Upstream - COVID and the Pandemic with Beatrice Adler-Bolton

Episode Date: February 15, 2022

By traditional metrics, the U.S. economy is doing pretty well right now — better than any other high income countries. But, at the same time, we have the worst COVID health outcomes of any of these countries too. It seems pretty obvious that by reopening the economy and all but abandoning any interventions aside from the vaccine, the Biden administration has pretty much this outcome. But of course, the problem goes much deeper — it’s a combination of years of disinvestment and neoliberal policies. In this Conversation we’re talking COVID with Beatrice Alder-Bolton, co-host of the Death Panel podcast and co-author of the forthcoming book, "Health Communism: A Surplus Manifesto," which will be published by Verso Books this fall. What are the structural causes of our skyrocketing COVID rates? How has COVID laid bare the rotting foundations of not just the U.S. healthcare system — but almost every single institution in this country? How are our political leaders using the pandemic as a launching ground for the rewriting for the social contract in a way that even further minimizes the responsibility of the state to protect people? These are just some of the questions we explore in this Conversation with Beatrice Alder-Bolton.  This episode of Upstream was made possible with support from listeners like you. Upstream is a labor of love — we couldn't keep this project going without the generosity of our listeners and fans. Please consider chipping in a one-time or recurring donation at www.upstreampodcast.org/support If your organization wants to sponsor one of our upcoming documentaries, we have a number of sponsorship packages available. Find out more at upstreampodcast.org/sponsorship For more from Upstream, visit www.upstreampodcast.org and follow us on Twitter, Instagram, Facebook, and Bluesky. You can also subscribe to us on Apple Podcasts, Spotify, or wherever you listen to your favorite podcasts.

Before we get started on this episode, please, if you can, go to Apple Podcasts and rate, subscribe, and leave us a review there. It really helps us get in front of more eyes and into more ears. We don't have a marketing budget or anything like that for upstream, so we really do rely on listeners like you to help grow our audience and spread the word. And as always, please visit upstreampodcast.org forward slash support to support us with a reoccurring monthly or one-time donation. It helps keep this podcast free and sustainable, so please

if you can, go there to donate. Thank you. So of course, the prioritization of reopening has led to massive, massive amounts of death. But our inability to provide people with a bare minimum of healthcare in the US, health finance, that in and of itself, is also responsible for our absolutely astronomical rates of death in the US, because it's not just the immediate economy, it's also all of the other things, all of the other economic decisions, and all of the things we have decided

are not the responsibility of the government or any sort of collective effort, but they are individual choices at the consumer level. And that being the sort of underlying thesis of how we run things in the US is deadly during normal times. You are listening to upstream. Upstream.

Upstream. Upstream. A podcast of documentaries and conversations that invites you to unlearn everything you thought you knew about economics. I'm Dela Duncan. And I'm Robert Raymond. According to mainstream metrics, the US economy is doing pretty well right now, better than any of the other high-income nations.

At the same time, in comparison with these same countries, we have the worst COVID health outcomes. It seems obvious that by reopening the economy and pretty much abandoning any interventions aside from the vaccine, the Biden administration has all but ensured the continuation of the horrifying COVID numbers we're seeing, almost a million deaths since the start of the pandemic. But the problem goes much deeper than the last couple of administrations and their obsession with keeping the economy going at any cost. What's happening right now is the result of years of neoliberal policies and disinvestment

in social services. As you might have guessed, in this conversation, we're talking COVID with Beatrice Adler Bolton, co-host of the Deaf Panel Podcast, and co-author of the forthcoming book Health Communism, a surplus manifesto. What are the structural causes of skyrocketing COVID rates in the US? How has COVID-laid bear the rotting foundation not just of the US health care system, but of almost every institution in this country? And how are our political leaders using the pandemic as a launching ground for the rewriting of the social contract in a way that further

minimizes the responsibility of the state to protect people. These are just some of the questions we'll explore in this conversation with Beatrice Adler-Bolton. Beatrice, it is great to have one-third of the Death Panel podcast on really great to have you on the show. Thank you so much for having me. I'm so glad to be here. I'm wondering maybe just to start if you could introduce yourself. And yeah, also maybe just talk a little bit about what's inspired you to start death panel. Yeah.

Well, my name is Beatrice Adler-Volten. I am chronically ill and disabled. And so obviously that informs a lot of my interest in covering healthcare policy, particularly in the United States. And in 2018, after many years of sort of being involved at the level of like organizing and just following this stuff obsessively, we started death panel to cover the sort of left health beat

because we felt like it was a conversation that we really wanted to have. And there were all these people we really wanted to talk to about healthcare. And there just wasn't really a show that was doing that, right? So we got started before the pandemic, November of 2018, covering things like the privatization of Medicare and these rule changes during the Trump administration that we're going on, that we're very sketchy and very bad for patients that are coming up the sort of boring administrative level.

The kind of stuff that's like very easy to ignore because at first it seems really boring, right? And so what we tried to do is to look at that kind of wonky stuff, I guess you could call it, and make it really like explicit and make it easy for people to understand actually sort of how these things actually do have material impacts in people's lives,

in workplace conditions, and in terms of like ultimately defining what the range of political will is at the end of the day. So while my personal identity obviously like factors into why I care about this stuff, it's more sort of born out of advocacy for programs like Medicare for All. And realizing, you know, we need Medicare for All, but that is just the first step. And so we started death panel to really kind of try and push the

narrative on the left towards a little bit more of an aggressive strategy on health care, because I think it is an important area that, you know, we've obviously worked a lot on over the years, but there's still so much more to do in the United States. And as we've seen in COVID, right, it's, it's necessary not just to do during normal times, but if we had had a robust healthcare system that would have been able to accommodate the needs and effectively allocate resources, I think we would have seen a different pandemic response ultimately in the US. And so that pre-existing desire to essentially be trying to push the envelope on, you know, what are we really talking about when we're talking about healthcare on the left?

What is healthcare? Beyond Medicare for all? What are the social determinants of health? Housing is healthcare, economic policy is healthcare. All of these things are also healthcare. And so when the pandemic hit, it just basically became the situation where the sort of small niche that we were working in suddenly was the national conversation. Beyond just how Medicare for all was factoring into the general election in 2020.

Yeah, and your podcast has been such a breath of fresh air. And I love how you end with Medicare for all now, solidarity forever. I really love that. And thank you. I came to it a little late in the game, I guess. I just started listening a few months ago, but I really, really do appreciate all of what you just mentioned that you provide and the analysis and the breadth of analysis and information that I've been lucky enough to get from the podcast. So yeah, really appreciate that resource out there. Yeah, I guess talking about getting started during the Trump administration, and let's talk about that a little bit. Let's talk about Trump. I really want to focus a little bit on how the Biden

administration's COVID response is compared to Trump's because I think it's a really interesting perspective. Obviously, Trump was just a horrible in so many ways. And yet, I'll let you sort of get into the response to that. So just, yeah, just in terms of, we'll talk about stimulus or economic supports maybe in a minute, but just like, in terms of handling the virus and its spread, how would you compare the Trump and the Biden administration's COVID response? Well, I mean, this is something we talk about on the show all the time. The most important thing is really like what does the presidency signal in terms of general vibes, right? I think that's been the biggest shift because during the Trump administration,

obviously you had a major incentive from liberal media and from more mainstream voices to be critiquing their actions on the pandemic. So there was a lot of scrutiny early on, which I think was really good because you know you had stuff like rampant misinformation about like hydroxychloroquine being super helpful that was then resulting in patients that are on this medication regularly having a shortage, right?

