately 8,000 people infected. SARS was also highly infectious (R0 value of 2-4), but was successfully contained. Then in 2009, there was the Pandemic H1N1/09 virus ("swine flu"), which had a higher infection rate than seasonal influenza, and a similar fatality rate. In comparison Middle East Respiratory Syndrome (MERS), also a coronavirus, has a high fatality rate (36%) but a low transmission rate (R0 value of 0.3 to 0.8).

Recognising these rather impressive precursors, certain individuals also have tried to raise concerns. Michael Osterholm of the University of Minnesota, argued in 2005 that "Time is running out to prepare for the next pandemic. We must act now with decisiveness and purpose", and in 2017 had his book, "Deadliest Enemy: Our War Against Killer Germs" published. Virologist and flu expert Robert G. Webster warned of an upcoming 'flu pandemic, “Flu Hunter: Unlocking the secrets of a virus" late last year. The US Intelligence Team has warned about the possibility of a pandemic for years. Dr. Luciana Borio, once a member of the White House National Security Council (NSC) team responsible for pandemics, warned of pandemic threats; the team was disbanded under the Trump administration. Famously, Bill Gates argued in a TED talk in 2015, that we simply were not prepared.

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The System Kills

It is the system that is killing us. Yes, the direct cause is from a deadly infectious disease and part of that is, of course, the potential rate of transmission from a world that is a smaller place. But that could be managed with proper environmental considerations and animal welfare regulations in place. They are not in place because of the terrible levels of global inequality, the lack of social infrastructure in developing countries, and most of all because they would cost money. Our political economy is geared towards providing a race to the bottom in terms of value, and a race to the top for monopoly profits, which inevitably must be shared among fewer and fewer. Add to this either sensationalist private media which concerns itself more with shock value for sales rather than accuracy, and totalitarian media systems which have the facts at hand, but refuse to release them as to retain their social order, or engage in disruption through misinformation directed to more liberal societies. Managing the entire rotten edifice is the worst sort of political leaders whose concern for public welfare is demonstrably lacking in favour of their quest for perpetual power, manipulation of public opinion, and fulfilling their mission of their true masters. The irrational quest for the accumulation of power and wealth, at a cost of the lives of human and non-human animals, has reached the insanity that we witness today. The next pandemic, however, will be worse if these causes are not addressed; public health, media transparency, and the environment will not occur without smashing these accumulations in favour of more egalitarian power structures and a greater commonwealth. The warning has been given by this virus; and if the system does not show itself capable of reform, then revolution will be inevitable.