Zero Covid Ireland with Socialist Policies
by Diana O’Dwyer
Introduction
The latest figures from NPHET indicate we are right back in a second wave of coronavirus. Hospitalisations and deaths are already increasing as infections spread from younger people to over-65s. The time lag between cases and deaths has been longer this time round due to social distancing, mask-wearing, and the fact that many older people and people with underlying conditions are still cocooning. But the virus hasn’t changed and is creeping inexorably towards the vulnerable, bringing with it an inevitable second wave of sickness and death. The same pattern can be seen across the US, Spain and France where the virus initially resurged among young people with few deaths for 4 to 8 weeks before spreading to the elderly. Already in Ireland, clusters are re-emerging in nursing homes, where the majority of first wave deaths occurred.
Back in early June, cases bottomed out at 5-10 per day but the 7-day average now stands at 1,100. The burning question is why has this happened and why has the government allowed it to happen? This article identifies three main reasons, all of which are rooted in the relentless capitalist drive for profit: the state failed to deal with major drivers of the first wave or to take full responsibility for public health; the economy was re-opened too fast; and the class politics of Covid-19.
1. Failure to deal with drivers of the first wave
Back in the summer, the second wave was seeded with renewed outbreaks in meat factories despite them having been so central to the first wave. In the Dail in April and May, the government had been warned repeatedly about the need for unannounced inspections and full sick pay for meat plant workers but dragged its feet out of a reluctance to interfere with the market freedoms of the beef barons. Only when Kildare, Laois and Offaly were locked down to stop the spread from the meat factories were unannounced inspections increased. However, the government still failed to legislate to close the factories, preferring to rely on the ‘good will’ of the owners, rather than the force of the law so readily applied to working people. The bosses’ refusal to even negotiate with the unions on sick pay is still passively accepted and the unsanitary living conditions forced on workers, including the disgusting practice of ‘hot bedding’ (where workers sharing accommodation are forced to share beds between shifts) have not been addressed.
Sick Pay
Ireland remains one of very few EU countries with no legal entitlement to sick pay from your employer - a gaping hole in the social safety net that is welcoming the virus back into the workplace. In nursing homes, childcare, homecare, hospitality and cleaning, the vast majority of workers are still not entitled to proper sick pay. At the start of the first wave, the government introduced a souped-up Illness Benefit for people with confirmed cases of coronavirus and those told to self-isolate. But at €350 a week, it’s less than the minimum wage for a full-time worker. Low paid workers who can barely pay rent can’t afford any drop in their income and so are likely to keep working, especially if they don’t feel very sick, which is common with this insidious virus.
Lack of sick pay was an important factor in the outbreaks in meat factories and will happen again in other workplaces. How likely is it that a substitute teacher who feels a bit under the weather but may not have all the classic symptoms will err on the side of caution and refuse a day’s work when they won’t get paid for it? This also highlights the problems caused by precarious work for managing the pandemic. “Gig economy” workers for companies like Deliveroo, along with many bogus self employed meat factory and construction workers, are not recognised as employees let alone entitled to sick pay. To pull out the roots of the pandemic would require tackling these underlying conditions but because that would mean cutting into the profits of big business, the three government parties have no intention of doing it. The same callousness in the cause of profit is apparent in the attempt to force high risk teachers with multiple underlying conditions back to work and in the wider refusal to open up employer sick pay schemes or even Illness Benefit to people who aren’t currently sick but shouldn’t work due to being in a high risk category for coronavirus.
Outsourcing responsibility for public health
Another major driver of the first wave was the government’s failure to protect vulnerable people living in institutions, particularly nursing homes and direct provision. Ireland had one of the worst death rates in the world for people in nursing homes, at 56% of all deaths. [1] Most nursing homes are private businesses that had no formal relationship with the HSE, enabling the state to wash its hands of the people living there. At the height of the pandemic, the HSE bought up all the available PPE and delayed re-deploying healthcare workers to the homes despite dangerous staff shortages. In one nursing home where 22 residents died, a single nurse was left caring for 69 people including 15 suspected Covid cases!
