In the Time of Coronavirus

A Tale Of Two Cities: Wuhan – New York

The discovery of the infectious disease now referred to as COVID-19 in clusters of cases in Wuhan, China, in late December 2019 set off alarm bells among Chinese health officials. On December 30, they shut down the suspected source, a market that sold live seafood, poultry and wildlife. The World Health Organization (WHO) was informed on December 31 of a “pneumonia of unknown origin.” Racing to identify the pathogen that caused the mysterious disease, they identified the coronavirus by January 8 and the news was broadcast on China Central Television the next day. Thus claims by the bourgeois media and politicians in the U.S. that China initially “covered up” the outbreak are a flat-out lie.

However, amid uncertainty about how infectious the new disease was and whether it could be transmitted among humans, with no new reported cases, local officials did not immediately follow up initial discoveries with energetic public health measures. But when on January 18-19 the number of cases suddenly shot up, growing exponentially and appearing in major cities, the Communist Party leadership in Beijing took notice. With the annual Spring Festival (lunar New Year), when hundreds of millions of Chinese travel around the country, about to begin two days later, the central government imposed a quarantine on Wuhan (population 11 million) on January 23, blocking travel to and from it and other major cities in Hubei province.

Doctors and state officials wrangled with how to effectively mitigate the spread of the novel coronavirus. At first the medical system was inundated with new cases. Hundreds showing symptoms rushed to hospital entrances seeking help. They jammed into crowded corridors, probably infecting others. There was a run on masks. By the beginning of February, China confirmed 28,276 cases and 564 deaths. But in a very few days the chaos was brought under control, by the authorities but also by tens of thousands of volunteers. World Health Organization (W.H.O.) vice president Dr. Bruce Aylward, who led a mission to evaluate China’s effort, reported: “They’re mobilized, like in a war, and it’s fear of the virus that was driving them.”¹

Although much of China’s urban medical system is private – a betrayal of the gains of the 1949 Chinese Revolution – the response to the coronavirus outbreak was not. Quickly, the superiority of a centrally planned economy was shown. With clear and decisive swiftness, orders went out to erect two new hospitals, Huoshenchan Hospital and Leishenshan Hospital, to treat COVID-19 patients. That was accomplished, providing 2,600 new beds in two hospitals fully equipped with the latest technology – all within ten days, from start to finish. Webcams were set up so that millions across China could follow this amazing feat, with dozens of excavators on the first day. In the capitalist West it would take years to accomplish this.

It wasn’t haphazard at all. China had done it before. In 2003, Xiatangshan Hospital in Beijing was built in seven days to treat the SARS (Sever Acute Respiratory Syndrome) epidemic. Today, plans for such an emergency already existed, so that suppliers and workers could be mobilized quickly. Sports and exhibition centers, gymnasiums and building complexes were converted into isolation centers with 10,000 more beds for those with milder cases. Tens of thousands of medical workers were sent or volunteered from other provinces to tackle the spread at ground zero. Special trains were sent with fruits and vegetables, which were then distributed by volunteers to those in locked-down neighborhoods. It was a national effort, millions pitched in.

Most importantly, those with symptoms but also others who were at risk were tested and quarantined. The Report of the W.H.O.-China Joint Mission on Coronavirus Disease 2019 stated: “Measures were taken to ensure that all cases were treated.” Patients waited for the four-hour processing of their results at the fever clinics, rather than being sent home. Moreover, testing was free. Compare that to the U.S., where in the epicenter of New York for weeks it was almost impossible to get tested, due to a huge shortage of test kits, and then people had to wait days for the results.

In Wuhan, if you tested positive and had mild symptoms, you were placed in an isolation center where you received treatment. Severe cases were sent to the hospitals. People were not sent home to wait it out and combat an unrelenting fever, hacking cough and difficulty breathing on their own. Why? It sounds ludicrous to even ask such a question, but they did not want people spreading the virus to their family members. Dr. Aylward noted that “75 to 80 percent of all clusters are in families. You get the odd ones in hospitals or restaurants or prisons, but the vast majority are in families…. So they try to isolate you from your relatives as quickly as possible, and find everyone you had contact within 48 hours before that.”

As the W.H.O. mission report summed it up, “In the face of a previously unknown virus, China has rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history.” So that was China’s response.

