CORONAVIRUS AS TOTO

Dorothy:         Please, sir, we’ve done what you told us.  We’ve brought you the broomstick of the Wicked Witch of the West.  We melted her.

Wizard:          Ah.  You liquidated her, eh?  Very resourceful.

Dorothy:         Yes, sir.  So we’d like you to keep your promise, please.

Wizard:          Not so fast!  Not so fast!  I’ll have to give the matter a little thought.  Go away and come back tomorrow.

Dorothy:         Tomorrow?  Oh, but I want to go home now!

Tin Man:        You’ve had plenty of time already.

Cowardly Lion and Scarecrow:       Yeah.

 Wizard:          Do not arouse the wrath of the great and powerful Oz!  I said come back tomorrow.

Dorothy:         If you were really great and powerful, you’d keep your promises.

 Wizard:          (Toto pulls back the curtain to reveal the Wizard and his smoke and mirrors machines.)  Do you presume to criticize the Great Oz? You ungrateful creatures! Think yourselves lucky that I’m giving you audience tomorrow instead of 20 years from now.  (The Wizard sees the curtain has been drawn back.) Oh, oh, ah….Pay no attention to that man behind the curtain!  The Great Oz has spoken! 

L. Frank Baum, The Wizard of Oz

Let's consider the coronavirus as a metaphor for Toto, Dorothy’s frisky little dog who unmasks the Great Oz, and let's consider the Great Oz as a metaphor for the incomplete promises and unfulfilled dreams of America.  The virus has pulled back a curtain fabricated from a stock market that rocketed into the stratosphere, an ever-increasing number of freshly-minted billionaires, and the promise that, if you work hard, you will succeed.  What has been revealed is a soft underbelly of failure.  Here are just a few of the shams that yapping little viral Toto exposed behind the tattered curtain.

A FAILED HEALTHCARE SYSTEM.  America spends more on healthcare than any other western democracy and yet achieves worse outcomes, even after the passage of the Affordable Care Act, which has been gutted and compromised administratively by the GOP.  The problems are legion.  Many Americans remain uninsured or underinsured, struggle with unaffordable co-pays and increasing costs, and must reckon with uneven distribution of medical personnel and facilities, particularly in rural areas.  Despite concerted efforts to destroy it, the A.C.A. is working, albeit imperfectly, and remains popular among the American public.  (See NYT Obamacare for an excellent summary of what’s good and what’s wrong with the Affordable Care Act.)

And yet the Trump Administration continues to undermine it.  Even as hundreds of thousands of Americans are being infected by COVID-19, their federal government continues its legal assault on the A.C.A.  The latest attempt to kill the law once and for all by declaring it unconstitutional is scheduled to be heard by the Supreme Court this term.  If there is a term and if the suit is successful, it would invalidate the A.C.A. and immediately put 20 million previously uninsured Americans now covered by the A.C.A. back on their own, without health insurance.  

Work and health insurance continue to be inextricably linked for most Americans.  For those workers not enrolled in the A.C.A., access to healthcare depends on employment.  That means that of the 10 million Americans who filed for unemployment benefits in the past two weeks, an estimated 3.5 million are now uninsured.  According to Axios, “Of the remaining two-thirds, some probably had other sources of coverage, but many likely didn't have health insurance at all — low-wage jobs are less likely to offer it.”

Adding insult to injury, the Trump Administration has decided it will not allow a special enrollment period under the A.C.A., established for just the kind of emergency presented by the pandemic, denying those Americans now out of work the opportunity to obtain health coverage.  

And if you’re poor but make too much money to qualify for Medicaid but too little to qualify for the A.C.A. and you live in one of the 14 states that rejected the Medicaid expansion originally mandated by the A.C.A. and subsequently struck down by the Supreme Court, you continue to be uninsured.  Content with the result, the Trump Administration has offered no recommendation to those states to expand their Medicaid coverage, even though under the A.C.A., the federal government covers 90% of their costs in the first year. 

Finally, even if you have insurance, there is the issue of rural hospitals and the disparity of service.  According to Becker's Hospital Review:

About 60 million people — nearly one in five Americans — live in rural areas and depend on their local hospitals for care. This year, 18 of those hospitals have closed, making 2019 a record year for rural hospital closures. [Between 2005 and 2019], 161 hospitals in rural communities have shut down. The number of closures has steadily increased over the past three years…. Across the U.S., more than 600 rural hospitals are vulnerable to closure.