So it was sort of we were seeing all these things that were just really sloppy, right? Really not well thought through like the idea of like, oh well, can you just put like drink bleach and make it go away or put UV light inside of you? You know all the things that like the New York Times love to make a big deal about and question Trump's competency and question the nature of what was underlying the decision making, right? Like, was this driven by science or was this driven by economic priorities? And I think that that was ultimately beneficial because what we did see is, we definitely saw

like some unprecedented spending, which I think really just reflects more of the fact that you had a absolutely sort of catastrophic sudden shift in the situation with labor, and you had to actually deal with the large amounts of people who were so suddenly unemployed in early 2020. And I think that a lot of those things, they ultimately have worked out to be pretty great programs. The problem is that we've just sort of dropped them

and our new impetus is to do the bare minimum. So I feel like that sort of nature of skepticism being a necessary part of the public's engagement with any public health strategy has sort of dropped. What we've really seen is that that segment of the liberal media that was so ready to critique Trump have been so ready to paint the Biden response in a really good light. And we saw this happening before the vaccine rollout, even was in place. We talked about this on our episode about David Leighenhart that came out recently on Dutth Pinnale. David Leighenhart, who has tremendous influence,

he writes this morning newsletter for The New York Times. He was incredibly critical of the Trump response. And I think public health responses need, especially when things are moving as quickly as they were in the beginning of the pandemic, you need that scrutiny to make sure that we're doing it right. And ultimately, like what we saw is

that the scrutiny that the liberal media provided was not enough to keep people safe. And now that they're not even willing to critique the Biden administration on those terms anymore, you know, which we saw from David Lee and Hart, he started talking positively about Biden pretty much as soon as he's inaugurated. And this is in, you know, this is January 2021. This is crazy high levels of death in the United States records that we only broke recently in this last month, right? And the fact that these commentators, you know, they have that perspective. They wrote the glowing article in January of 2021, praising Biden's reopening plan, none of which actually ended up getting enacted. There were supposed to be OSHA protections for workers. There was supposed to be testing, tracing, none of

this happened, right? And all those people a year later, instead of demanding that the Biden administration actually provide people with like the bare minimum they need to survive the pandemic right now. Like, instead, you know, they're saying it's time to live with the virus and they're trying to normalize it. So you really had more than anything else, sort of a shift in who was willing to like stand up and make public criticism and where that criticism was perceived to be coming from. And I think there's a whole sort of credibility aspect to it that comes into play, right?

The idea is that like Republicans are unhinged and Democrats have their head above water and they go high when Republicans go low, right? This is sort of the Obama mindset, which like obviously is carried through into the Biden administration because they've hired many of the same people. It's the same type of political thinking, and that type of political thinking really relies on public-private partnerships just as much as the Trump administration did. It's just as much oriented towards capital. Yet we do not have that pressure and criticism of the administration that would be required

to bring enough attention and bring enough outrage to try and force their hand. And I think that's been the biggest shift is we've actually been able to do less, they've been able to offer less. And that's because they're not in this antagonistic position with the New York Times and there's incentive for the New York Times to try and help them win elections, right? Yeah, I think that could be applied in like so many different policy areas. Absolutely. Yeah. I guess we're just sort of seeing the real time like we're back at brunch liberal sort of attitude taking place right now. And yeah, I mean, I've been seeing numbers that like more Americans have died of COVID in the one

year under the Biden administration with the vaccine than the one year under Trump without the vaccine. And so I think that's like a pretty, pretty stark indictment in terms of how the Biden administration and sort of the democratic liberal establishment have been dealing with this. And liberal establishment have been dealing with this. And yeah, maybe if you could talk about what are some of the measures that the different administrations have used to get people sort of through the pandemic, right? Like there's quite a bit of support that came out from the Trump administration surprisingly. And I guess to many surprisingly, a dearth of that coming out of the Biden administration. So like, just for that, like someone who may not

really be paying too much attention to this, like, what did the Trump administration do in terms of economic supports? And it's sort of like where has the Biden administration fallen short on that stuff? Well, you know, in the United States, we don't like giving people money directly to help them. And I think that was one of the most astonishing things that we saw early on,

which was the direct checks that were sent to people, as well as the pandemic unemployment assistance, which obviously there was like a huge amount of that that was only possible because of Bernie Sanders. But it's like Trump gets credit for it, but there was the capacity and the incentive for Democrats to sort of be pushing him at that point, too. And that's a big part of it, is sort of what incentive do they have? Because now they don't really have incentive

to be trying to go against what the White House's plan for COVID is going to be right now. But early on, we saw the typical American response to crisis, which is to go hard on public-private partnerships and hire a bunch of consulting firms like McKinsey to try and help sort out the messaging. That's pretty standard, very reminiscent of the 2008 financial crisis.

But you also saw beyond the corporate partnerships that you're used to seeing in American crisis response of getting companies and employers involved at the level of trying to enforce and support public health measures, you saw these direct supports going out, which were actually really strange, making sure that people were able to get food on the table. We had eviction moratoriums that were limited. They have had limited efficacy, but it was still an unprecedented decision to say, listen, you cannot evict people right now. And that should have been done better, and we should have been in the position where we could

have pushed harder to actually provide blanket protections for renters. But what we're seeing now, though, is a retrenchment of all of those direct supports that go directly to people. And the continuation of the kinds of supports that we're more used to seeing in neoliberalism, which is just sort of going for the level of public-private partnership? And I think a really good example of that has been the Biden vaccine mandate, which just was challenged and basically struck down in the Supreme Court, which no one was surprised about. But part of the thing is that they're trying to do these population level interventions, right?

But they're trying to do them in a way that is pro-business and pro-capitalism and doesn't step on the toes of business freedom. And so now what we see is really only those sort of business freedom level interventions where you have stuff like, you know, it's a bit a huge fight to keep student loan payments paused, but it's not been such a huge fight to protect businesses from, you know, having those PPP loans collected upon.

They gave money that was forgivable to businesses if they used it on the set of expenses they're supposed to use it on. But we don't give people money for college that way. It's just a two different mindsets about needs and generosity and what the role of government in our lives is supposed to be. And we actually saw a little bit more of this sort of robust social welfare response under Trump, right? Because what we've seen under Biden is like,

even the promises for that early in the beginning where he said, oh, we're gonna have $2,000 checks. It became a $600 check and like a $1,200 check. You know, it was, you know, a $600 check and like a $1,200 check. You know, they started immediately moving the goalpost, shifting the dials, but the generosity towards corporate interests has not changed. What we've seen is the retraction of generosity towards the people and towards the kind of interventions that are prioritizing low income people

and people who are frontline workers and who are low income workers, right, or who are disabled like me, who have very little, if any income, because what we have now is this consumer driven approach where everything is prioritized towards the needs of like companies like CVS, well, they work their pharmacy staff into the ground and force people to wait in line to request free masks from the government, which they don't even have a tool set up for where you can search for where these free masks are supposed to be that they've announced. And the fact that we're a year into the pandemic, 60,000 people died in January.