A Tragicomedy of Errors

Now, what about New York? If, faced with a new disease whose nature was only beginning to be known, the Stalinist bureaucracy in China was slow to impose drastic measures over a period of ten days (when the number of cases seemed frozen and there was as yet no evidence of human-to-human transmission), the bourgeois politicians in the U.S. and the capitalist medical system had two solid months to prepare. Their failure/refusal to undertake massive testing,² the destruction of stockpiles of critical equipment and failure to replace them; the shortage of hospital beds due to cutbacks – these are nothing short of criminal. And then there’s the delusional president Donald Trump, who said of the virus, “like a miracle, it will disappear.”

But it’s not just the megalomaniacal Republican CEO of American capitalism, who imagines he can dictate the course of hurricanes and has a miracle cure for COVID-19. The Democrats are no less responsible for the disastrous state of the U.S. medical system. For years they presided over the grotesque profit-gouging and skyrocketing inequalities of the “your-money-or-your-health” racket, shoveling billions into the coffers of the medical insurance companies through Obamacare while cutting back on hospital funding, eliminating surge capacity in the depression that has followed the 2007-09 financial crisis. They, too, prepared the way for the catastrophe that the coronavirus crisis has unleashed on working people. On March 2, Democratic NY governor Andrew Cuomo bragged at a press conference: 

“We have the best healthcare system in the world here. And excuse our arrogance as New Yorkers, I speak for the Mayor also on this one, we think we have the best healthcare system on the planet right here in New York. So, when you’re saying what happened in other countries vs. what happened here, we don’t even think it’s going to be as bad as it was in other countries. We are fully coordinated, we are fully mobilized, this is all about mobilization of a public health system.”

Three days later, on March 5, after the appearance of cases of COVID-19 in New Rochelle (a lawyer who worked in Manhattan) and in NYC itself, Democratic mayor Bill de Blasio admitted, “You have to assume it could be anywhere in the city.” Even in the second week of March, “senior Health Department officials believed” that widespread testing “was a waste of limited resources. They urged instead a public awareness campaign to tell people with mild symptoms to stay home and not infect others, or themselves, by going to testing centers”!³ On top of this, the mayor and governor were sparring as de Blasio called for a lockdown while Cuomo on March 20 ordered social distancing plus closing non-essential businesses.

In this chaotic scene of last-minute improvisation, it was clear to all that the hospitals would soon be overwhelmed with coronavirus patients. By our count, New York City has closed at least 60 hospitals since the 1970s, and in the last two decades New York State has lost 20,000 hospital beds through cuts, dropping from 73,000 in 2000 to 53,000 in 2020, according to records obtained by the New York State Nurses Association (New York Post, 17 March). Cuomo’s answer was to call for “the Army Corps of Engineers to leverage its expertise, equipment and people power to retrofit and equip existing facilities … to serve as temporary medical centers.”⁴ The next day de Blasio called to use the Javits Convention Center on Manhattan’s West Side as a “medical surge facility.”

So on March 23, Cuomo announced plans to convert the colossal 840,000-square-foot Javits Center in Manhattan into four emergency federal hospitals with a capacity of 1,000 beds on the main showroom floor in just seven days. The National Guard and Army engineers were deployed to assist in carrying this out, along with 320 Federal Emergency Management Agency (FEMA) officials to staff the hospitals. With U.S. and New York State flags hanging above, the beds were “designed to promote comfort and hope,” each adorned with a potted plant. According to the governor, “That’s the New York way, that’s the American way” to “kick coronavirus ass.”

By April 1, the U.S. Defense Department announced it was set up and good to go. Except there were some problems. To begin with, the commander of the JNYMS (Javits New York Medical Station), New York National Guard Col. Dennis Deeley, said bluntly: “I don’t know how to manage a hospital.” He was commanding a couple of hundred military doctors, nurses and other medical personnel, along with 400 National Guardsmen. Moreover, it seems that the Javits medical facility was not intended for coronavirus patients or cases. Hello?! The plan was to keep the JNYMS “COVID-free” and accept only “low acuity patients,” like those recovering from surgery or with a diabetes flare-up.⁵

Next problem: where are the patients? Cuomo held a press conference in the Javits station on March 24 in front of stacks of boxes of medical equipment. But aside from the odd COVID-19 patient trying to sneak into the facility, there were no non-coronavirus cases. With everyone sheltering in place, “Victims of trauma and other ailments vanished from emergency departments as automobile traffic and crime rates – except for domestic violence – plunged” (Washington Post, 10 April). And with over 7,000 emergency ambulance calls a day, the city declared new EMS (Emergency Medical Service) guidelines prohibiting the use of CPR (Cardiopulmonary Resuscitation) in the field, for fear of spreading the virus. Patients that could not be resuscitated on the spot were declared dead. They weren’t taken to the Javits.