The carnage in the homes has forced the state to take on somewhat more responsibility for them. Yet, in addition to refusing to mandate full sick pay, it has done nothing about the circulation of agency workers across different homes and is actually repeating the same mistakes with private hospitals. On September 8th, the Minister for Health responded to a parliamentary question from Paul Murphy TD about a lack of consistent Covid testing for patients undergoing surgery that ‘My Department does not have a remit in relation to the operation of private hospitals’. The same was said of nursing homes six months ago.
This evasion of responsibility stems from a deeply embedded neoliberal ideology of outsourcing public services like welfare, health, education and public transport to the private sector. Shrinking the state in this way has many benefits for the capitalist class, including providing additional arenas for profit-making and cutting public spending, which reduces the tax burden on big business and the wealthy. The minimalist neoliberal approach to the state has become so entrenched in governments and civil services over the last 50 years that there has been a huge loss of skills and resources that states formerly had for organising public services. One result is a generalised state incompetence (leading to calls for yet more privatisation to a supposedly more competent private sector), clearly a major problem during a pandemic.
The clearest example here and in the UK during the current crisis is the failure to develop an adequate FTTIS (Find, Test, Trace, Isolate, Support) infrastructure. Rather than employing a permanent workforce of dedicated civil servants and public health doctors, both governments went for the cheapo neoliberal option of outsourcing it to private agencies and hiring a casual and even partly voluntary workforce with poor pay and conditions. In Ireland’s case, highly skilled healthcare professionals like physiotherapists and speech and language therapists were also redeployed to do the basic job of testing, presumably as a cost-saving measure.
The result in the UK has been the ignominious collapse of testing and tracing as profit-seeking companies cut costs by not following up on contacts and patients were told to drive hundreds of miles to get tested. Less dramatically, in this country the underfunding of the system forced the HSE to ration testing (by cancelling serial testing of meat factory workers and nursing home staff) as soon as there was any significant uptick in cases - much like it does with every other form of healthcare through endless waiting lists. The state also hasn’t resourced public health doctors to trace the origin of outbreaks, as opposed to the close contacts of infected persons. According to Philip Nolan, the Chair of NPHET’s Irish Epidemiological Modelling Advisory Group, generally all that’s done is to trace an infected person’s contacts for the previous 48 hours rather than try and trace where they were infected in the first place, which could have been 5-7 days previously. Incredibly, Dr. Nolan described this as an ‘academic exercise’ before later admitting that ‘of course our colleagues in public health would track down the source if they had the resources to do so, but they don’t’. The predictable result is that we’re flying blind as to where infections are coming from, leading us inexorably towards a second lockdown.
It’s all on you!
The mirror image of the neoliberal state’s refusal to take responsibility for public health is a huge emphasis on personal responsibility. As Margaret Thatcher famously said, ‘There is no such thing as society. There are individual men and women’. What this amounts to during a pandemic is the neoliberal state offloading responsibility to individuals to stop it, so as to evade its own responsibility and ensure the continuation of profit-making. It’s not a coincidence that right after ignoring NPHET’s advice to immediately move to level 5, the Minister for Health, Stephen Donnelly, was tweeting to “Please try to focus on what you can do” and that “Individual actions are key”. Likewise, his coalition partner, Fianna Fail’s John Lahart, tweeted that “It's all about individual responsibility now”.
So rather than tackling the rotation of agency workers with no sick pay between private nursing homes, family are told not to visit lonely elderly relatives and rather than ensuring rapid, voluntary and universal access to testing and quarantine facilities, you’re told to wash your hands, don’t touch your face, wear a mask, go home and self-isolate. The same shifting of responsibility is evident in the emphasis on house parties and ‘household’ clusters. Through warnings to ‘stay home this weekend’, we are made believe the virus primarily spreads in the limited leisure time people have outside of work, rather than through commuting on crowded public transport and working in cramped, poorly ventilated offices, factories, shops or colleges. By diverting attention to people’s social activities, bosses forcing workers back into unsafe workplaces and children back into unsafe schools are let off the hook. This is despite SAGE, the UK’s equivalent of NPHET, recently estimating that closing schools and mandating work from home would each have double the impact on reducing virus transmission as stopping people mixing in each other’s homes.
