Omicron, fascism, and the US healthcare system
I wrote something awhile back that I was reflecting on this morning. In December 2019 during my first semester as a health informatics student, our final essay for one class asked us to reflect on the challenges to the current and future implementations of health IT in the US and also across the globe.
Before I get into that, let’s start with a couple of different thoughts. The first will be about sports, the other a current feel. BUCKLE UP THIS IS GONNA BE A LOT. (This is how I spend my free time, no wonder I’m single. I think I need to find a hobby).
On January 25th, 2022, the Wizards led the Clippers by 35 points. The Wizards were still up by almost double digits in the closing minutes, and then completely collapsed in what can only be described as #SoWizards, as Luke Kennard hit a game-tying 3, was fouled, and then made the game-winning free throw. Since that Tuesday, the team morale is completely gone.
After losing to the Suns on February 5th, Montrezl Harrell said this afterwards:
It sucks, bro. That's the mood of the team. It [expletive] sucks. Coming in here and teams are basically beating our [expletive] from start to finish. So, it sucks, man," Harrell said.
"Nobody likes losing. Everyone in our locker room is competitive-minded people and love to compete and get after it. But it just sucks right now because over the last eight games we've played, we lost seven of them. That's tough for anybody to withstand or have on their plate. So, that's the energy in the room right now, it just [expletive] sucks."
On January 18th, Sociologist and NY Times Columnist Zeynep Tufecki said the below on Ezra Klein’s podcast.
Ok back to my class assignment.
We were supposed to use the textbook as a guide and reference for our positions. I did the math in my head and figured I was going to get an A unless if I totally bombed the assignment, so I wrote something of urgency to my teacher almost trying to communicate directly to her. It was like I was testing the waters to see if it was alright to share my thoughts with her. For the first few paragraphs, I kept to what was expected of me in the rubric to show I understood the content, and towards the end I veered off into my personal beliefs. I won’t share the entire thing or context since I want to focus on one idea, but this is a screenshot.
I ended up getting an 89 on the assignment and an A in the class (*phew* lmao). I asked my teacher for feedback. Her main critique was that I “need to stick to the facts.” She was definitely right. I did.
This was not at all mentioned in our textbook.
What data or literature existed at all to back up my point?
Now though, I have an immense regret about not fleshing this idea out further because I feel I understood something that very few even considered:
Fascism is the greatest threat to our entire healthcare system.
As I write this in February 2022, we now have definitive proof that this is the truth. You might ask, how so?
Here are two points I can offer as evidence.
900,000+ deaths in two years, and 1 million documented deaths will likely happen by the end of March. Maybe sooner because the peak in cases for Omicron in the US seems to be around January 16th, which means a major amount of outcomes will be happening between then and February 16th give or take (though accounting for undercounts or related deaths, we're well past a million).
Dr. Maia Majumder is (from her Wikipedia page) “a computational epidemiologist and a faculty member at Harvard Medical School and Boston Children's Hospital's Computational Health Informatics Program (CHIP). She is currently working on modeling the spread of the COVID-19 pandemic.”
Her message is echoed by ER Doctor and Public Health Professor Craig Spencer.
To tie it back before we go forward, what do the Wizards have to do with any of this?
Well, the US feels a lot like the current morale of the Wizards. There’s this elephant in the room that 900,000 people have died, and life just goes on and no one cares, but we live in that traumatic apathy every day. At one point in 2020, 100,000 deaths was considered unthinkable and an upper bound of something like 250,000 deaths was the absolute worst case scenario. We had the potential to handle this thing and keep it minimal, and then we shot ourselves in the foot. Instead of maturely handling the situation, the president at the time told people to drink bleach and shine rays up their buttholes. He actively fought against the science in public, except for this year when he finally praised the vaccines. Still, the damage was done. Our institutions have failed us. For perspective, here are the numbers for every country with a population over 100 million people.