60,000 people died in January. 60,000 people just in January. I mean, we're seeing like, we don't know breakthrough death numbers for January, because they haven't been reporting that data very quickly. I mean, it doesn't look good for them, so I get it. They're dragging their feet on it. But in November, October and December, it was about 20% of deaths were breakthrough infections. So that's deaths in vaccinated people. So it's like the idea of even who's being affected, right?

It's completely not reflective of reality. It's this straw man of a sort of unvaccinated Republican who's made their choice, right? Who's a Trump voter, who they're telling you, is the reason why life is not back to normal. And it's become this very sort of adversarial relationship where I think, you know, instead of providing social supports or putting a lot of work into getting people what they need, the Biden administration is putting all their effort into turning this into like a culture war kind of thing. And it's just, it reflects I think not only a like poverty of perspective and political will from their part as like people in the government, I think it also like reflects our lack of pushback and outrage at them. And frankly,

like we have seen this even on the left. People have really given up on COVID. I mean, you guys had Matt Krisman on your show who was leaning full into pandemic nihilism. There's nothing that we can do to stop this. So why do we even bother doing anything at all? And it's hilarious. Matt Krisman sounds like David Lee and Hart on the daily podcast.

Like that's embarrassing for the left. We should be all over COVID. You know what I mean? This is a tremendous workplace issue. We are making workers miserable. Even if nobody died, this level of sickness in the workplace is absolutely absurd. And for some reason, the left just does not have the energy, I guess.

I don't know, or the desire to engage with this. And it's incredibly frustrating because, you know, not just for the people like me who could die of a breakthrough death, but like of all the people who could get long COVID, of all the people who are going to COVID, of all the people who are going to be worried about missing work and not being paid, or are they going to make rent? It's just, is it really worth it to make everyone feel so precarious and then to bully each other into not talking about it? And to try and help the people who are trying to normalize mass death at this incredible scale,

where we're having like 60,000 people die in a month, one year after vaccines are rolled out. That's absolutely a failure. And people are just complacent. And they think that it doesn't matter and it doesn't affect them. And it's because they've fallen prey to the messaging that this is just an individual choice issue, right?

That this is about your personal health, your personal freedoms, your personal choice. And it's disappointing to see so many people fall for such classic neoliberal tropes. And you know, it's okay to make mistakes and have bad ideas about COVID. And I hope that people see this as an opportunity to sort of rise to the occasion and say, listen, I may have been like apathetic a week ago,

but I see an opportunity here for us politically. And I want to take advantage of that because so much of this is framed in terms of people who want to mitigate COVID are making other people feel bad and that this is really about everybody's personal choices, but it's not. This is a population level issue. This is about solidarity. This is about collective action.

This is about organizing. This is about supporting each other. This is about trying to think about more than just ourselves. It's like one thing to say, you have to fight for someone who's not you during the Bernie campaign. And I understand it's a lot harder to do during a pandemic, but it doesn't make that message any less urgent or salient. You know what I mean?

That's one thing I really, really appreciate about the podcast is about your podcast is it really, like, invigorated me with a sense of urgency that, you know, I'm definitely, I think, a lot more cautious and a lot more like, I guess, conscious of the fact that we're still in a pandemic than a lot of like my friend group or, you know, folks that I like associate with, I feel like I'm the one who takes it most seriously still. And I do think that definitely starting to listen to your podcast was a big part of that just because of the sense of urgency that you do bring. Yeah, so I really do appreciate what you all are doing. And yeah, thanks so much for all of that.

And for your really thoughtful response. I want to talk a little bit about, so the US economy is doing very well right now. This is of course at least a, lots of traditional measures of growth and GDP and stuff, which are very problematic in many ways, but putting that aside for now, our economy has grown more than any

of the other G7 economies. And we've also got the worst COVID health outcomes out of any of the G7 countries as far as I know. So yeah, our daily death toll of excess deaths from COVID is greater than in all high income countries. So I'm wondering, economies doing great, lots of people are dying. Are these two things related? Well, it's like there are actually like many things going on right there actually. More so than just those two things. And of course, it's all related.

What Ruth Wilson Gilmore calls contingent phenomena, right? Like none of the things that come to pass politically were preordained by destiny. They're all the result of political affinities and political will and the media and our sociology and our ability to organize with each other. These are all things that sort of mediate like what actually comes to be. And right now in the United States,

what is driving are absolutely stellar death records. I mean, I'm saying that sarcastically, but it's like, it's impressive how bad we're doing in the US, right? As you're saying, like compared to a lot of these other high-income countries, you would think that we are just spending all of this money, right? And it's going nowhere, because you really can't see the sort of impacts of what we're claiming we've done to get rid of COVID in the US, actually, in the numbers that we're seeing of people dying.

But the other thing to keep in mind is that the Biden administration has been saying, like, this is the best economic growth in 50 years. And we are setting like records for first term economic recoveries. And we recovered even faster than during the great recession this time. And look at us go.

And part of that is like, look at all this money we've spent. Part of it is that they had to spend all of that money because we don't have the kind of social safety net that a lot of these other wealthy countries also have. Like if we didn't have a fractured for-profit healthcare system that forcibly disinvests from rural communities, to the point that there are towns where you have to drive two hours

to get to the closest pharmacy if you wanna be vaccinated for COVID, right? Let alone like seeing a doctor or in an emergency, we have none of these things. We do not have paid leave. We don't have parental leave. Most people do not have like own their homes in the United States.

No one has stable housing. Rents have gone through the roof, through the pandemic. And as you're saying, like all of the metrics of sort of normal success, right? The, the GDP has the stock market doing. It doesn't actually reflect actually people's lived experience of whether or not they're surviving okay, or if they're actually getting by right now. And part of it is that I think we saw a lot of really

wonderful benefits from people being given direct cash. And this is something that if you look at like my background is disability studies. Disability study sort of encompasses a lot of things, but one of the things that I look at is sort of the political economy of like how are policies to give people money or oriented, right? And what are the factors that influence like how much money we will give someone when they become disabled? And when these programs were being started, when SSDI, social security disability insurance was being started, people were like, I don't think we should get people cash directly. This is going to be a really big problem.

And it is one of the most successful programs in the United States, despite the fact that it is so underfunded that it is a miracle that anyone gets their checks at all on time. So part of what the issue is, right, is that the United States is starting from this position where our economy also includes all this healthcare crap, right? There's so much money spent in the US, especially, on people being individual consumers of their healthcare.