Get back to work! (And don’t worry too much about ventilation)
The absence of strong public health advice on working from home and on ventilation are perhaps the strongest examples of the individualisation of responsibility for the pandemic and neglect of wider social conditions. The HSE’s slogans to the public on preventing coronavirus are to ‘Wash your hands, Cover mouth if coughing or sneezing, Avoid touching your face, Keep surfaces clean, Stop shaking hands and hugging, Keep a safe distance’. Avoiding indoor spaces, including crucially indoor workplaces, and ensuring adequate ventilation where this is not possible are still not mentioned despite a wealth of evidence showing fresh air is crucial to stopping transmission of this airborne virus.
If the government’s primary consideration was to protect public health, it would mandate employers to implement remote working where at all possible or else face hefty fines or imprisonment. Instead they have left it up to individual bosses to judge whether on-site work is essential, which has been one of the key differences compared to the first wave, when only workplaces designated essential by the government were allowed remain open. The then Acting Chief Medical Officer, Ronan Glynn, indicated weeks ago that NPHET were worried about this when he complained to the Oireachtas Covid Committee that “look[ing] at the amount of traffic on the roads – it’s hard to believe people have taken the message to heart that they should not be going to work unless it’s absolutely essential”. He later clarified that he “was asking employers to facilitate employees to #WorkFromHome under level 3 guidelines” not “speaking directly to employees”.
Where on-site work is genuinely unavoidable, the state could require employers to install proper ventilation and air filtration systems or it could provide them. In fact, there are no government guidelines on workplace ventilation and very little for schools [2] even though more than 80% of secondary schools lack a proper ventilation system. This is literally all the Return to Work Safely Protocol (p.21) has to say about it:
‘Air conditioning is not generally considered as contributing significantly to the spread of COVID-19. Switching off air conditioning is not required to manage the risk of COVID-19. For organisations without air conditioning adequate ventilation is encouraged, for example, by opening windows where feasible etc.’
The reason for this is simple: the government is prioritising profits over public health. Ensuring proper ventilation could be costly so bosses don’t do it and many schools wouldn’t be able to reopen because they don’t have it, leading to productivity losses for employers of working parents.
So the government ignores the evidence that the coronavirus is airborne and tells you to wear a mask and maybe open a window if you’re able. This has a knock-on impact on public health messaging generally. Probably a majority of Irish people don’t know the virus is airborne i.e. spread by microscopic particles with a much wider range than the two metres of larger droplets. This has been recognised as a possibility by the World Health Organisation since July and by Dr. Anthony Fauci in the US but there is still no mention of it on the HSE public information website on how coronavirus is spread. Airborne transmission is in all likelihood a major reason for household and restaurant transmission but this is still not being properly explained, fuelling public scepticism and even opposition towards renewed restrictions.
Despite the flaws in public health advice, the state has been so successful in shifting responsibility onto all of us as individuals that over 70% of people in a ESRI survey believed that anyone who tested positive was likely been ‘reckless or careless in following advice’. [3] The emphasis on individual responsibility has grown over the course of the pandemic, as the government lifted the lockdown and increasingly and more obviously prioritised the economy over human health.
2. Rushing to re-open the economy
Back in May, the government published a relatively cautious Roadmap for Re-opening Society and Business that was substantially based on NPHET advice. No one was to travel more than 20km and hotels were to remain closed until July 20th, remote working was to continue ‘for all workers/businesses that can do so’ until August 10th and no pubs were to re-open before that date. But bowing to intense big business lobbying, Varadkar slammed on the accelerator and sped up the roadmap. Against NPHET advice, most pubs were reopened on June 29th with the figleaf of a €9 meal, including two-thirds of pubs in Dublin; the 20 kilometre travel limit was abandoned early as a sop to the tourism and hospitality industry; and the government responded to pressure from the Restaurants Association of Ireland (RAI) to send public servants back to the office so as to help cafes and restaurants in the city centres return to profit. Successful lobbying to reduce the 2 metres social distance to 1 metre for pubs and restaurants probably also reduced compliance with this rule overall, significantly contributing to higher transmission. [4] A recent survey in the US found people were twice as likely to test positive if they had eaten out in the last two weeks. Likewise, the public health authorities in England have found that ‘eating out was the most commonly reported activity in the two to seven days prior to symptom onset’ with a quarter of positive cases linked to pubs or restaurants in this way.