China has over 4 times the number of people, and the US has almost 200 TIMES the number of deaths. Brazil and India are the next closest to the total number of deaths from COVID, and we have almost 300,000 more deaths than Brazil. The US is now inured to mass death.
From an institutional viewpoint, Biden’s largest impediment to passing anything at a federal level regarding COVID are the states who don’t want any federal help at all. Arkansas Governor Asa Hutchinson was recorded saying as such on a call with Biden. I won’t go down the path of how COVID is like the best thing a fascist could hope for because it widens the gap in racial inequities (i.e. rich white man rises to the top because they have access to resources and have no incentive to stop because they’re getting richer and richer so fuck everyone else). This of course leads to state and local levels being left on their own to figure everything out. While there’s some unity around people understanding that getting boosted, wearing a mask, and social distancing are the ways to prevent the spread of COVID, we all know that the reality of actions we see are vastly different across the country (See: Bari Weiss saying she’s done with COVID or children going on strike at schools because of administrators being stupid).
What any sane scientist has said since the world of COVID started has generally stayed consistent. That this is all a very fluid situation, there’s a lot we don’t know and we’re figuring it out as we go. That the vaccine is safe, that masks are effective, and there are approved treatments which can save lives. Compared to March 2020, clinicians at this point largely know what the right protocols are for a COVID patient.
So, what has changed then? If anything at all?
Well, Donald Trump happened. The same people who are vaccinated and boosted themselves are the same people who told everyone they didn’t need to get the vaccine, and then people listened and now their beliefs are hardened. And once those beliefs are initially set, it’s much harder for people to change those beliefs. They double down. Because that’s what fascism does. Trump just gave them the courage to think that it’s ok to be so stupid, even though he himself publicly stated the vaccine works. There’s a reason Ron DeSantis is probably going to win the 2024 election, and how he’s also the same guy whose state just doesn’t report COVID deaths. Thousands and thousands of cases among a large unvaccinated population? No deaths here at all! COVID isn’t a real thing! DeSantis created a fictional society where he decided that real numbers hurt his feelings and image, so he can just make them go poof and all of a sudden he’s the Greek god his small-dick self dreams he is. These same people aren’t explicitly saying it but their followers are following their implicit words and attacking fucking healthcare workers. Because they’re telling you that you’ll be rewarded and protected for doing their dirty work, and someone without bias trying to save your life is telling you lies even on your deathbed.
(Do you still have a hard time calling a fascist exactly that? This is an ad running on my local TV stations in Birmingham for an Alabama gubernatorial candidate. This is not a drill. I don’t know anything about the guy since this is the first we’re hearing about him. But, his message is consistent with what other candidates are saying in other races.)
Additionally, apparently a lot of people did not realize they’d have to continue to get vaccinated for new variants like an annual flu shot. I assume people thought the end of all of this would be the deus ex machina of two shots, and then life would be back to normal. There are likely going to be people who come to grips with this and get a booster every 6-12 months, and also a large contingent of people who say fuck that, stop getting vaccinated, and take their chances of living their life with no fear anymore of COVID.
This can be seen in the number of people who’ve received their booster shots. As of February 5th, the CDC reports that 42.1% (89,594,265 people) of the US population has received their booster shot, and an astounding 50.6% (84,416,108 people) of the population eligible for a booster has not gotten one. There’s a point to be made about data tracking as well, where because of the lack of a national healthcare system in the US there’s convoluted data collection and some boosters are being recorded as first doses. That’s besides the point though, since even if we assumed every new first shot was actually a booster, there’s still a good 100+ million people who are not vaccinated.
So, in the face of a fast-spreading variant, over 100 million people in the US are STILL not getting their first dose, and another 80 million eligible are choosing not to get boosted. When we consider how Omicron is vaccine-resistant and needing its own booster, this poses an incredible threat for the future wherein a fast-spreading Omicron coronavirus combines with another virus which has a higher death rate. One hopes that doesn’t happen, but if it does, we’re fucked. It’ll take 6 months to be able to start rolling out a vaccine for the masses and by that point a mass death event will have already occurred. The situation will be like that in a country like India where we can’t accurately depict death counts because people aren’t a data point from a hospital but instead a buried body on the side of the road.