Then there was that hospital ship. On March 18, Governor Cuomo announced amid great fanfare that the USNS Comfort was coming. On March 29, President Trump saw the ship off from Naval Station Norfolk, proclaiming it a “a 70,000-ton message of hope and solidarity” with the people of New York, “a place I love.” (You think?) But, alas, the Comfort, with its 1,000 beds, 1,200 personnel, “12 fully equipped operating rooms, radiology services, medical lab, pharmacy, optometry lab, CAT-scan and two oxygen producing plants” was also never intended for coronavirus cases. With 20 patients aboard and strict admittance guidelines meant to keep the virus off-board, the hospital ship was, as the head of Northwell Health put it, “a joke.”

The Navy’s hospital ships have always been a public relations exercise more than genuine medical assistance. After Hurricane Maria in 2017, the Comfort was deployed to Puerto Rico, where it “mostly sat empty in the San Juan harbor” while the U.S. “dispatched 10,000+ troops to ‘keep order,’ distribute some meals-ready-to-eat and bottled water for a few days and install some mobile cell towers.”⁶ The Comfort only treated six patients a day while the numbers dead surpassed 4,000. After the 2010 earthquake ravaged Haiti, the Comfort reportedly performed 8,000 operations, while “the more than 800 Cuban medical personnel and Cuban-trained Haitian doctors performed over 100,000 operations and serious medical procedures.”⁷

So here we have nurses, doctors and orderlies working 12-hour+ shifts in overflowing hospitals, desperately caring for coronavirus patients and armed with limited protective gear, rendering them exposed to the deadly virus. Hospitals running out of body bags as refrigerator trailer morgues stockpile the dead to be transported to mass graves on Hart Island off the Bronx … and the Comfort and Javits are virtually empty. As angry medical professionals denounce this atrocity, Cuomo announces that Javits would become COVID-only, and non-COVID patients would be transferred from the convention center to the ship. Except when the eleven patients were transferred, they turned out to be – you guessed it – COVID-positive.

On April 16, it was announced that all medical personnel were being withdrawn from the Javits Center. At its highest point it had 138 patients. On April 22 it was announced that the USNS Comfort was no longer needed in New York and would be departing to its home port in Norfolk, Virginia.

That brings us to the Central Park field hospital across Fifth Avenue from Mt. Sinai Hospital in Manhattan. You’ve probably heard of it: a 14-tent hospital with 68 beds, ventilators, x-ray machines and 98 staffers, that’s taking in coronavirus patients from the overloaded hospital. However, this facility belongs to Samaritan’s Purse, a proselytizing evangelical Christian outfit run by Franklin Graham, son of Billy Graham, the U.S.’ most famous evangelical leader, and a notorious anti-Islam and homophobic bigot. Graham has long proclaimed Islam as “a very wicked and evil religion” and in 2015 proposed a ban on Muslims entering the U.S. He has worked in tandem with U.S. occupation forces during the 2016-17 battle for Mosul, Iraq.

Samaritan’s Purse is known for utilizing international disaster relief to aggressively promote Christianity in Muslim-majority countries. Moreover, in New York City, all volunteers and healthcare workers in its field hospital are required to sign an explicitly transphobic and homophobic “statement of faith,” which among other things declares marriage as “exclusively the union of one genetic male and one genetic female.”⁸ On his Twitter feed, Graham declared, “Everyone needs to wake up to the dangers of the transgender lie.” He has proclaimed gay people “the enemy” and said that COVID-19 has spread “because of the sin that’s in the world.”

There has been opposition to Samaritan’s Purse and fears of homophobic discrimination, with one protester arrested outside the field hospital. Given Graham’s notoriety, it’s hard to believe that Mt. Sinai, de Blasio and Cuomo didn’t know who they were dealing with. The fact that such a bigot could be given official sanction is an indication of what a god-awful mess the New York response to the coronavirus has been: any charlatan can get in on the action. And the treatment for COVID-19 patients in the Samaritan’s Purse hospital is hydroxychloroquine, the anti-arthritis and anti-malarial medication being promoted by President Trump. Many hospitals have stopped prescribing this medication after indications it has caused serious cardiac arrhythmia (irregular heartbeat) which can be fatal.