RACISM AND POVERTY.  The virus affects people of color and the poor disproportionately, revealing that America continues to turn its back on the most vulnerable.  According to Axios Deep Dive: 

Communities of color and low-income families are bearing the brunt of the coronavirus. There's no nationwide data on the demographics of coronavirus cases or deaths. But preliminary data from several large metro areas seem pretty clear:

·         Black residents make up about 33% of Mecklenburg County, N.C., which includes Charlotte, but account for roughly 44% of its coronavirus cases.

·         Milwaukee County, Wis., is 26% black — yet African Americans account for almost half of the coronavirus cases and 80% of the deaths.

·         The hardest-hit neighborhoods in New York City have large immigrant populations.

·         Statewide data from Michigan show that African Americans make up a plurality of both cases (35%) and deaths (40%), but just 14% of the state's population.

This apparent inequity in coronavirus cases reflects a slew of other, pre-existing disparities.

·         African Americans are more likely to have several underlying health conditions, including heart disease, diabetes, hypertension and some cancers that can make COVID-19 infections more severe.

·         Lower-income areas — which tend to have larger nonwhite populations — have less access to health care services.

·         Substandard housing, multiple families living together, and homelessness all facilitate the virus’ spread.

HOMELESSNESS.  The CDC guidelines tell us that social distancing is the only defense against COVID-19.  But how do you social distance if you’re homeless?  The Department of Housing and Urban Development reported in 2018 that there are about 553,000 homeless people in the United States on any given night.  Approximately 65 percent are found in homeless shelters, and the other 35 percent are found on the street in places not intended for human habitation, such as sidewalks, parks, cars, or abandoned buildings.  These numbers have certainly increased since HUD's 2018 survey.   

As Wired Homeless says, homelessness is incompatible with staying healthy, and a homeless shelter or the street is the last place one should be in a pandemic. 

Shelters are full, or closed, or too fraught with coronavirus risk to consider sleeping in. They have no access to toilets, much less toilet paper. They’ve been laid off, and there’s nobody on the street so they can’t even panhandle. Common places to find shelter and a bathroom—libraries, gyms, fast food restaurants—are closed. Soup kitchens are closing, out of food, out of workers.

The [online] forums have become literal survival guides: How to set up a safe shelter in the forest; where to find an electrical outlet; how to clean yourself with dry leaves, newspaper, and isopropyl alcohol.

Unhoused people are already among the most sick in society, and now they’re physically incapable of following the Centers for Disease Control and Prevention’s most basic virus-fighting directive: stay home. It’s nearly impossible for homeless people to maintain social distance. Their needs are met en masse. The CDC recommends 110 square feet per person for people housed together during the outbreak. Most homeless shelters simply don’t have that kind of space.

You can see the severity of the problem and the cruelty of the response in this photo of a Las Vegas parking lot converted into an outdoor coronavirus homeless shelter, above. 

FOOD INSECURITY.  There is plenty of food in America, but many Americans go to bed hungry.  Yet the US does not recognize the fundamental right of everyone to be free from hunger.  158 other nations do.  According to Wiki Hunger in the US:

Hunger in the United States of America affects millions of Americans, including some who are middle class, or who are in households where all adults are in work.

Research by the USDA found that 11.1% of American households were food insecure during at least some of 2018.…In 2019, over 12.5 million children, and 40% of US undergraduate students experienced food insecurity. [Note that latter statistic and think of the college students who were sent home to economic instability and food insecurity when their universities closed their doors.] 

The United States produces far more food than it needs for domestic consumption—hunger within the U.S. is caused by some Americans having insufficient money to buy food for themselves or their families. In 2017, the US Mission to International Organizations in Geneva explained, "We do not treat the right to food as an enforceable obligation."

Where government fails, food banks usually pick up the slack, but they can’t keep up with current unprecedented needs.  The food bank Feeding South Florida (above) reports a 600% increase in demand.  Per Politico: 

The fast-spreading coronavirus is squeezing [New York City’s] food pantries and soup kitchens, with dozens closing across the five boroughs and crucial delivery volunteers staying inside as the number of homebound people in need of meals skyrockets.

The Food Bank For New York City, which supplies more than 1,000 pantries and soup kitchens, said 118 of those in its network suspended service as of [March 20^th].

