COMMENTARY: The Sinatra Doctrine Confronts a Global Consensus

The next U.S. administration could restore faith in its ability to learn from its mistakes if, in cooperation with the global community, it can create robust new systems of public health protection and economic regeneration inclusive of all its communities and all nations

A photo-collage. Credit: Peter Costantini.

By Peter Costantini
SEATTLE, Oct 23 2020 – By late September, the COVID-19 pandemic in the United States had claimed 200,000 lives. That’s equivalent to a slightly higher toll than the 418,500 United States deaths in World War II, adjusted for relative population and duration. [See note below.]

With four percent of the world’s population, the U.S. has suffered 20 percent of global COVID-19 deaths.

Tragically, most of these deaths need never have happened. They were caused primarily by the public-health equivalent of friendly fire: massive malpractice and deception by the Donald Trump administration. A Columbia University study in May estimated that over four-fifths of those deaths could have been avoided if emergency measures had been invoked nationally just two weeks earlier in March.

With four percent of the world’s population, the U.S. has suffered 20 percent of global COVID-19 deaths. Tragically, most of these deaths need never have happened. They were caused primarily by the public-health equivalent of friendly fire: massive malpractice and deception by the Donald Trump administration

Contrary to political posturing, there was never a trade-off between saving lives and saving the economy. Passively accepting mass deaths has not worked to restart economic activity. Instead, opening up too much too fast has fanned the viral flames in many areas, forcing the re-shuttering of businesses and stalling incipient recoveries.

As much of the world recognized months ago, the fastest and most effective way to restart the economy is to aggressively control the pandemic. As Federal Reserve Bank chairman Jerome Powell, a Trump appointee, told Congress: “’The path forward for the economy is extraordinarily uncertain and will depend in large part on our success in containing the virus.”

The problem was not that Trump failed to lead. Had he simply left the management of the crisis to competent public health authorities, the country would be in a much better place. Instead, despite his awareness of the dangers of COVID-19, his demagogic helmsmanship steered the country 180 degrees off course on a perilous bearing.

The President’s white nationalism and “America First” rhetoric have mutated into an exceptionally dimwitted strain of American exceptionalism. Call it the Sinatra Doctrine: Trump did it his way. Consequently, many borders are closed to U.S. travelers. His Republican régime is now scorned by much of the world as a rabble of incompetent, racist, corrupt bullies whose hubris has turned the richest and most powerful empire in history into a rogue government stewing in its own juices. Many in Trump’s flock have elevated the freedom to not wear facemasks into a cause nearly as sacred as their right to open-carry assault rifles into legislative chambers.

As Dr. Joseph Varon, chief medical officer of a Texas hospital, put it: “I’m pretty much fighting two wars: a war against COVID and a war against stupidity. And the problem is that the first I have some hope about winning. But the second one is becoming more and more difficult to treat.”

With minimally competent leadership and international cooperation, however, the U.S. could have dramatically diminished the catastrophe. But it would have required the Trump administration and Senate Republican leadership to learn from countries that have taken the most effective public health and economic paths, and to share the advances made here. The U.S. government would have had to join the global fight to protect vulnerable communities and economies, rather than C-suites and share prices.

A tentative consensus is emerging in much of the world that the best way to keep families and firms safe and solvent and to rekindle economic growth is to confront the pandemic early and systematically with all the resources and resolve that would be mustered for a military conflict.

This approach requires complementary policies: a comprehensive public health model that integrates massive testing and contact tracing, combined with an approach to economic relief and recovery that marshals the fiscal resources necessary to preempt mass unemployment by covering payrolls before workers are laid off. These measures mutually reinforce each other: strong early health interventions make it possible to quash the pandemic rapidly and allow the economy to begin reopening sooner, while effective economic relief for afflicted families relieves the desperation to get back to work that has led to premature restarts, resulting in renewed outbreaks.

These models, however, are based on multilateralism in the world and inclusivity within the country, both alien to Trumpism. Excluding millions of “essential workers” and vulnerable families in marginalized communities at home, and billions of people in poorer countries with underfunded public health systems, risks undercutting those remedies and allowing the pandemic to continue ravaging humanity.