That kind of spending has gone through the roof. You've got to understand that like the actual sort of baseline conditions of the United States make it so that we can't even compare our economic growth to countries like England or Denmark or Germany or the Netherlands, right? You can't even compare us to like countries like that don't have as much travel. So I think the idea that the death is coming just from our economic prioritization is really insidious because it hides the fact that we were in a crisis before COVID, that we had a health care crisis before COVID. And then it didn't matter how much money the United States could make. People were still going to die slow early deaths because of how we treat healthcare as a

scarce and highly commodified resource and how we treat workers in this country too, which is also very different than other countries. So of course, the prioritization of reopening has led to massive, massive amounts of death, but our inability to provide people with a bare minimum of like healthcare in the US, health finance, that in and of itself is also responsible for our absolutely astronomical rates of death in the US because it's not just the economy. It's not just the immediate economy. I should say it's also all of the other things that all of the other economic decisions and all of the things we have decided are not the responsibility of the government or any sort

of collective effort, but they are individual choices at the consumer level. And that being the sort of underlying thesis of how we run things in the US is deadly during normal times. And during pandemic times, it's exponentially deadly. And that's exactly what we're seeing. So it's like more complicated than just what Biden did now to get the economy better.

It's more like what Biden did 20 years ago to fuel mass incarceration. And what Biden did 10 years ago to drop the ball on like real healthcare reform, right? And so it all compounds, right? And it's not just about inflation or businesses winning this time or businesses winning that time, you know, it all adds up. It builds up over time. And what you start to have is systems where you just start to expect people to be dying.

And that's very much the sort of process we're in now in the United States is they're trying to normalize thousands of people dying a day by saying everybody that's dying had a choice to get vaccinated and we don't need to care anymore. But that ignores the fact that basically regardless of like political affiliation, if a county is low income, less people are vaccinated. There's an obvious Trump effect, my colleague Phil, Phil Rocco, he's great, he's amazing. One of the best things about doing death panel is getting to collaborate with him. And he was doing this analysis and he said,

you know, there is an obvious Trump effect. When you go into a county and it's a majority Trump county, you've got like a flat line. And there's just gonna be less vaccination. But if you look at Biden County as even, if it's a poorer county, there's going to be less vaccination. So it's like just to say, oh, the problem is the unvaccinated, it's just them that are dying every day. Hides the fact that it's not just Republicans, it's disproportionately people of color. It's a lot of working people who are young. It's a lot of people's parents.

It's their grandparents. It's their children. It's their co-workers. These are thousands and thousands of people we have lost because of our refusal to accept that this is a collective problem that requires solidaristic thinking and not a consumer issue. And it's just been so hard to get people to unlearn this sort of consumer framing that I think, you know, it's totally understandable to be locked into that,

because we're just, we're so programmed to think of our health as the sort of asset that we purchase and then use, you know, to barter with our labor power in order to survive in the United States. Yeah, I'm so glad that you brought all of that up because I, yeah, we're listening to to death panel, a couple of the most recent episodes that you all do talk quite a bit about that and I found it really insightful. Yeah, and recently I was listening to an episode of Citations Needed and they did this really great analysis where they showed how the words essential worker and frontline worker are being phased out of the media now.

And I think it's like a really, it's really great demonstration of how the establishment is trying not just, I guess, to like discipline labor after a year of deficit spending, but to really manufacture consent around this idea that we're done giving any special treatment to people, to workers, that we should all sort of just accept that when it comes to government assistance, that the pandemic is pretty much over. And you've explored this idea, like this idea, sort of most recently in the context of COVID being a sort of launching ground for the rewriting of the social contract and how the state has really been treating protection from COVID like you said is this like consumer service as opposed to something to be

provided by like a robust social welfare state. Yeah, I mean, I think Adam and Emma have done a great job and we like we always appreciate other shows that are like standing in solidarity because it can be very lonely to be pushing the ideas that we push about COVID. The most common feedback we get from people is like, oh my God, we love your show. But it's like, as you said, now completely alienated me from it all of my social group

because they see things totally differently. Or I love your show. But for months, I was like, maybe they're a little hysterical, no offense, but, you know, I'm not seeing anyone else on the left talking about this stuff. But I think, you know, we are starting to see some people start to recognize that the things that we were promised by the Biden administration and by scientific communicators and the kind of experts that you see on your read so often in the media, you know, and this is why citations needed as great as

they do this sort of like they look at these patterns, right? And more so than just the individual frame of the essential worker being dropped, which is obviously, you know, a huge part of how early in the pandemic we were using that word to sort of generate compassion for workers. But it was also used as a way to collapse low income workers, like grocery workers, in with high paid frontline workers. And I think that also had some really negative effects in terms of forcing people to work in person who maybe weren't essential as that. Meaning of what essential worker was sort of expanded from people who work in

hospitals, doctors, offices, the sort of essential services, like keeping subways running, garbage collection, power, whatever. And then it sort of became, well, also people who work in supermarkets, obviously. Well, also people who work in chicken packing plants,, well, also people who work in chicken packing plants, obviously, we've got to get food. But then there's like no mitigation that was ever done for the workers in the chicken packing plants or the workers in the grocery store. And so many of the frontline workers that are being forced to sort of put together their

own PPE, who are not being provided adequate PPE by the hospitals are not the high paid hospital workers. They are the low paid hospital workers. They are the people cleaning the buildings who are just as in contact with the virus as people who are providers who are working on patients directly, right? But we've really taken this class stratified approach to the pandemic We've really taken this class stratified approach to the pandemic that is made worse by the framing of individual consumer choice. Because if everybody has to buy their own protection, not only are we sort of competing with each other for scarce resources, we're also competing with all of the other expenses that capitalism demands of us to survive in the United States.

And it can be really difficult to justify spending a huge chunk of your paycheck on PPE if you're only making like $7 an hour. I don't know how the fuck To make that decision if you're immune compromised and yet you have people going out like Lena one who is a doctor and a public health professional and she's been all over the news recently We just did an episode on her this week with Friend of the Show Justin Feldman, which is great. I highly recommend that one, but she's going around saying, well, one way masking works. And we can open everything up.

We don't need any mask requirements and all the chronically ill people, all the immunocompromised people, anyone who wants extra protection, they can just do one-way masking. Well, I'm sorry, but you're just asking basically a bunch of people to pay out of pocket for extra protection for the convenience of the average non-immune compromise person who doesn't want to have to pay for masks anymore. And that is a hell of a fucking trade-off to try and sell as an equity measure about normality and needing to protect the sort of fabric of society through ultimately what all of the people calling for reopening and for dropping masks mandates and for keeping children from having to be required from wearing masks in schools as they want to make workplaces more dangerous for people

because they think that mask wearing discourages consumption. And these people think that like the most important thing is keeping that GDP number going because if the economy fails, all else fails. And so it becomes very easy to start to write off human life in that kind of cost-benefit analysis when you're weighing 60,000 dead here versus the entire GDP of the United States, right? Like, it's no wonder that we are seeing

decisions being made that are resulting in these sort of craven amounts of death because we don't have the sort of organized pushback right now to really point at people like Lena Wen and say, what this person is doing is horrific and they should be ashamed of themselves for advocating this stuff because everyone is exhausted and I get it, you know, it's exhausting. I've been covering this stuff every day for two years. I've just become accustomed to like a state of constant rage. It's my new feeling of calm, right?

