A COVID Charter, A Better World

A COVID Charter, a Better World

A COVID Charter, a Better World

Toby Miller

Rutgers University Press

New Brunswick, Camden, and Newark, New Jersey, and London

Library of Congress Cataloging-in-Publication Data

Names: Miller, Toby, 1958– author.

Title: A COVID charter, a better world / Toby Miller.

Description: New Brunswick : Rutgers University Press, [2021] | Includes bibliographical references and index.

Identifiers: LCCN 2020054572 | ISBN 9781978827455 (paperback) | ISBN 9781978827462 (hardcover) | ISBN 9781978827479 (epub) | ISBN 9781978827486 (mobi) | ISBN 9781978827493 (pdf)

Subjects: LCSH: COVID-19 (Disease)—Political aspects. | COVID-19 (Disease)—Social aspects. | COVID-19 (Disease)—Government policy. | Public health—International cooperation.

Classification: LCC RA644.C67 M55 2021 | DDC 362.1962/414—dc23

LC record available at https://​lccn.loc.gov/​2020054572

A British Cataloging-in-Publication record for this book is available from the British Library.

Copyright © 2021 by Toby Miller

All rights reserved

No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, or by any information storage and retrieval system, without written permission from the publisher. Please contact Rutgers University Press, 106 Somerset Street, New Brunswick, NJ 08901. The only exception to this prohibition is fair use as defined by U.S. copyright law.

www.rutgersuniversitypress.org

References to internet websites (URLs) were accurate at the time of writing. Neither the author nor Rutgers University Press is responsible for URLs that may have expired or changed since the manuscript was prepared.

Contents

Introduction: The Year of the Mask

Chapter 1. Before the Crisis

Chapter 2. During the Crisis

Chapter 3. After(?) the Crisis

Chapter 4. The Charter

Acknowledgments

Notes

References

Index

About the Author

Introduction

The Year of the Mask

Just as the past is written in its future, so the future is written in its past—aka our present. Just as many historians think of 1848 as the year of revolutions, 2020 was surely the year of the mask.

We stand at an epic moment in world history, akin to the transformations brought about by feudalism, plague, slavery, imperialism, colonialism, revolution, capitalism, socialism, urbanization, war, emancipation, industrialized meat, electricity generation, nationalism, the combustion engine, anesthesia, automation, antibiotics, electronics, nuclear power, decolonization, birth control, human and civil rights, feminism, globalization, and climate change.

We know this conjuncture matters a great deal—it feels distinctive—but that doesn’t make it easy to understand or to imagine what lies beyond. For COVID-19 weighs like an alp upon the brain of the living.¹ Only by confronting oligarchic and oligopolistic power, and their extension through deregulation and privatization, can we comprehend and successfully intervene as the conjuncture unfurls, chaotically and frighteningly, before us. The hope is that its contradictions may "‘fuse’ into a ruptural unity" and produce real and positive social change.² The question is whether those tendencies represent something organic and powerful or something contingent and passing, mere evanescent moments.³ I suspect they are more than that.

The pandemic is a limit case, an emergency of cosmic proportions that alerts us to the failings of the day, specifically in the elemental field of health. It throws into sharp relief the fault lines of inequality that divide the world both between and within sovereign states, compelling near-universal fear and suffering and raising a vital question: How should we reconstruct our societies, environments, cultures, and economies in the anticipated wake of the pandemic—a world after it? To find an answer, we need to examine the dominant discourse of public policy, and health care in particular, then lay out a comprehensive alternative. We need a COVID charter.

In search of such a thing, this wee volume looks at the opportunities, as well as the terrors, that present themselves. It examines corporate, scientific, activist, and governmental actions and perspectives and their impact, notably on disadvantaged, vulnerable communities, drawing on particular cases as well as the wider (im)balance of geopolitical power to consider how we got here, what is going on, and what might come next. Then it looks at various manifestos and charters to help form a new set of rights that could emerge from this otherwise sorry story.

The cases come from two wealthy countries (the United States and Britain) that were supposedly well prepared for such a pandemic but were devastated by it and two poorer nations (Mexico and Colombia) from the region that has been most affected. As of mid-January 2021, the Americas accounted for over half the world’s new infections and 45 percent of fatalities. This from nations that make up a tenth of the global population. Mexican deaths were up 19 percent in the previous week, and the United States was up by 20 percent. Colombia reported a 26 percent increase in contagion. With over four hundred thousand new infections and an uptick of 51 percent in fatalities, the United Kingdom fell behind only its craven gringo partner in the Anglo world.⁴

I have lived in these four places over the past three decades, serially experiencing excellent private health care in New York and LA, thanks to my employment; good public care in London, courtesy of my citizenship; and no work insurance or access to socialized medicine in Cartagena de Indias and Mexico City, as a consequence of being a damn foreigner.

Moving across the conceptual and geographical board, the chapters to come deploy the human sciences as grids of investigation, alongside a few personal stories. The agenda and mode of analysis derive from epidemiology, public health, political economy, sociology, literature, area studies, political theory, science, anthropology, environmental studies, philosophy, and history. I commingle these disciplines under the sign of a materialist analysis committed to progressive change.