 

Public health

The public-health piece of this global model has been crystalized by former World Bank president Jim Young Kim, a veteran of campaigns against cholera in Haiti and Ebola in West Africa.

Kim argued that stopping COVID-19 requires orchestrating “[f]ive elements, five weapons: social distancing, contact tracing, testing, isolation, and treatment.” With this model, countries including South Korea, Singapore, China, Taiwan, Hong Kong, Australia and Germany have “gained control over the virus.” These countries have recognized that the novel coronavirus “is sneaky, nasty and durable – and that it has to be hunted down” using “large teams of public-health workers … on a war footing.”

This approach incorporates the insights of the battles against SARS, MERS and other previous epidemics.

While China initially tried to cover up the epidemic, it soon made an about-face and contributed significantly to global efforts. The WHO made some questionable judgements, but has continued to play a key role, providing international coordination and assistance to countries that need it.

The Trump administration, for its part, failed to learn from China’s early denials, which it praised. Many months later, it continues to deny the seriousness of the pandemic, with fatal consequences.

Trump has initiated U.S. withdrawal from the WHO, which would deprive the organization of its biggest source of financing. He has rejected international cooperation on developing vaccines, and pressured government agencies to approve a U.S. vaccine before the U.S. presidential election.

Prior to the crisis, the Trump administration had cut two-thirds of U.S. public health staff based in China, and disbanded the National Security Council directorate charged with pandemic response.

When the pandemic hit, Trump failed to scale up testing and contact tracing to track down recently exposed people. He abdicated his powers to accelerate and coordinate production of tests, personal protective equipment, and medical equipment. Instead, his boondoggles such as Project Airbridge enriched medical supply companies while failing to deliver supplies to hard-hit states.

Trump’s political gyrations have produced a CT scan of the internal weaknesses of U.S. health and social services. The absence of federal standards have fragmented requirements for mask-wearing and social distancing into a patchwork of disparate state regulations. Reflecting the deep inequalities in American society, low-wage workers in “essential” industries, communities of color, immigrants and prisoners have suffered disproportionately.

Inclusivity, though, is not simply an imperative of a just society, but also a necessity for defeating a pandemic: the more groups excluded, the larger the sacrificial population in which the virus can regenerate itself.

Unpayable bills for tens of thousands of dollars that some patients have received for their treatment highlight the country’s lack of universal health insurance and affordable medical care, shortcomings almost unknown in other wealthy countries. Containing COVID-19 is much harder when many working and unemployed people can’t afford to pay for testing and treatment.

Nevertheless, the Republican machine has continued trashing protections for all these groups. It is poised to extirpate what’s left of the Affordable Care Act, and has hamstrung occupational safety and health agencies. It has turned the process for developing a vaccine into a private-sector, America Only horse race.

Yet most developing countries don’t have the capacity to produce vaccines. No less a competitive capitalist than Bill Gates, Jr. argued: “We need to get most of the world vaccinated to bring the pandemic to an end. … [T]he disease will keep coming back into the developed countries if we don’t end it in the entire world.” The process of vaccine development and production, he said, involves many countries. “[T]here’s no doubt that only cooperation will get us out of this thing.”

Inclusivity, then, is indispensable domestically and internationally. And the “war footing” essential to implementing Kim’s response model requires public solidarity to override private profit.

 

Economic relief and recovery

The economic-recovery component of the global model is not just a matter of deploying better social safety nets: it’s about preventing people from falling out of the economy into those nets in the first place. And it requires scaling up responses to the magnitude of the moment.

“The coronavirus pandemic is a human tragedy of potentially biblical proportions,” emphasized former European Central Bank president Mario Draghi, and the response must be to mobilize as for a war. “The key question is not whether but how the state should put its balance sheet to good use. The priority must not only be providing basic income for those who lose their jobs. We must protect people from losing their jobs in the first place. If we do not, we will emerge from this crisis with permanently lower employment and capacity, as families and companies struggle to repair their balance sheets and rebuild net assets.”