And that's like a big lifestyle change. And I'm not saying that like we all wanted to go through this kind of shift where all of a sudden we are thinking about COVID all of the time, nobody wants that. Nobody wants COVID to continue. But COVID's going to continue to be especially this bad. If we keep trying to pretend that it's just going to go away if we ignore it because

that's not how viruses work. And everything that we've done, all these decisions that we made, like the Biden administration in May of 2021 saying, you know what, we're going to be good by 4th of July, vaccinated people don't need to mask anymore, like go back to your life, go to the movies, go consume, go travel, go spend money. That, like, is part of why we have ended up with variance, right? When you start to just have uncontrolled levels of infection, viruses will mutate. The more opportunities you give them to mutate, the more

they will mutate. That's literally all they do. Viruses aren't even alive until they're in your own cells in your body, replicating and mutating. So the more people that get infected, the longer this is going to go. And yeah, you can say, all right, so we don't care if people die anymore. We only care about the economy, but that doesn't make people stop dying. And I think leftists generally care when thousands of people are dying a day for no damn good reason. And it's unfortunately like a game where

we do not have a lot of resources behind us. We cannot be together in spaces the way we're used to. We cannot organize together. The same way that we're used to, things are organize together the same way that we're used to, things are not safe, it's not safe to be inside, especially doing the winter. It's incredibly difficult and I understand why people were down to pessimism, but part of that is that you're kind of buying into what they want you to feel, right? They want you to feel powerless, they want you to feel like you can't do anything and that all that's left for you to do is find your piece with COVID

and learn to accept your risk, right? And that's like saying, like, we can't close Guantanamo Bay. Or that's like saying, you know, we can't get rid of the filibuster. Or we can't do shit about climate change. You know, it know, it's the kind of thinking that is only helpful to the needs of capital. It does not help us as individuals, does not help us as a society, does not help us survive together, and it certainly does not help left movements achieve any of the things that they profess to want to achieve. You're listening to an upstream conversation with Beatrice Adler Bolton. Co-host of the Deathpanel podcast will be right back. I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one

I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one

I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one

I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go back to the last one I'm gonna go, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man, I'm a man That was Dummy Cards by God's stumper. Now back to our conversation with Beatrice Adler-Bulton. One thing that came to mind and which has been brought up on death panel, I think most recently in the episode that you mentioned with Justin Feldman, this idea that these variants are purely biological, like a, quote, like natural phenomenon, and that they don't have anything to do with

like epidemiological reasons. Right. And they just sort of, you know, we don't talk about how variants are like the social aspect of how they're created. And I think it's really important to think about it in that way. I mean, like this new variant, like a sub variant of Omicron BA2.

There are three actually. Oh, great. There's BA2 and BA3. When Omicron was made into one variant, there are actually three sub variants already. BA1, BA2, BA3. BA1 became dominant first, and that's what everyone's been calling Omicron. But BA2 is now becoming dominant.

And it's more contagious, right? Well, so I talked to a lot of scientific experts for the show. I talked to a lot of doctors. I talked to a lot of researchers, epidemiologists, because I don't have this background, so I want to make sure that I'm communicating on this properly. And that's why we try and have these difficult conversations about, you know, isn't more transmissible or is it an epidemiological factor that's driving the increase in cases.

But this is a sort of complicated and really nuanced way to talk about the pandemic that most people are not prepared for. And I think we have a tendency to see the variance and say, okay, you know, more people are getting infected and say, well, it must have evolved biologically. And you have a lot of that being pushed by people who are commentators who actually frankly, like, do not know what they're talking about and are not talking to as many people who do know what they're talking about as I am, that's very clear from their inability to understand and like they're continued like a absolutely inane way of making the virus seem like a person

that has desires and could be negotiated with it's absolutely absurd, but you know, diseases, right? They have social determinants, not just biological ones. And in public health and in sort of health equity and health justice, we call these things like the social determinants of health. And I actually really like also Tim Faust, who's a good friend in the show. In his book, Health Justice Now, he also talks about the sort of structural determinants of health, which are more the political institutions that,

that drive and prevent us from ever making any change and push us towards reformism, but so you have these sort of additional factors if you are being sent to work and you have to pay for your own PPE and there are no mask requirements, right? And let's say you work in food service in Florida, for example. So minimum restrictions, low vaccination, you are working in an air conditioned environment and you're paying for your own PPE, so you're sure as hell you're gonna try and get eight hours use out of it, right?

You are in a position right now where you're all of your protection from the virus, right? It's sort of being mediated just through you as the individual. You do not have like high community uptake. You don't have people saying like, okay, I'm gonna get vaccinated at a high level, but you have everyone behaving as if there is high mask wearing.

There is high vaccination status. They're just acting like everything is normal. And what that results in is just more virus particles being in the air. More infections mean more mutations. As soon as a virus enters your body, it goes in, it finds a cell and it goes into the cell and it tells the cells to start making parts. And that cell will just make parts to make more virus particles. And as this happens, you become infected.

So it's not like you get one virus particle in you and you've got COVID. It's more about volume. So if you have all of these people with all of these infections, we had a million infections in one day. And testing in the United States is terrible, right? So you know that's like way less than what the actual totals are. But if you're hitting like 800,000 a million infections in a day, that is so many opportunities for

evolution that are driven by epidemiological and social choices about what the social determinants of health are going to be? Will people have workplace protections? Will they have a safe place to sleep? Do they have good food? Do they have access to primary care if they get sick? Do they have paid leave? Do they have parental leave? Do they have child care? Do they live in an intergenerational household? Are they immune compromised? Are all these factors, right, which contribute to just not only the spread, but the level of cases, right? So if we have this many people getting sick, then the variants are an inevitability.

But the variants are not a direct result of biology alone. They are also directly resulting from our decisions and these intentional decisions that we have made to minimize and downplay what the meaning of an infection is. And we've seen this rampantly in recent months with people trying to say, oh, we got a decouple mitigations from total infection numbers. And instead we should tie it to hospitalization, but we should only look at the people who are hospitalized for COVID because some people are hospitalized with COVID. They may have come in, you know, after a car accident and happened to test positive for COVID, but it's not like someone with an incidental COVID infection can't spread COVID if they're not in the hospital for COVID specifically.

So it's all it's really designed to do that sort of way the four strategy is to minimize the occurrence of infections that are happening in hospitals which does not keep workers in hospital safe. And it does not keep patients safe. What it does is it keeps executive safe, keeps profit coming and keeps them, you know, indemnified from being responsible for hospital infections, but it also really hides the fact that we are talking about things that happen at a population level. This is solidaristic. This is interdependence. This is not individual people in their own little bubbles. These are not communities that don't intersect. These are people who live together and

the amount of virus in the air is not just affected biology. It's more so a fact of our epidemiological choices, of our policy choices, of our choices, about whether or not we're going to protect people, and whether or not we want people to feel safe or we want them to act normal, consume, spend money in the service industry, go to Disneyland, Disney World, whatever. And we've made these choices, which are resulting in things like Omicron, which yes, biologically, could be more transmissible, could also be that we were like, fuck it, we

can go back to normal and went through a holiday season in the middle of a Delta wave. That would also do it. You know what I mean? It's never one thing. We can't find one origin point for a virus. A virus is a collection of millions and billions of small particles. Like, there's no point of origin.

