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A Healthcare Worker Answers Governor Cuomo’s “Conundrum”

Recent data out of New York City shows a large number of people with COVID-19 have largely been staying home. Governor Andrew Cuomo called this a “surprise.” But capitalism is forcing working-class people to spread the virus. A socialist doctor from New York explains the problem to all the Cuomos of the world.

Mike Pappas

May 11, 2020
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In a recent press conference Governor Andrew Cuomo highlighted information from new analysis of COVID-19 data finding a majority of the new patients being admitted were staying at home. Cuomo described the new data as a “surprise” to him as it was initially thought exposed frontline healthcare workers would be the brunt of new admissions. According to Cuomo discussing the new patient cases, “They’re not working, they’re not traveling, they’re predominantly downstate, predominantly minority, predominantly older, predominantly nonessential employees.”

As Newsday reported, this gives the state “a conundrum” of how to stop viral spread. “A conundrum,” you say? A surprise? For those of the working class, this new data is probably no surprise whatsoever, but for the Cuomos of the world, let’s look into this a little further. An examination of the dynamics of labor in the US can clearly suggest where new infections are coming from. 

Exposure from Work to Home

While New York has worked to continue to shut down nonessential businesses — unlike other states who are moronically reopening prematurely — there are large numbers of workers deemed essential who have been traveling to work during the pandemic. Those who do a bulk of the work to keep the city running such as grocery workers, food service workers, transit workers, custodial staff, first responders, and healthcare workers — 76 percent of whom are people of color and a majority of who hail from communities hit hardest by the virus like the Bronx, Queens, and central and east Brooklyn — have not had the luxury of working from home or isolating to protect themselves. Many must continue to work to make ends meet and do not have adequate savings to fall back on in order to self-isolate. As FAIR.org recently cited after analyzing the survey Cuomo cited, it is clear we really do not know what percent of newly infected patients are actually staying home in isolation.

Many of these same workers either live with or care for loved ones who stay at home. These essential workers are generally younger and healthier, and after exposure to COVID-19 may be asymptomatic. Alternatively, even if these workers are symptomatic they may downplay their symptoms as they still have to work to continue to pay rent and they have nowhere else to self isolate. Those same essential workers come home and expose an at-risk loved one living with them who becomes sick and must be admitted to the hospital. 

Workers who live in communities such as the Bronx, Queens, or Brooklyn also live in areas chronically harmed by various forms of structural violence and systemic racism (poor air quality, unhealthy food options, etc), which leave both them and their loved ones more at risk for comorbidities that can lead to more serious complications from COVID-19. This dynamic could be further exacerbated as the EPA has continued to rollback regulations on polluters during the pandemic. 

I personally have at least one or two patients every single clinic session — often people of color, working essential jobs — voicing their concerns over having to work in order to continue meeting basic needs (buying food, paying rent, paying utilities). They are afraid to then come home and expose their elderly father, mother, aunt, uncle with diabetes, COPD, HTN, etc. 

To take one specific example: Amazon’s warehouse in Staten Island. The warehouse has 5,000 workers coming to work every week and recently had one employee die. Viral incubators like this factory are likely causing workers to spread the virus to their loved ones. Many essential workers such as these employees have minimal funds and do not have adequate access to healthcare (lack of funds, lack of insurance etc). Recently the company ended its unlimited unpaid time off policy and workers say they are showing up to work sick. When they are infected, workers are recovering by themselves at home and are left out of any state-recorded data sets. At the same time they may be helping care for a relative living with them and when their relative gets sick, it looks like they got sick at home despite being almost two months locked in the house. 

Sacrificed at the Altar of Capital

While corporate media likes to praise all of these workers as “essential” and note how we are “all in this fight together,” it is clear many of these workers do not need to be working. Amazon workers for example are being expected to fill orders orders of products that certainly are not essential, but need to continue to work to meet basic needs. They are being forced to work and potentially expose themselves and their loved ones because our society has not been able to ensure their basic needs are met during the pandemic. Government has not been able to freeze rent, mortgage, utilities, or other burdens on the working class. 

And there aren’t sufficient protections on the job for workers deemed essential. Healthcare workers are offered free stays in hotels to protect their family members from the virus, which we are all very grateful for, but what about the other essential workers? What about the transit workers, food service workers, warehouse workers? The federal government has only been able to distribute menial $1,200 checks that have not even reached a great number of US citizens — I say citizen because they will never reach the millions of undocumented workers in the United States. 

State and federal governments have been unwilling to actually halt the gears of capital as workers continue to be held hostage, as they are forced to continue paying rent, utilities etc. during the pandemic. Many states are even pushing workers back to work even while they have not met the Trump administration’s own pitiful standards for reopening. The Associated Press recently reported that the CDC recently shelved its own guidelines for re-opening economies after being considered “too strict” by the White House, with a CDC official stating the report would “never see the light of day.”