There was also enormous pressure for schools to be reopened. A lot of this came from exhausted parents worried about their children’s education and well-being and forced to juggle childcare with working from home during the lockdown. But there was also huge pressure from employers anxious for working parents to return to normal levels of productivity - and profit-making regardless of the risks for teachers or children.
The result has been a disastrous collision between re-opening and a resurgent virus. Biding its time in the seedbeds of the meat factories, it burst out into communities busy with staycationers and seeped into re-opened schools and increasingly crowded public transport, pubs and restaurants. The government rushed headlong to re-open the economy and now we are all reaping the whirlwind. This shows how utterly short sighted the capitalist establishment is. Their hunger for short-term profits over the summer meant a golden opportunity to get to zero community transmission was lost. Take Larry Goodman as a prime example. On the one hand, he is the biggest owner of meat factories in the state, which seeded the virus over the summer, on the other, he is the biggest owner of private hospitals, which netted over 300m from being rented out by the state during the first wave of the pandemic. What a win-win for the capitalist class but unfortunately not for public health.
3. The class politics of coronavirus
It’s hard not to suspect that part of the reason governments across Europe and the US re-opened so recklessly is that they now know for certain that some of us are all in it together more than others. This is a virus that takes a far heavier toll on manual workers, ethnic minorities, and low income pensioners. The wealthier you are, the better able you are to work remotely and cocoon. Initially in Ireland, it was wealthy holidaymakers back from skiing trips who contracted the virus but as time has gone on, the evidence everywhere is that working class people are in the firing line. In England, security guards, care workers, nurses, sales assistants, taxi drivers, bus drivers and chefs were the most likely to die. Research by the ESRI identified the same workers here as being at greatest risk, in addition to cleaners, van drivers and factory workers. With schools so far remaining open during the second wave, teachers may be about to join that list.
The greater vulnerability of these workers is due to a combination of the manual or public-facing nature of their work, their age and/or poorer underlying health and being more likely to live in lower income areas with higher rates of the virus. Among the worst affected areas in the last few weeks have been Blanchardstown-Mulhuddart, Tallaght Central, Celbridge, the South West Inner City and Balbriggan. Many of these areas also have big immigrant and ethnic minority populations, who are likely to be worse affected because of the work they do and because they are more likely to be living in overcrowded conditions. A big percentage of meat factory workers, care workers and taxi drivers are non-nationals and there have been numerous outbreaks in direct provision centres. When it comes to pensioners, again it’s the working class that are worst affected. Well-to-do pensioners can cocoon comfortably but retired manual workers are more likely to have underlying conditions, rely on public transport and live in low income areas.
Ultimately, our defences against this horrible disease are only as strong as the weakest link. The rush of the capitalist establishment to re-open and resume making profits, while hypocritically emphasising personal over state responsibility exposes their shortsightedness and the bankruptcy of the whole system. The relentless capitalist profit motive is driving the second wave across the world. It’s also what lies behind the glaring contradictions in public health advice: stay at home, reduce your contacts, don’t make social visits, wear a mask. But go back to poorly ventilated schools and workplaces on crowded public transport if your boss says so, reopen shops and gyms, and (until recently) take off your mask for two hours inside busy restaurants and pubs.
Such mixed messages are fuelling the rise of conspiracy theories. People understandably ask, how come it’s not safe to go without a mask on a bus but it is in a restaurant or classroom? Why is it ok to have shops and pubs open now with far more cases than when they were closed during the lockdown? Why did they lock down whole counties but keep meat factories open? Why is one office open but another identical one closed? Why do I still have to go to work but I’m not allowed visit friends or family? If the government was so worried about people spreading the virus why have they ended the eviction ban and cut the pandemic unemployment payment?
