The first UK death from Covid-19 was recorded on 2 March 2020. Twelve months and over 120,000 deaths later, most people have been through greater upheavals than since the second world war. The UK has been one of the worst hit countries in the world.
Fear rapidly grew – an unknown illness, highly infectious, no known treatment, a high fatality rate among the elderly but even fit younger people sometimes dying or left with life-changing after-effects. Lockdown and lost income as sectors of the economy ground to a sudden halt magnified feelings of stress. Boris Johnson’s reckless determination to prioritise capitalist business crashed after ending up in intensive care himself.
Last spring London hospitals had every bed full, with alarms sounding as oxygen supplies ran low. Exhausted staff made do with insufficient and inadequate personal protective equipment. Withdrawing health care from millions of people with non-Covid health problems avoided complete NHS breakdown. Hospitals in many other parts of the country became eerily empty as patients were hastily discharged without Covid testing into care homes. Low-paid agency workers moving between homes quickly spread the virus to the elderly people most vulnerable to it. Care workers, again without adequate PPE, carried Covid back to their families, spreading it further into the community.
It soon became clear that risks were not equally shared. Pre-existing poor health, often resulting from lifetimes of poverty and hard manual work, increased risk. Workers with the highest Covid infection rates couldn’t work at home, working close to others. Health and care workers, bus and taxi drivers and shop workers were among high risk groups. Living in crowded multi-generational homes added risk, especially affecting black, Asian and ethnic minority communities.
The more the virus reproduces the more often it mutates. Some new variants are more infectious, as in the UK, South Africa and Brazil. It seems increasingly likely that vaccine reformulating and repeat vaccination will be needed, as happens with flu.
Vaccine development and the vaccination programme is the one aspect of this past year that has gone well in the UK. Worldwide, the costs of research and development were underwritten by huge sums of public money, financing an unprecedented mobilisation of laboratories, scientists and other vital experts: $10 billion has gone towards researching ten vaccines, with more large sums given in China and Russia and smaller amounts to over 200 other vaccines. However, profits will be sucked up by the pharmaceutical industry. AstraZeneca claims to sell its vaccine at cost price but only while the pandemic continues – and they will decide when it ends. As vaccination programmes continue in years ahead, AstraZeneca will have plenty of opportunity to profit from taxpayers’ investment.
The NHS-run vaccination programme has established 1,500 centres in England with 30,000 NHS workers (including returning retired staff) and 100,000 volunteers. Five thousand armed forces personnel are involved in testing, logistics and vaccinations. GP practices are devoting much time to vaccination, with ‘non-essential work’ on hold.
An annual programme on this scale, aimed at vaccinating all 53 million adults within months, is unsustainable without much more government money. Permanent staff, resources and premises are needed.
GPs backlog of work, caring for people with long-term health problems, cannot safely be left. Telephone and video consultations look set to continue and do suit many, but are less likely to be used by those with worst risks. They are also easier to centralise in larger call centres, ripe for privatisation, de-skilling and profiteering. The ‘family doctor’, already disappearing after past health service reorganisations, will vanish completely if these trends continue.
After mass vaccination, if new cases drastically fall, it is possible future booster doses might only be recommended for the elderly, clinically vulnerable and workers at risk, as with flu. Fourteen million people were vaccinated against flu in 2019/20, although only about 75% of over-65s. A combined vaccine could make the task much easier. However, it is unknown whether new Covid variants will prove to be more or less serious. It may still be necessary to vaccinate most adults, and possibly children too, so the resources must be found to do so. Nationalisation of pharmaceutical and medical supplies industries, integrating them into a democratically-controlled NHS, is vital.
Covid’s indirect impact on health affects many more than those infected. Children’s education and social development has been disrupted. Workers who have lost jobs, often in industries that may not return for years (if ever), face desperate times. Long-term unemployment has a serious impact on health. Many working from home face isolation from colleagues, competing for work space with family and unable to ‘leave work behind’ at the end of the day. All this affects the mental health of millions, young and old.
Post-traumatic stress and burn-out among health and care workers will also take a heavy toll. Intense emotional demands on front-line staff dealing with extremely ill patients, including having to choose who gets scarce resources such as ventilators, are similar to wartime demands on military personnel. Staff redeployed to areas of work outside their own speciality often feel anxious. Nurses normally providing one-to-one care can feel guilt and depression after dividing their attention between five patients.
Nightingale hospitals made a good news story when quickly built, but after the photographers left where were the health workers to move in? Pre-Covid’s 100,000 NHS staff vacancies will grow if more take early retirement or leave professions mid-career, demoralised and burnt out. Government and employers’ hypocrisy fuels this, happily clapping their ‘heroic’ employees while refusing to pay decent wages.
Unless urgent action is taken the consequences of these shortages for health in general and health care in particular could last many years. As an immediate measure, NHS workers’ 15% pay claim must be met in full and care workers paid £12 an hour minimum (£15 in London), with secure contracts.
This must be supplemented with a massive training programme for both health and social care, recruiting many college and university leavers and workers laid off from other industries. Fees must be abolished and bursaries at a living level reinstated.
Mental health services, always under-resourced and suffering especially heavy cuts during the past decade, desperately need new community facilities, staff and mental health beds. Preventive measures are also essential, like removing exam and work pressures, providing support groups and community services.
The imminent threat of mass unemployment shows the capitalist ‘free market’ cannot meet these needs. Millions of new jobs should be provided including building well-insulated homes and schools with well-ventilated classrooms; teaching smaller classes, attending to children’s physical and mental health and social development with sports, music and arts programmes (for which youth services, decimated by austerity cuts, must also be restored); public transport in which passengers aren’t crammed in like sardines; urgent expansion of renewable energy; entertainments on a smaller more local scale.
Trade unions with community, youth and pensioners’ organisations should draw up plans for full employment and good public services. But implementing them against the inevitable resistance of profit-seeking big business requires an organised mass struggle for a government by and in the interests of the working class. That means building a party to fight for socialism.
The speed at which Covid travelled across the world from its first recorded outbreak in Wuhan shows the importance of a global eradication campaign. Viruses have been successfully conquered before. Smallpox is estimated to have caused 300 million deaths during the twentieth century. The World Health Organisation launched a vaccination programme in 1967, the last naturally occurring case being recorded in 1977. Polio has also been almost eradicated by global vaccination.
While the SARS-CoV-2 virus causing Covid-19 remains in any part of the world it has the potential to quickly return in a mutated and vaccine-resistant form. As more people get infected or vaccinated population immunity will grow and new infections fall. Future mutations could make it a less serious illness, but whether this will happen cannot be predicted.
Roughly $27 billion is needed to fully fund the COVAX programme to vaccinate about one quarter of the population of developing nations, but failure to vaccinate these nations would cost the global economy up to $9.2 trillion, according to a new International Chamber of Commerce Research Foundation study. COVAX only includes the most vulnerable and front-line workers. Although younger populations are less likely to become seriously ill from Covid, the risk of transmission remains.
While Covid remains an imminent threat only an international socialist plan to manufacture, distribute and administer vaccines in every country, with the money and logistics required, can end it. Logging, mining and road building in formerly remote parts of the world bring more humans into contact with viruses in other animal species. International travel quickly spreads infection. Covid is a warning of the vulnerability of capitalist society to future pandemics.