Several European and Asian countries have adopted corresponding policies. Denmark’s approach provides a clear example. The Danish government took over the payrolls of companies harmed by the pandemic, preventing workers from being laid off, and guaranteed at least three-quarters of their salaries up to a living-wage level. For those already out of work, the plan improved and extended benefits. For businesses, the plan covered some fixed expenses and deferred taxes. The economic measures accompanied a strict public-health lockdown.

The three-month program cost slightly more per capita than the first U.S. relief package. Yet it had strong support across the whole Danish political spectrum, including from labor unions and employer associations.

Thanks to the interaction of the public health and economic measures, the country was able to reopen its economy more quickly than most of Europe and keep monthly joblessness no higher than six percent, while in the U.S. it reached 14.7 percent. The pandemic-induced drop in economic output is predicted to be a little more than half that of the whole Eurozone.

Many other European nations, including Germany, the Netherlands, the United Kingdom, France and Spain, have also implemented similar programs to keep workers on payrolls of distressed firms, as have Asian countries including South Korea and Singapore.

The U.S. economic response, by contrast, foundered on the weaknesses and fragmentation of existing safeguards, and was later dragged down by Republican stonewalling.

U.S. Federal Reserve Bank Chair Jerome Powell called the economic hit from the pandemic “without modern precedent” and cautioned that that the recovery might be slow. “Additional fiscal support could be costly,” he said in a speech, “but worth it if it helps avoid long-term economic damage and leaves us with a stronger recovery.” Former Fed Chairs Janet Yellen and Ben Bernanke have also vocally advocated for aggressive fiscal and monetary policies to revive the economy, and downplayed concerns about the deficit and debt.

Economic relief packages pumped over $3 trillion dollars into the economy and initially helped to stabilize households and firms. But rather than keeping workers employed, most of the funding went to augmenting unemployment insurance for those laid off. In the U.S., this program is administered by the states, however, resulting in a fragmented bureaucracy. Average benefits are smaller amounts and of shorter duration than in most other wealthy countries.

In the face of the pandemic, some states’ administrative machinery has been unable to handle the surge in unemployment claims. An estimated forty percent of people who applied for benefits were not receiving them in late September.

A particularly acute consequence of much unemployment in the U.S. is the loss of health insurance. Coverage is typically tied to employment, so when workers are laid off, they lose their access to health care in the middle of a pandemic.

Although Democrats in the House of Representatives have passed two versions of another major relief bill, the White House and Senate Republicans have stalemated negotiations with demands for substantial benefit cuts.

As a result, millions of low-wage workers are confronting debilitating crises: hungry children, unpayable medical bills, and looming eviction or foreclosure, sometimes leading to homelessness. Long-term unemployment is reportedly rising for those laid off or furloughed because of the pandemic. As usual in the U.S., these setbacks have hurt families of color and mothers of school-age children disproportionately.

Although by now most of the economy is functioning again at some level, legislation has been proposed in Congress to create robust paycheck protections. In future downturns, its proponents say, it could serve as an “automatic stabilizer” to take the load off of unemployment insurance systems.

Facing the current resurgence of COVID-19 and the threat of future pandemics, the next U.S. administration should explore ways to implement global-consensus public health and economic measures as soon as possible. It will also have to address long-standing demands for universal health insurance, mandatory sick days, and more functional unemployment relief.

Internationally, the U.S. should quickly rejoin the World Health Organization and double its old contribution. To provide financial support for restarting the economies of developing countries, restructuring of debt could help free resources for the desperate needs left in the wake of the pandemic. Another avenue worth exploring to provide sustainable non-debt financing is the creation of Special Drawing Rights through the International Monetary Fund.

The next U.S. administration could restore faith in its ability to learn from its mistakes if, in cooperation with the global community, it can create robust new systems of public health protection and economic regeneration inclusive of all its communities and all nations.

Note: World War II lasted 45 months; the COVID-19 pandemic death toll reached 200,000 after eight months. The U.S. population in 1942 was 134,900,000; in 2020 it is 331,000,000.The average monthly toll for the U.S. in World War II was equivalent to 22,822 deaths, in proportion to the 2020 U.S. population; the pandemic monthly toll for the U.S. as of September 2020 has been 25,000 deaths.

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