This isn't like a fire investigation. There's never gonna be like one answer is to why more people are sick with Omicron and anyone trying to tell you one answer, right, is really just trying to collapse the reality that spread is contingent not just on biology, but also on epidemiology. Yeah, yeah. And I think what you were talking about a second ago in terms of like this idea of protection and like the idea that the really feels like the only form of protection that we are sort of getting from, I guess, the top down is this idea of the like being vaccinated is the ultimate protection from COVID. And of course, I'm not like, I think the vaccines are great. Obviously, I'm triple-vaxed all of that.

Oh, yeah, they're awesome. I don't want to give that impression out there. But yeah, can you talk about like the faults in this idea of the pandemic of the unvaccinated and what like you introduced me to the term NPI or non-pharmaceutical interventions. And can you just sort of talk a little bit about that? Yeah, of course. So the vaccines, as you're saying, they are fantastic. I mean, it is impressive what we were able to do in such a short amount of time. And a lot of that has to do with a lot of public money that's gone into funding mRNA projects for decades

now. That of course these companies were then scooped up by Pharma as soon as this technology starts to become available because pharmaceutical companies really just, they do a lot of acquisitions more than they actually do direct research. They buy the research that people are doing. We had this tremendous flood of money into a new technology and it went great. But the fact of the matter is that vaccines

are rarely intended to be the only mitigation that you use. For example, like with hepatitis, there is a foodborne version of hepatitis. We vaccinate people for it if there's an outbreak in the area. But we also require people who work in food service to take food safe handling courses and to get certified. And we have these socially reproduced rules

of our society about how to not pass foodborne illness. For example, we do things like we don't need to mitigate for cholera anymore, but we still clean our wastewater in the United States. And so there are all these sort of interventions that are public health, right? Clean water, plumbing, we've all these interventions that are beyond the level, it's like workplace safety,

it's the kinds of things that actually help the vaccine work. Right? And that's what we on the show try and talk about all the time is and call non pharmaceutical interventions because the vaccine is a technology, right? It's a tool and it is super effective at preventing severe illness and death in certain populations. In other populations, it doesn't work the same way. I'm one of those people, I'm on immunosuppressants. So my body just does not have the same ability to create, like an immune

response when I get vaccinated. And that's has to do with the medications I need to take to keep me healthy and alive. And there are millions of people like me, like who you probably work with, or you probably know, and you may not know, but they're on immune suppressants. Like so many people have rheumatitis arthritis and they're on methotrexade or they have crones and they're just millions of people right who are in the workforce or out of the workforce. Doesn't matter, they're still in society where the vaccine is not as effective in their bodies. And it doesn't

offer the same protection as someone who's what's called immune competent, which is a framing that always makes us laugh on the show. But you know, it's the fact of the matter is, if you just are using the vaccines alone to mitigate the virus, it doesn't do anything to protect people like me who are immune compromised. It doesn't do anything to protect people from breakthrough infection and death. Again, as I said, the breakthrough death numbers are not being reported with a lot of urgency in the United States, but it has been on averaged 20 to 25% of monthly deaths are in vaccinated people.

And it completely ignores also children who can't get vaccinated yet, who are under the age of five. It ignores elders who also have less immune response to the vaccine. And it ignores people who are working and working conditions, which make them vulnerable to the virus.

As in, they have long shifts in small spaces where they can be exposed at high volumes for long periods of time. Like people who work in hospitals, people who work in meat packing plants, people who work in food service, for example, especially doing indoor food service, working in a kitchen, right, where you have a lot of humidity going on. So, you know, what it is, it's an incomplete strategy. It's like putting on a condom that has a hole poked in it. It's not going to do everything. It's not supposed to do everything. It was never supposed to do everything.

Over time, our immunity changes. What we have is this race to using like as little mitigation as possible. And so people have been like, okay, we don't need social distancing, we have vaccines. We don't need to close indoor dining, we have vaccines. We don't need to wear masks, we have vaccines, right? But the masks, the social distancing,

paying people to stay home, something like a circuit breaker shutdown, which would be great right now because infections are exponential and we're expected to see another 77,000 deaths over the next four to six weeks in the United States. Like, these are the kinds of things that help the vaccine work better.

But instead, what we've done is we've rolled all of these things back and we're relying on the vaccine work better. But instead, what we've done is we've rolled all of these things back, and we're relying on the vaccine alone, and it's not designed to be used that way. And it's not designed to be used that way, especially when we have this low of a level of vaccination as we have in the United States. Because ultimately, our vaccine response is not hitting people at the level that it needs to be. There were discussions about herd immunity

early on in the pandemic where people were like, a little more reasonable. And this was still whenever one was like, oh, we should do it through natural infection and just let her rip. Now, you know, that was like, okay, well, if we can hit 80% herd immunity, then maybe we'll be fine.

Now, people are just happy with like, okay, we've got like 80% with one dose, like great, we're good to go. And that's asking way too much of the vaccine. And that's what we're seeing now. But, you know, what it's resulting in is just gonna be like more arguments over vaccine misinformation.

And every time we say something where we're saying, like you cannot just have a vaccine-only strategy, I get like three to five emails that are like, you're encouraging anti-vaxxers. And I'm like, no, you are because you're lying to people about what's actually going on, which is that like the vaccine is awesome, but the vaccine alone doesn't do very much for us without NPI's, without these like coordinated, solidaristic efforts to try and keep overall the amount of virus particles that are in the air. Whoa, that's HVAC.

That's being able to open windows. Half the schools in the United States, the windows are like painted shut and they don't have air conditioning. These are the kinds of decades-long disinvestment and abandonment by the state that are making this so much worse. And we see this in all aspects of our life, especially in the workplace and in schools in the United States, though. And we need to be thinking of MPIs in terms of, okay, are we releasing people from federal prison that don't need to be there anymore? Or are we maybe trying to reduce the amount of people that we arrest because we're seeing that because of jail cycling, a lot of infections are happening and then being brought back

into people's homes. And we did a great episode recently with Dan Berger. And he talked about how many millions of people just cycle through jails in a single year in the United States. And there are small things that we could do, right? Like universal masking that would help. And then there are small things that we could do, right? Like universal masking that would help. And then there are big things we could do, like major carceral reform, de-carceration, freeing people,

the kinds of like structural long-term interventions that would prepare us better for a pandemic. And we're not seeing anywhere even close to that because we're so busy fighting for just, you know, the social acceptance to wear a mask in public without being shamed and bullied out of it or people turning it like outright aggressive on you. I mean, the fact of the matter is,

is it's like asking so much of a technology that really just is not designed to work the way that it's being asked to and what we're seeing is the natural downstream result of using a technology wrong, which we're pretty good at at the United States, I guess, but yeah. Okay, so yeah, I wanna just spend,

I guess just a little bit of time talking about vaccine conspiracies and I think not so much the ones that are coming out of like right wing spaces, maga spaces and stuff, I think those are relatively easy to explain. And like you mentioned the Matt Christmas interview we did, I think he does a fairly decent job of sort of tracing the structural and systemic causes of a lot of those, which are not related to the one, not unrelated to the ones on the left, too. But yeah, I'm more interested in how the mistrust of vaccines manifests on the left, because there are quite a lot of folks who I have come into contact with who are pretty anti-vaccine,

anti-vaccine mandate. I know those are two different things, but oftentimes they overlap. One example would be Charles Eisenstein, who maybe wouldn't characterize himself as being anti-vaccine, but who definitely sympathizes with that idea and enables it through these incendiary polemics comparing the unvaccinated to Jews during the Holocaust.