Why the Coronavirus Ravaged Corona

The big question is why the overflow facilities weren’t filled to the brim in the epicenter of the coronavirus pandemic in the United States. Just look at the raw statistics: according to the NYC Department of Health, to date there have been 141,754 cases of diagnosed COVID-19, but only 36,723 have been hospitalized. (Altogether there have been 15,411 confirmed and probable deaths in NYC due to the coronavirus.)⁹ What happened to the other 105,000+ cases of people who tested positive (and likely tens of thousands more who have had symptoms but have not been able to get tested) yet were not hospitalized? Answer: most never made it past the triage tents set up outside the hospitals, but were sent home because only severe cases were admitted.

So with all the talk of “flattening the curve,” “social distancing,” “shelter in place” and masks, the way that the New York City medical authorities managed to avoid a complete breakdown of the hospital system was by sending large numbers of coronavirus-positive people back out into the community instead of isolating and hospitalizing them! This is guaranteed to spread the virus. For the vast majority, this meant going back to their families, even though it was known that in China three-quarters of “community transmission” was to family members or others in the same residence. This is an obvious reason why the disease has spread so quickly in the Corona section of Queens, New York, where tens of thousands of immigrant workers live jam-packed in tiny apartments.

Moreover, as soon as patients were “stabilized” – i.e., without acute fever for several days – they were discharged to make room for others, even though by now there is plenty of evidence of relapses. As the number of discharged COVID-19 patients grew, New York City authorities decided to very make a very limited attempt at isolation, citing the experience of “Asian cities” (Wuhan). So they contracted to rent 11,000 rooms in empty hotels for “healthcare workers, New Yorkers discharged from hospitals and those who are showing symptoms but live in cramped quarters that make social distancing impossible” (Politico, 13 April). Except, just as with the overflow “medical” facilities like the militarized Javits Center, when isolation is tried under capitalism, it turns into a caricature..

Recently a scandal broke out when several of the “recovering” COVID-19 patients died in Hilton Garden Inn hotel in Manhattan. It turns out, first, that there were no emergency medical personnel – much less lifesaving equipment – in the hotels. Second, the whole thing was managed by a Texas company, Crewfacilities.com, which judging by its web site specializes in putting up military personnel, oilfield crews and the like. To top it off, monitoring consisted of twice-daily phone checks by temps from a Brooklyn staffing company. They were supposed to summon medical help if the phone was not answered, but it seems their protocols “were not tightly followed” (New York Times, 24 April).

It gets worse: a little over one-third of these rooms are occupied. Why? It turns out that two different agencies deal with city-contracted hotel rooms, and navigating them is an ordeal. Those discharged from a hospital are dealt with by the Office of Emergency Management (OEM). Those in homeless shelters go through a separate bureaucracy, the Department of Homeless Services (DHS), which has its own block of 2,500 hotel rooms. But if a person has tested positive for the virus but has not been hospitalized, they have to call 311 to request an isolation unit, and then they are referred to a “partner agency,” the DHS or a hospital (The City, 16 April). Result of this labyrinth: over 8,000 hotel rooms which have been contracted sit empty.

The helter-skelter response of New York City to the crisis is a reflection of the capitalist system, in which bourgeois politicians, religious and other shysters compete for influence, while profit calculations stop the production of vital medical equipment¹⁰ and not only drive private hospitals but also public facilities, which are constantly under pressure to cut costs rather than provide a needed social service. The experience of two cities – Wuhan and New York City – in the coronavirus crisis is a powerful proof of the qualitative superiority of a centralized, socialized planned economy which is geared to fill social needs rather than the chaos of capitalism.

At the same time, the Chinese Stalinist bureaucracy claims that there can be coexistence with the capitalist system, despite the virulent campaign of China-bashing by all sectors of the U.S. bourgeoisie. It continues to push this dangerous illusion even as the coronavirus debacle has shown just how deadly and dangerous capitalism is to all humanity. This and the counterrevolutionary threat of capitalist and pro-capitalist forces inside China are further proofs of the need for the workers to take political power away from this privileged, nationalist caste and establish the revolutionary proletarian democracy of workers councils, joining their sisters and brothers in the capitalist countries in the struggle for international socialist revolution. ■