In the absence of strong class consciousness, such contradictions feed into conspiracy theories that the virus is a hoax invented by big pharma to sell vaccines, or created in a Chinese lab and spread through 5G to help China rule the world. Many of these have been orchestrated by the far right and are deliberately designed to lead people suspicious of the contradictory official response down the rabbit hole’ to hyper-individualist and xenophobic conclusions.
The emptiness of the government’s ‘all in this together’ rhetoric reinforces this. It’s blatantly obvious we’re not in all this together. We never were. But rather than identifying the economic interests of the capitalist class and the class politics of the coronavirus as the reason for this, the far right instead tries to confuse people and turn workers against each other by pointing the finger at shadowy “globalist” forces and foreigners. A good example is how it blames refugees and migrants for the housing crisis and attacks direct provision centres, rather than the pro-market policies of landlords, governments and developers.
To counteract this, we need to reclaim the solidarity shown during the first wave when healthcare workers were applauded for heroically fighting the virus in hospitals and nursing homes and respect was finally shown for the essential workers that keep society running. This time though, it has to be a bottom-up class solidarity, not one hijacked by the establishment, that can fight for a zero covid Ireland with socialist policies as the only pandemic response that can avoid repeated future waves of the virus and thousands more thousands deaths.
Socialist policies for a Zero Covid Ireland
Any time a zero covid strategy is mentioned, the knee jerk response from governments and business is that it’s impossible to eradicate the virus without a vaccine. This deliberately misunderstands what such a strategy means - which is to reduce cases to the minimum possible, by eradicating community transmission and aiming for zero. At the moment, the policy in most Western countries is only to suppress the virus to a level where it won’t overwhelm the health system and cause chaos. By contrast, countries as diverse as New Zealand, Iceland, South Korea, Taiwan, Vietnam, China and Australia have gone for some variation of a zero covid strategy and been able to safely reopen their economies and societies to a much greater extent. None of them have completely eliminated the virus of course but they all have far fewer cases and deaths than in almost all of Europe and North America.
A zero covid strategy with socialist policies would adopt some but not all of the tactics used in these countries. Aspects of their experience in developing effective FTTIS systems could be learned from but we would obviously not be in favour of compulsory mass testing, militarily-enforced lockdowns or mass surveillance like in China, Australia or South Korea, or any other measure that would interfere with civil liberties and the rights of workers and oppressed groups to organise collectively for their interests. Instead, we would emphasise giving people the economic and social supports they need to voluntarily comply with public health advice. This is backed up by scientific research, which shows that encouraging good behaviour is far more effective than threats of arrest or fines.
Socialist policies for protecting public health
Unfortunately at this stage avoiding another lockdown is no longer possible. It could have been in May or June when ‘community transmission’ or cases whose origin can’t be identified was almost down to zero. But this time, policies need to be put in place that will allow us to get out of lockdown without cases erupting all over again.
First off, everything possible must be done to fight the pandemic. This means massively expanding the health service by hiring thousands more permanent staff and nationalising private hospitals. This would maximise ICU capacity and enable the close to a million patients on public waiting lists for other illnesses to be promptly treated. Private nursing homes and homecare companies would also be incorporated into a well-run universal public health system with decent pay and conditions for workers and full access to PPE, healthcare and whatever else is needed to avoid a repeat of the tragedy last April.
It also means developing a world class publicly owned Find, Test, Trace, Isolate, Support (FTTIS) infrastructure that goes after the virus and gives people the support they need to protect others from getting infected. Testing would expand from people who request a test and their close contacts to sewage testing and voluntary pool and mass serial testing to seek out isolated cases before they develop into outbreaks. The definition of a close contact would be widened and contacts of contacts would be tested. Tracing would go back in time to find the source of outbreaks and detect the super-spreading events thought to account for 80% of cases. Transport would be provided to bring people safely to testing centres and isolation facilities, which would be provided for free to all who want them.
All of this would be much easier with a coordinated all-Ireland approach that would enable effective quarantine and isolation of incoming travellers to the island and put an end to the current crazy situation where contact tracing stops at the border but the virus obviously doesn’t. Once a zero covid island is achieved, Ireland could be linked up with other zero covid ‘green zones’ around the world. For zero covid to work, it must be an internationalist project.