Meanwhile, President Trump recently used the Defense Production Act (DPA) to actually reopen meat packing plants that had closed due to high infection rates. The deaths we are seeing, and unfortunately will likely continue to see, are the direct result of profit being put over people’s lives. Capitalists need workers to work because exploitation is what creates their profits. By heeding to these demands, local and state governments have blood on their hands.

Nursing Homes and Home Health Services

During his recent press conference, Cuomo also cited “18% of the patients had been admitted to the hospital from a nursing home” while highlighting the majority of recent coronavirus patients were over the age of 51. In the U.S., as an individual grows older and can no longer work, they may need home assistance to meet their daily needs. Even if living in the same community, many working-class family members must work, so it can be difficult to care for an elderly loved one. A family can apply for services, but there often is not adequate funding for home health services and insurance typically does not cover the necessary amount of hours to allow most elderly individuals to stay home with adequate assistance.

The alternative option is having an individual enter a nursing home, hoping their insurance can cover the costs. Unfortunately, these facilities are chronically underfunded and understaffed. This may be graphic, but in many locations those who enter are literally left to rot. Individuals who enter these facilities often have a multitude of co-occurring chronic health issues that make their care difficult and this combined with understaffing leads to poor outcomes. It is no surprise during this pandemic we still continued reports of deaths in nursing homes. In my workplace, I cannot even count the number of times we have had patients admitted to the hospital with signs highly suspicious for neglect. It has become a running mantra, “oh, a patient from x facility again,” suggesting we all know what type of problems the patient may have.

Additionally, those who work in assisted living facilities or as home health workers are often people of color from communities most affected. The chronic underfunding and understaffing of this sector of work has led both the workers and the patients they serve to be at risk. There have been reports highlighting the lack of staffing and PPE for home health workers.

The old mantra of “respect your elders” is often repeated in the U.S., but our society only truly values your life when you are exploitable and can produce profit for the rich. After an individual is used and abused by the capitalist system, they are no longer useful for the production of capital so they are left to fend for themselves. Capitalism does not value life unless it can be used for profit maximization. If they happen to have accumulated enough money during their lives to pay for private care or have a family member who can dedicate time to caring for them, they can have better outcomes. Unfortunately, this is not the case for many of the elderly working class and they are being disproportionately hit hard during the pandemic. In a society where government officials suggest the elderly should sacrifice themselves for the economy, it should be no surprise that we see many of the new hospital admissions coming from nursing homes. 

Putting the Blame on the Workers

In his address, Cuomo tried to put the blame back on the individual, saying, “Government has done everything it could. Society has done everything it could. Now it’s up to you.” 

The government did “everything it could”? Really? The governor has the nerve to utter those words while at the same time people are still being forced to pay rent, utilities, mortgages during this pandemic, leading them to unnecessarily expose themselves to cover bills. The government has done “everything it could” yet we still do not have near enough testing to know who is or is not infected. We still do not have adequate PPE in many workplaces as highlighted above, yet the government has done all it can?

Cuomo still has not mentioned the fact that 5,000 Amazon workers still are having to work , be exposed, and potentially bring the virus home to their families for the profit of Jeff Bezos, whose wealth increased by $24 billion during the pandemic. Billionaires in general have seen their wealth soar, adding over $300 billion to their wealth even as 26 million people lost their jobs. 

It is interesting that we always do “everything we can” right up until the point that it actually threatens the interests of capital. From the beginning of this pandemic there should have been free universal paid sick leave offered to all workers (frankly, we should have always had these things). Federal and state government should have worked toward freezing all payments for working people — halting credit card payments, student loans payments, utilities payments, and all rent and mortgage payments.

These measures, among others we have previously highlighted would have allowed members of the working class to protect themselves and their loved ones during the pandemic. Unfortunately such measures would have also threatened the interests of the wealthy. 

Working Class Will Stop the Virus

As a healthcare worker, I cannot stop the spread of this virus. By the time someone sees me in the hospital, it is too late for them in terms of preventing viral spread. The only thing I personally can do is help treat someone who is sick and hopefully help them recover from the infection. 

Cuomo argues that we should focus on whether we are wearing a mask enough or using enough hand sanitizer. It is easy to place the onus back on individuals, especially when we see parks packed full of individuals not appropriately distancing and not wearing masks in close quarters. Unfortunately, though, singing one or two more choruses of “Happy Birthday” during each hand washing session will not solve our problem. 

Those who will really help stop viral spread are those fighting for safety in their workplaces. Otherwise we will continue to see the most vulnerable among us fall ill and potentially die.

There is much talk in the media about “healthcare heroes.” What about other essential workers? These workers, fighting for safety in their workplaces despite the ongoing exploitation by the bosses are true heroes and must be supported. This is part of the reason our COVID-19 Frontline Worker Task Force stood with Amazon workers and transit workers at their action on May 1. These workers protecting themselves, and our society protecting them, is the only way we will truly stop the spread of COVID-19.

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Mike Pappas

Mike is an activist and medical doctor working in New York City.

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