Where food banks can’t help, some locals are taking matters into their own hands.  In Holmes County, Mississippi, the poorest county in the poorest state in the US, 35% of the residents are food insecure.  In the town of Lexington, Holmes County, every one of its 3,000 school children qualifies for free school meals.  But the schools aren’t open, and children risk going hungry.  According to The Guardian Hunger:

For many, said superintendent Dr James L Henderson, breakfast and lunch at school are the only nutritious meals a student will eat in a day. For a few, they are the only meals. Many children in this rural district come from households too poor to afford a car. So the superintendent embarked on an improvised project, driving 6,000 meals a day out across the county in a small fleet of 70 school buses, dropping each packet off at a stop along the route.

“We absolutely see this as a matter of life and death,” he said. “We have to do it on behalf of our children. It’s just that simple. Families are suffering here.”

  

INADEQUATE LABOR LAWS.  According to PRI, 179 countries have paid sick leave, including the 22 countries listed above, excluding the US.  Well, the US kinda sorta has paid sick leave now, since March, but with significant exclusions that draw the efficacy of the law into question.  Prior to March, employers were not required by federal law to provide paid sick leave for their employees.  The coronavirus challenged that.  To enable workers to conform to CDC guidelines to stay home without losing pay, Congress enacted the CARES Act, which among other things, addressed paid leave.  But then last week the Executive Branch emasculated the benefit.  According to New York Times:

The legislation, which provides two weeks of paid sick leave and 12 weeks of paid family leave, and reimburses employers for it with tax credits, already excludes workers at companies with more than 500 employees.  In guidance issued on Wednesday, the Labor Department said that employers at companies with fewer than 50 workers had broad latitude to decline to offer the 12 weeks of paid leave that the law required for workers whose children were home from school or for child care because of the coronavirus pandemic. In all, more than 75 percent of American workers are at companies that qualify for exemptions from the law.  Health care providers and first responders, as well as certain federal government employees, can also be denied the paid leave. 

The combination of plutocratic bailouts and increasing precariousness and physical danger for the working class is an explosive one according to  The Nation:

 In The Washington Post, Helaine Olen described the first stimulus package as “not only a missed opportunity to permanently give American workers the benefits enjoyed by those in other wealthy countries, but yet another successful cash grab by corporate interests and the wealthiest among us.” In exchange for four months of expanded unemployment benefits and a one-time stimulus of $1,200 (plus $500 per child), the stimulus opened up the money spigots for Wall Street with a corporate rescue fund that could reach $6 trillion.

As ProPublica reported on Tuesday, “Emergency room doctors and nurses—many of whom are dealing with an onslaught of coronavirus patients and shortages of protective equipment—are now finding out that their compensation is getting cut.” Many of these health care workers are employed by staffing companies that in the wake of lost revenue from elective procedures are cutting back compensation.

Millions of white-collar workers are telecommuting from home to stay safe as the coronavirus extends its terrifying reach across America,…but millions of other workers—supermarket cashiers, pharmacists, warehouse workers, bus drivers, meatpacking workers—still have to report to work each day, and many are furious that their employers are not doing enough to protect them against the pandemic.”

The growing lethality of the American workplace is fueling a wave of strikes, both union-led and spontaneous wildcat protests [like the Chrysler walk-out above].

 

INTIMIDATION AND DEVALUATION OF IMMIGRANTS.  The pandemic has increased xenophobia and racial violence, particularly against the Chinese, who have been blamed for the coronavirus outbreak, but also against immigrants in general.  This has pushed immigrants—legal and illegal-- further into the shadows, unleashing medical consequences.  First and foremost, immigrants have a higher uninsured rate than others in America do.  But that isn’t the only factor that puts them especially at risk during the coronavirus pandemic.  Per Axios Immigrants, public health experts are concerned that the Trump Administration's immigration policies could scare immigrants away from getting medical help, increasing infection rates within immigrant communities and the public at large.  

The fear may not be justified, but it is very real.  Despite being in the country legally or awaiting action on a visa application, immigrants are wary of the new “public charge rules” enforced by ICE that can result in deportation or denial of entry.  Even before the public charge rules took effect, immigrants were reportedly dropping out of Medicaid or public nutrition programs for fear of being blocked from a green card.   From Axios Immigrants:

A DHS spokesperson pushed back on the impact the public charge rule would have on immigrants seeking medical care. "Nowhere in the rule does it say an immigrant will be denied a change in status if they seek medical care," the spokesperson said.