To support people in complying with public health advice, the Pandemic Unemployment Payment must be restored to at least €350 a week. Full sick pay and paid childcare leave would be provided for all workers, which would mean ending bogus self-employment and the ‘gig’ economy. Leave on full pay would be available for anyone suffering from an underlying condition or living with someone in a vulnerable group. Evictions would be banned again, only this time mortgage and rent payments would also be written off. Public transport could be made safe by massively expanding it rather than telling people to take individual responsibility and avoid it, providing free masks and hand sanitiser and retrofitting proper ventilation. Cycling could be made a more realistic alternative for many by investing in free public bike sharing schemes in addition to safe cycling infrastructure. The money to fund all these measures is already there. RISE in conjunction with socialists, trade unionists and activists across Europe has proposed a number of Covid taxes on wealth and profits that could fund it.
Ultimately, the pandemic will only be resolved when an effective vaccine becomes universally available but the above measures would enable a gradual safe reopening of society and the economy when community transmission was brought down to zero. The fact that several countries that don’t provide anything close to that level of social supports have managed to achieve this shows that it is perfectly possible. With socialist policies, it could even be made relatively comfortable.
Finally, rather than leaving it up to establishment politicians and lobbyists, what to re-open, when, and how could be decided democratically by workers in individual workplaces and through online people’s assemblies and plebiscites. This would be informed by the best public health advice and the needs of workers, rather than big business lobbying. They might well decide seeing family or friends again is more important than immediately going back to work or out shopping. Workers’ committees could also be set up to supervise health and safety in the workplace, to decide what work can be done from home, and to vote on workplace closures as necessary. Paul Murphy TD previously raised this in the Dáil as a way of dealing with meat plant outbreaks.
From where we’re standing now, a lot of this probably sounds unrealistic and even impossible. But the first step in getting somewhere is to figure out where you want to go. The next is to work out how to get there. One of the most striking features of the current crisis is how it has centred the essential role of workers in keeping the economy and society going. During the first wave, the status of supermarket workers, cleaners, carers and healthcare workers was temporarily elevated as people suddenly realised how important they were. But this moment of potential consciousness of class power was obscured by cynical ‘all in this together’ rhetoric designed to fob frontline workers off with applause rather than pay rises, much less workers’ control. This combined with the shock of the pandemic and the weakness of workers’ organisation to limit industrial action during the first wave. Second and subsequent waves could be very different, especially if the government persists with its woeful mishandling of the pandemic and is seen to be sacrificing public health on the altar of profits.
Much like a war, a pandemic is a time when the capitalist establishment desperately needs the full cooperation of workers and society as a whole to maintain its rule. It is also when the withdrawal of our cooperation can be most powerful. Trade unions must now support workers in refusing to work in unsafe conditions, in demanding better health and safety measures and the right to work from home, and in fighting for all the supports we need to survive this plague. The wider left must also be central to these battles and in putting forward an alternative socialist programme for dealing with this unprecedented crisis. The more victories we win the closer we can get to the socialist future we need, not just to reach zero covid but to save our climate too.
Notes
[1] https://data.oireachtas.ie/ie/oireachtas/committee/dail/33/special_committee_on_covid_19_response/reports/2020/2020-07-31_interim-report-on-covid-19-in-nursing-homes_en.pdf
[2] The original guidelines from the Department of Education didn’t mention it at all. Updated advice said: “Consider if room ventilation especially in classrooms can be improved without causing discomfort. Where possible the opening of doors and windows should be encouraged to increase natural ventilation ……. .” (Section 5.6 Environmental Hygiene); and “Increase air flow and ventilation where climate allows (open windows, use air conditioning where available, etc.)” (Section 8.1, checklists for School Management, Teachers and Staff). https://t.co/y8lz5fv1kq?amp=1; https://twitter.com/Orla_Hegarty/status/1307624249566392320
[3] https://www.esri.ie/publications/public-understanding-and-perceptions-of-the-covid-19-test-and-trace-system, p. 11-12.
[4] A study in The Lancet found that 2m distance offers double the protection of 1m https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31183-1/fulltext