And there are a fair amount of even socialists in the area, polemics comparing the unvaccinated to like Jews during the Holocaust. And, you know, there are a fair amount of like, even socialists in Marxist who I've come across who think that we can't trust the vaccines because of, quote, capitalism or big pharma. And there's a point at which, what they're saying makes sense. And then there's a point into which it sort of like,

spirals off into stuff that doesn't make as much sense. So I'm wondering, like, what are your thoughts on that? Just more broadly. Like, what are your thoughts on these conspiracies or these, like, vaccine hesitancies or anti-vax, anti-mandate stuff coming out of left spaces? Yeah. My partner and co-author and collaborator

on the show, Artie Virkant, and I actually have written about this in a piece that we did for the new inquiry recently called Pfizer Walk With Me, where we talked about the way that the trips waiver and technology transfers have has really been captured by the United States in order to sort of disincentivize sharing the vaccine technology. And we also talk about the sort of built-in structural biases

of the pharmaceutical industry and some of the financially driven motivations of it that make it very dangerous for patients and also ultimately do result in the kinds of things of like drugs being available in high-income countries but being available in high-income countries, but not available in low-income countries. Also, someone who literally relies on very expensive, kind of scary biological pharmaceutical products to survive, I totally understand the skepticism because it has a cartel. It's this super, financial behemoth that during the pandemic has had tremendous power.

Artie and I even wrote about it in our piece and the new inquiry is sort of approaching if not exceeding the power of many states throughout the pandemic. And we're writing about Pfizer in particular because CEO Albert Borla has really been playing statesmen on delivering these absolutely exploitative contracts to, particularly like countries in the global South, like if you

even want vaccines, you have to submit to these kinds of unreasonable terms. And this has obviously been a tremendous profit opportunity. And format ultimately is an industry that is built on exploitation. Expoits the intellectual products and research and labor of researchers, many of whom do not start out working for form of it, but a lot of this research starts publicly funded in universities. And Farms job is really figuring out how to monetize and sell these things that we sort of discover in more decentralized ways.

If you watch the farm industry over time, you start to see how a lot of these big pharmaceutical companies are really kind of like landlords. They own all of these little subsidiaries. They own this company that does that research. They own this company and that does that research. They've sort of put together this portfolio. And their goals are ultimately like long-term financial stability for their shareholders. And that is antithetical to like goals of global public health. We are people on Duffinale who like

argue for seizing for for seizing IP for eliminating IP. And yet we trust the products because ultimately, like what is going on is that yes, there are incentives to form a, but there are so many other things at play. Like we say this on the show all the time, it's not conspiracy, it's simply hegemony. It's not that forma made the virus and is like doing this to make a bunch of money.

It's that there is a virus. Farma has an answer. They are incentivized to make a bunch of money and countries are incentivized to give them a bunch of money because they're essentially being held hostage. And so ultimately, you know, the thing that I would encourage people who understand, you know, how exploitative Pharma is is I would encourage them not to ascribe a level of competency

to Pharma that they haven't earned because they may be evil and diabolical, but they certainly do not have their shit together to plan some sort of gigantic conspiracy that would necessitate a vaccine product. Frankly, they have way, way, way easier ways of making a ton of money by exploiting existing patients, right? This was a political opportunity and our political economy and the needs and the drives and the values, more importantly, the sort of moral values of capitalism or the problem. Those are the things, not the actual technology itself. Those are the things that people should be mistrustful of. Yes, it's hard to trust research when it's for profit. That's why it shouldn't be. And these are

the kinds of things that we try and talk about on on death panel because they do take nuance and they do take thought. And it has been helpful for me to be chronically ill, as long as I've been a leftist, because I've always had to sort of negotiate my reliance on products from this incredibly capitalist global cartel from pharmaceutical companies that cost hundreds of thousands of dollars a year.

And at the same time, you know, like I'm fully dependent on these products, right, which I completely, you know, disavow and disagree with the entire financial structure that we are told is what leads to innovation in the sector. And I think the important thing to understand is that, you know, Pharma is really all about branding. And they want you to think that they are hyper-competent because that is how they sell value to their shareholders. Which is why, you know, we talk about things

on the on the death panel like, how do you even do research without Pharma? Well, it'd be really fucking easy because a lot of research is already done without Pharma. And they're coming in at the end of the day. And so we talk about this in our book Health Communism too, because the way that we're seeing right now with unequal access to vaccines,

particularly in lower income countries, is very reflective of the landscape with HIV AIDS treatment. When the HIV AIDS epidemic, quote unquote, ended, it ended only for white people in rich countries. And we have a habit with pharmaceutical companies of allowing them to basically only make products for the wealthy. And this is something that like might sound conspiratorial, but in our piece for the new inquiry, already, and I quote,

a guy who was the CEO of Merck in the mid-2000s saying, you know, oh well, you know, we made this expensive cancer drug for Western nations. We don't wanna let India do compulsory licensing because it's not made for them. It's not made for poor people. And so the problem that you see with, with Pharma, if you are skeptical of the vaccines because of your leftist politics,

like you're not crazy, but like the causal element as to why you should be skeptical might require like a little bit more contemplation because it's a lot more complicated than just simply, you know, the kind of right wing conspiracy of this is, you know, a sort of hyper competent targeted attack, you know, it's very similar to the kind of rhetoric that you see with like QAnon saying Like that there are vast conspiracies going on with like networks of child trafficking, right?

It's a kind of fantasy of competency and a fantasy of sort of Surveillance of the population that the government just doesn't actually have and there's nothing better than looking at like how incomplete Our picture of COVID is and and how little we actually know about people dying to understand how incompetent format and the government are. Because the fact that people aren't getting the vaccines that they need all over the world is a result of incompetence and it's a result directly of capitalism.

And ultimately, that's a much more important analysis than this is a vast conspiracy to sort of create some sort of, I don't know, like, pharmaceutical, whatever. I mean, I don't pay that attention to people who get super vaccine skeptical from the left. Because I honestly don't really know what to say with them, to say to them, rather, because it doesn't totally, like, make sense to me, frankly. but I would encourage those people to just think a little bit

deeper about causality and really what's at play, you know, is it like individuals or is it the political economic system that drives it all? It's a much more complicated thing than just one company, one conspiracy, it's hegemonity. Absolutely. Yeah, thank you so much for that. And I guess to wrap up, I want to ask you what you think an appropriate and just COVID response might look like. If you want to go back to the beginning of the pandemic or if you want to start from

maybe what we could do now up to you. But yeah, if we had an administration focused on getting COVID under control and not simply like to maintain and manage the economy or act as the bureaucratic layer of capitalism, what could things look like? Well, I think that's a great question. The first thing I would say that we would need to see immediately if we were actually seeing some sort of competent left equitable response to the pandemic is robust workplace protections, paid leave, sick leave, parental leave, facilitating people to move out of intergenerational households if they have to work in person and they live with someone who's older or who's immune compromised, we haven't done any of these targeted interventions that a lot of

pandemic minimizers like to claim that we've done. And so I think the first thing would be to make sure that if people are working, if they are there, like out there sacrificing their body for the economy, they should have all the PPE they could possibly need, right, we need to be upgrading ventilation, we need to be making sure that schools are safe, we need to be investing money in general on public infrastructure and making sure things like

buses have adequate HVAC and subways have adequate HVAC and that we're increasing public transportation for people because right now what we've seen is just an increase in people driving in their cars, which is only going to make climate change worse because it's like a little bit more dangerous to ride public transportation right now. So we can't just expect things to go back to like a pre-2019 normal. I mean, as we've talked about on the Deaf panel often, it's almost as if people want like a pre-2016 normal now that the Biden administrations in office and they just want to erase it's almost as if people want a pre-2016 normal now that the Biden administrations in office and they just want to erase it all

and memory whole everything and just move forward. But ultimately, you need to be really trying to get people vaccinated, get people PPI that they need. We need to do something like a circuit breaker paid shutdown, right? Like cases are exponential. I assume that this is like a basic fact that most people understand.