In the past, Immigration and Customs Enforcement has issued public guidance during natural disasters to assure immigrants they would not be arrested for getting medical help, former acting ICE director John Sandweg told Axios. He said the same should be done in response to the coronavirus. "The reality is that ICE is very reluctant to arrest and detain anyone with a contagious disease," Sandweg said. "While the risks of arrest are low, the fear in the immigrant communities is real."

And while the US has for the past three years detained and deported immigrants and asylum seekers, it has also vastly devalued them.  The fact is, immigrants fill both professional and unskilled labor roles that are critical to the American economy, especially during this epidemic, as this chart above shows.

TOO MANY GUNS.  There are more guns in America than there are Americans, and the former number is increasing.  The pandemic and social distancing have non-medical consequences triggered by job losses, anxiety over a possible infection, and more togetherness than families and couples are accustomed to.  That leads to an increase in divorce petitions, child abuse, substance abuse, and domestic violence, as well as—what else?—a sharp uptick in gun sales.  According to NBC News:

Firearms sales and federal background checks for purchases soared to all-time highs in March as the coronavirus pandemic brought buyers out in record numbers, even though gun dealers were included in orders shutting down businesses in some states.

The FBI conducted 3.7 million background checks last month, according to its latest figures, the highest total since the national instant check system for buyers was launched in 1998 and 1.1 million higher than the number conducted in March 2019.

I predict we will also see an increase in suicides, especially among those who live alone and are particularly vulnerable to loneliness.  In contrast to the loss of life to the disease, domestic violence, and possible civil unrest, there is likely to be an eventual spike in the birthrate, too, as people turn to sex to relieve the stress and boredom that come with social distancing and self-isolation.  Apparently online sales of sex toys are way up (pun intended).

INCOME INEQUALITY AND A BETRAYAL OF THE WORKING CLASS.   The gap between rich and poor is growing and the middle class is vanishing.  The pandemic has brought that into sharp relief in an obscene way.  If you’re rich and live in a dense urban area like New York City, Los Angeles, Chicago, or Seattle, you can escape contagion by leaving the city behind and heading out to your second or third home in the Hamptons, the Caribbean, or Jackson Hole, WY, where you can wait out the pandemic storm in relative comfort and seclusion.  But if you’re poor and living in a cardboard box, unemployed and living in your car, or middle class and living in a cramped apartment, you’re in the eye of the storm.  As has been widely reported, those escaping the cities have sometimes brought the virus with them, seeding the epidemic in affluent, but out-of-the-way, communities with fewer medical resources, infuriating the local population.

As reported in The Nation above, the recent stimulus package passed by Congress has broken the social compact between rich and poor:

This wave of [labor] protests is only likely to grow, not just because of the coronavirus but also because of the breaking of the social contract by the rich. By crafting bailouts that favored corporations and millionaires amid a pandemic during which blue-collar workers are being forced to work in life-threatening conditions, the American political elite is playing with fire. We could well see social strife far more intense than even the turbulence of Occupy Wall Street and the Tea Party movement that emerged in the wake of the 2008 economic collapse.

 

And that's not the half of it, but we'll stop here.  

The coronavirus has unmasked the dark truths behind the curtain that are the reality of America.  The wizards who mask these dark truths while spinning bright myths want to distract you.  They don’t want you to pay attention to what is really going on.  But that would be a mistake and a missed opportunity. 

“Pay no attention to the man behind the curtain.”  That may be very good medical advice when the man behind the curtain is the current President, who lacks medical expertise, is incapable of understanding or appreciating science, and who lacks a soothing bedside manner.  But it is poor social-political-economic advice.  We should very much pay attention to the Great Oz behind the curtain, because that Great Oz is a failed America. 

The virus has in a few months managed not only to inspire terror and lay waste to American society and its economy, but it has also revealed everything that is wrong with America, everything that is dysfunctional, if not immoral, in American society.  We should seize this vision of the warts and the decay, the smoke and the mirrors, because the truth of what is actually behind the curtain gives us the opportunity to fix what is broken and right what is wrong.  This is the time to recognize, foster, elevate, and celebrate the basic good in people and what America can be if it pulls together and learns from the pandemic.   

For as much as the virus has shown us the sham that lurks behind the curtain, it has also shown us how to find our way home. 

  

Keep it real! 

Marilyn