That involves looking at structural determinations on people vis-à-vis/versus their agency and transformations in the natural world. As Marx put it, "Man [sic] makes his own history, but he does not make it out of the whole cloth; he does not make it out of conditions chosen by himself."⁵ Dominant forces secure consent to the political-economic order through a hegemony that makes prevailing social relations appear inevitable, with new norms propagated by emergent classes or co-opted by elites.⁶

That said, material manifestations of power do not simply accrete bourgeois dominance or state authority—consider life in schools, prisons, allotments, libraries, cafés, hospitals, laboratories, arenas, changing rooms, waste dumps, music festivals, mass transit, art galleries, beaches, leather bars, dormitories, railway sidings, dating sites, newsrooms, or asylums. They may be shaped by such power but also deviate from it quite radically.⁷

And hundreds of millions of people live and work in the Global South’s informal sector. Immensely underprivileged but economically very active, they neither contribute to taxation nor benefit from it. Rarely the targets or recipients of public policies, these workers ply their trade outside the purportedly prevailing norms of housing, nutrition, health care, savings, and education. That leaves them particularly vulnerable at times of crisis.⁸ Ironically, similar problems affect people laboring in the most formal sector of the economy—prisons. Although dominated by governments in their economic activity, they suffer in similar ways to the informal proletariat.⁹ Or consider the situation of women. Across history and geography, they have experienced pandemics as moments of increased caregiving, heightened male violence, and diminished economic security and decision-making.¹⁰

The problem with many logics applied to COVID-19 is their failure to address these huge populations as starting points. Instead, they are subsumed by the imagined middle-class rational calculator so beloved of neoliberalism and taken as its purported fons et origo. So as background, I sought to understand the pandemic experiences of workers, prisoners, refugees, women, racial and sexual minorities, children, migrants, the disabled, medical staff, and slave descendants—what they share and what is unique to them and their surroundings.¹¹

Beyond that, in order to comprehend COVID, we need to see that the natural and social worlds are irredeemably intertwined. Engels recognized that nature does not just exist; it "comes into being and passes away."¹² He noted anthropocentrism’s peculiar faith in "the absolute immutability of nature;¹³ hence Adorno ambivalently defining the Enlightenment as the progressive technical domination of nature.¹⁴ Those words signify the putative need and right to manage or eradicate vulnerability to harsh climates and food shortages—and to shape polities. From plutocracy to patriarchy, appeals to channel or protect nature—to govern it—are crucial. Bruno Latour avows that every type of politics has been defined by its relation to nature, whose every feature, property, and function depends on the polemical will to limit, reform, establish, short-circuit, or enlighten public life.¹⁵ As a consequence, theorists should allocate equal and overlapping significance to environmental, social, and intellectual forces;¹⁶ Latour regards COVID as a global catastrophe that has come . . . from within."¹⁷

Back to 1848. In addition to revolutions, it was also a year of typhus: a terrible epidemic devastated Upper Silesia. Rudolf Virchow, the founding figure of social medicine who was an attending physician there, wrote a famous report detailing the litany of administrative failures that had mismanaged the crisis. He memorably insisted that politics is medicine writ large.¹⁸ Getting on for two centuries later, we can see how right Virchow was—that the key element of COVID-19 is making live and letting die.¹⁹

The latest, and most germane, form of the social medicine he pioneered is syndemics. It emerged in the 1990s to examine the complex interaction of sequential disease and comorbidity, social inequality, and the physical environment.²⁰ The Lancet proposes that responses to the 2020 crisis focused on cutting lines of viral transmission, thereby controlling the spread of the pathogen. That’s understandable. But the story of COVID-19 is not so simple: Two categories of disease are interacting within specific populations—infection with severe acute respiratory syndrome coronavirus 2 . . . and an array of non-communicable diseases . . . clustering within social groups according to patterns of inequality deeply embedded in our societies. The aggregation of these diseases on a background of social and economic disparity exacerbates the adverse effects of each separate disease. COVID-19 is not a pandemic. It is a syndemic.²¹

Syndemic analysis reminds us that we confront an even more horrifying, if slower-moving, environmental specter—an apocalyptic vision that one day there may be nothing left, nothing else, nothing beyond; what Kant called the shadows of the boundless void.²² This syndemic was not directly caused by climate change, but its propulsion around the world was produced by the same forces that wreak environmental havoc. For COVID-19 is both a natural artifact and an unintended consequence of human action.²³ It relies not merely on evolution but on various entirely unnecessary social relations, such as the industrialized miscultivation, slaughter, distribution, and consumption of our fellow animals, alongside and as part of globalization, culture, capitalism, nationalism, carnivorism, masculinity, and government.²⁴ The reality of ecological peril is made shudderingly shocking by the COVID alarm clock / mnemonic: even the oleaginous, self-anointed World Economic Forum admits that the inequality both indexed and created by the virus renders our climate crisis more complex to comprehend and counter.²⁵

The syndemic’s rapid spread and deep impact have been wider-ranging and more sudden than any event in our collective lifetimes, from new working norms to everyday fears about citizen interactions that were formerly taken for granted.²⁶ In Arundhati Roy’s words, Who can think of kissing a stranger, jumping on to a bus or sending their child to school without feeling real fear? Who can think of ordinary pleasure and not assess its risk?²⁷ This pulverizing syndemic is instant and directly threatening, but for all its tragedy, the crisis provides the opportunity to remake ourselves and our future, courtesy of a conjuncture generated by forces of nature and exchange.

Careful reflection on quotidian actions and their links to health encourages a longer