To reign it back into the current situation, Biden’s federal government vaccination mandate was also stricken down by the Supreme Court. When it was implemented, there was a lot of pushback and plenty of people didn’t comply or sought religious exemptions. It’s not a fringe idea either, there are plenty of healthcare workers I’ve talked to who think vaccines shouldn’t be mandated.
Meanwhile, in more sane societies, the French and Austrian governments have voted to mandate COVID-19 vaccinations. Can you imagine that ever happening in America?
It’s unthinkable. Because as seen from the booster numbers, Americans prefer obscured definitions of individualism, independence, freedom, and have a miniscule amount of regard for how their actions impact those around them. It’s a consequence of people like Asa Hutchinson not wanting federal government help, and individuals are ultimately left to fend for themselves. Who has time or space for community or social systems when you’re just trying to survive?
Americans spend their lives being preyed on at every corner. And from a healthcare perspective, how do you think that plays out?
In my head it looks something like this:
Some asshole at McKinsey who graduated from an Ivy League school crunches the numbers and says to a US healthcare executive, “COVID is good for your profits.” And instead of being repulsed, the executive says, “I’m listening.” The asshole from McKinsey says, “Your staff will be making the same amount with some overtime, but the entire hospital will be full. Also, if you make this small insurance billing tweak, it will make you this much more with little-to-no impact on what patients are currently expecting to pay.” And the executive responds, “Sign me up.” The executive then goes on patting their healthcare workers on the back with signs displayed out front of the building about how much they love their healthcare heroes. There’s free food or cake once a week. You know, small incentives to remind everyone how valued they are, trying to keep them at bay like an abuser telling them this is just how life is everywhere because he needs you to not quit so he can keep making his millions and maintain his lifestyle.
And this asshole from McKinsey and someone like Ron DeSantis join forces to unleash a burden on the modern US’s healthcare system unlike anything it’s ever seen before.
Fortunately, the current Omicron peak is waning.
Compare the above to the outlook from January 16th.
This is good. However, any sane person knows that Omicron is likely not the last variant. The sane, traumatized person will assume this rise, peak, stabilization, and fall will happen again, maybe 1-3 times a year. And culturally, with the rise in fascism, we face a systematic threat to our institutions. The capitalist is telling you to get back to work, the fascist is telling you a million deaths isn’t a big deal, and your society is telling you that these systemic problems you face are only yours to figure out (and if you can’t, you’re weak). Our hospitals get overwhelmed, our heroes deal with the trauma, our researchers fall behind on equally important work, and we all bear the brunt of the uncertainty because our leaders are cowards most concerned with seeming like they have it together and acting surprised when a new variant comes.
As Montrezl Harrell said, “That's tough for anybody to withstand or have on their plate. So, that's the energy in the room right now, it just [expletive] sucks."
Of course, the solution is to push back on the fascists. You punch them in the face. You don’t allow them into your spaces. You let them feel the pressure for having such foolish, shameful beliefs no matter how uncomfortable it makes you. Not an inch. There are more of us than them. Fuck decorum and fuck them. The consequences of not doing so are as plain as day now, that our society continues to deteriorate and fucking suck.
I’ll leave you with one of my favorite rants ever from Feminist Giant Author Mona Eltahawy.
“This idea of respectability, this idea of civility, this idea of unity, all of these words… ‘decorum’, who invented those words? Those words were invented by white men, for the benefit of other white men, in systems and institutions that were always designed to be for white men. And they weren’t designed for women like you and me, and so many others. Like you said, people of color and gender diverse people. They never imagined us in those spaces, and then we show up and we just ruin it for them. So no, I do not have the luxury or the privilege to sit there and be civil with people who do not acknowledge my full humanity. I refuse.”