But to stay the obvious, like viruses work when like one person gets infected and then they infect more people and those people infect more people and then it grows, right? It's like going viral. So right now what we have is we had a tremendous two month long increase where we set records

with cases. And if we wanted to do something tomorrow to stop the death, to stop the misery and to try and buy hospitals enough time to just treat all of the patients that are sick right now, right? And actually give us time to maybe try and make sure that healthcare workers can get enough sleep to do their job, or that they have enough space to do their job, or that they can transfer patients successfully between hospitals, right?

We would need to set up these sort of NHS style systems where you have the ability to coordinate across facilities and coordinate resources and get resources to where they're going, right? And to do that, you need to do something to interrupt the exponential spread. And cases that haven't tested positive yet are still cases that we can prevent, right? Positive cases two weeks from now, we could prevent if we did a paid shutdown tomorrow. And not all of them, obviously, but it would be a huge truncation of like the trajectory

of exponential spread that we're experiencing. And it's an incredibly effective strategy, but we're at the point where we essentially have no mitigations in place, and yet there is yet, you cannot open a media source without seeing an op-ed or an article saying, it is time for more off-ramps for the restrictions, which again are basically non-existent. And it's not like we need that many complicated things.

It could be just as simple as pay people $2,000 a month and coordinating grocery deliveries for two months. Who knows what would happen, right? That's a week's worth of time without exponential spread. And something like that could be absolutely transformative. And that's the kind of thing that we need to be thinking about in terms of, you know, how do we actually get to a point where we can live safely with the virus or get it to a level that is acceptable. And no one will say what is acceptable, right? We joked on our episode with Nathan Tankus about how in January of 2021, we were just

musing like, what would it cost to get down to 500 deaths a day. You know, what if we design policies by saying, okay, here's our goal. We want 50 COVID deaths a day, no more. What is that cost, right? And it involves like a totally different mindset. And I think we have to be thinking about policies for the long term as well. So it's not just what can we do immediately to stop the death, but how do we support workers and make sure that people have the resources they need when they get sick. We need

things like Medicare for all. We need housing. We need to address climate change. Really, the pandemic is not in a vacuum. It's a part of our lives now, whether we like it or not. And all of our policies and all of our advocacy for a while is going to have to consider COVID because it's not going anywhere as much as I would love for it to go away because I miss seeing people in person and I haven't really been able to do that because I'm immune compromised and we're having hundreds of thousands of positive cases a day and I really can't afford a trip to the ICU, you know, and I really don't want to get sick because I don't have to, right? We don't have to be getting sick right now. We don't have, even if nobody died over the next year, it would be horrific to send that many people to work sick.

We've got 200,000 people a day testing positive for COVID. That's like nothing like what we see during a flu season. Just the working conditions that are downstream of these decisions that allow such high levels of community spread themselves will decimate any gains that the labor movement has won over the last couple of years. And if we want to do anything in this country to support labor, we absolutely need to be finding demanding that OSHA get off their ass and start making some actual regulations about what is and isn't okay in a workplace because as it stands, it's not like OSHA regulations are super enforceable,

but there isn't even anything for an employee to take to their boss and say, listen, you have to provide a safe workplace for me under COVID. We haven't provided that to people. And it's really become a sort of every man for himself, every worker for themselves, and you know, immune compromise people can get fucked. And that's our current policy. And to be honest, like, I don't understand how we're going to survive this long term. I don't know how we can keep up this sort of level of death because our healthcare system was already in crisis and at the breaking point before the pandemic.

And it has been two years. We're going into year three. We have to stop the exponential case spread. We have to do something to slow down these waves. And we have to think realistically about what works, and not just what's good for the economy, but what's good for our collective survival for once. These are the problems that left us

are great at solving. This is the kind of messaging that we can really embody and push. And I would love to see some enthusiasm for people behind at least protecting workers at their workplaces, right? That would be the bare minimum that we would need to see right now. And it is like so far from the truth.

And it is so far from what we're actually seeing that I understand how frustrating it can be to feel like you're fighting a battle you can never win. But the fact of the matter is, is that, you know, on death panel, we've seen people weren't talking about the immune compromised issue. We started noticing it because I was talking to scientists who were saying, oh, by the way, you're immune compromised, you need to be careful. And I was like, well, why? And they're like, well, my no work the same in you. And I was like, oh, that's interesting, because I don't hear anybody talking about that. And so we kept asking and we got our audience to talk about it. And we we met

with and collaborated with people who agreed with us that, yeah, nobody was talking about the fact that immune compromised people are not responding the vaccine the same way. And lo and behold, they're forced to acknowledge it. It's not like they've done anything about it, but like it has to be acknowledged at the national level, even David Lee and Hart in his pieces where he's like totally minimizing COVID and saying, oh, well, it's admirable that you care about other people and you don't want to infect other people. He has to acknowledge that people and you don't want to infect other people, he has to acknowledge that that's not just the unvaccinated. That's also a lot of vaccinated people and it's a lot of older and vulnerable

people that are society already neglects and abandons, right? So it's only compounding. And this is exactly the kind of issue where you need really aggressive, expansive, political imaginaries. And that's what the left is capable of, and we are not rising to the occasion right now at all. Well, on that note, thank you so much, Beatrice. I really, really appreciate it. This conversation and as usual, really appreciate any time I get to hear you and the rest of death panel. And yeah, thank you again so much for coming on. Yeah, of course. Thank you for the ability to rant. I always love a chance to try and hammer

home. White COVID is really important because it ultimately is an opportunity for the left. It's a political opportunity that we are not using to its full advantage. And we are letting people down and we are not standing in solidarity with people we should be standing in solidarity with by not taking this issue up and organizing around it and really trying to think through how this fits into a leftist politic because it is a crucial issue that we are going to be living with for a long time. It's been two years. It's time we start organizing to try and have a real left perspective on COVID because it's the only way we're going to survive. You've been listening to an upstream conversation with Beatrice Adler Bolton,

co-host of the death panel podcast and co-author of the forthcoming book Health Communism, a surplus manifesto which will be published by verso books this fall. Thank you to God's stomp for the intermission music in this episode and to Beth and Meir for the cover art. Upstream The Music was composed by Robert. Upstream is a labor of love. We distribute all of our content for free and couldn't keep things going without the support of you,

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