From the World Socialist Party of the United States website
Over the coming months, hundreds of thousands of people in the United States are going to come down with severe forms of COVID-19 infection. How many of them will pull through and how many will die of suffocation depends crucially on the availability of life-saving ventilators in the intensive care units of hospitals. There are only 62,000 ventilators in service across the country. A recent survey found that even acute-care hospitals have on average only eleven ‘full-feature’ ventilators. Failing urgent acquisition of many tens of thousands of additional ventilators, hospitals will be overwhelmed as the pandemic spreads.
In a desperate attempt to mitigate the disaster, hospital staff are preparing to link up each of their ventilators to four patients. A video posted on YouTube shows them how to do it. As the instructor admits, this is an ‘off-label use’ of a machine designed to serve one patient at a time. I can’t help wondering how well it is going to work.
Go for it auto execs!
Initially Trump took the orthodox ‘neo-liberal’ view that there was no reason for government to get involved. ‘Unfettered free enterprise’ could be trusted to rise to the occasion. However, he ended up brokering a deal for a joint venture between General Motors and Ventec Life Systems. General Motors would retool a car parts plant in Kokomo, Indiana as a ventilator production facility using Ventec’s technology. A government order for 80,000 ventilators was to be fulfilled in just two months. Trump’s enthusiasm was unbounded. ‘Go for it auto execs,’ he tweeted excitedly on March 22, ‘let’s see how good you are?’ [1]
Then suddenly it was announced that the deal was off. Officials in the Administration were unhappy about the cost – over a billion dollars, a large part of which had to be paid upfront. True, it worked out at only $13,000 per ventilator – not bad, considering that the machines usually sell within the range $25–50,000. ‘But for Chrissake,’ lamented officials at the Federal Emergency Management Agency, ‘for that money we could buy eighteen F-35 fighter jets!’ And if you think I made that up for ironic effect then you are wrong. They really find it distasteful to spend large sums of government money for the benefit of ordinary people.
An interdepartmental working group under the direction of Trump’s son-in-law Jared Kushner (who was admitted to college only after his dad paid a hefty bribe – I mean ‘donation’) is now exploring the issue in detail. The GM-Ventec project remains on the table, but another dozen or so other proposals are also under consideration. The target of 80,000 ventilators has been whittled down to 20,000 and then to 7,500. So a plan to more than double the number of functioning ventilators ended up as a scheme to increase that number by just 12%.
You see, some officials are worried that too many ventilators may be ordered. What are they to do with the surplus?
Exclamation points
Give the guy credit where it is due. Trump must have started to get impatient, because on March 27 he issued the following statement:
Today, I signed a Presidential Memorandum directing the Secretary of Health and Human Services to use any and all authority available under the Defense Production Act to require General Motors to accept, perform, and prioritize Federal contracts for ventilators. Our negotiations with General Motors regarding its ability to supply ventilators have been productive, but our fight against the virus is too urgent to allow the give-and-take of the contracting process to continue to run its normal course. General Motors was wasting time. Today’s action will help ensure the quick production of ventilators that will save American lives.
The Defense Production Act of 1950 authorizes the President to require businesses to sign contracts and fulfill orders deemed necessary for defense, but it has also been invoked occasionally in non-military emergencies. Democrats in Congress were urging him to invoke it in the current crisis. Trump was under pressure from corporate CEOs and the Chamber of Commerce not to do so.
Trump then fired off tweets to General Motors and Ford, which was working on its own plan to adapt car parts for ventilators, declaring that they ‘MUST START MAKING VENTILATORS NOW!!!!!!’ (yes, in capitals and followed by six exclamation points).
It seems that this ‘very stable genius’ — as Trump has described himself — momentarily forgot how capitalism works, even though most of the time he understands this very well. How else could he fondly imagine that a few presidential exclamation points might induce a corporation to set aside considerations of profitability in order to satisfy a human need, however urgent?
As of this writing (April 4), no new facility for the production of ventilators is yet in operation in the United States.
An even harsher light
But there is another aspect to this problem — one that casts the functioning of capitalism in an even harsher light.
While American hospitals have only 62,000 ventilators in service, they have in storage a very large number – estimates run as high as 100,000 – older ventilators that could be brought back into use if repaired. Hospitals, however, are unable to have these machines repaired due to restrictions imposed by the manufacturers (Siemens, Philips, General Electric Healthcare, Medtronic, Ventec Life Systems, Hamilton Medical), who also fight legislative challenges to their repair monopoly.[2]
First of all, purchasers of ventilators and independent technicians are denied access to the documentation and software required for repairs. Second, unauthorized attempts to repair a ventilator are blocked by special ‘anti-repair software.’ Third, a hospital that hires a technician who manages to overcome these obstacles and repair a ventilator will face legal ramifications.
Of course, it is not only medical equipment manufacturers who deliberately make it very difficult or very expensive or altogether impossible to repair their products. Manufacturers of computers, tractors, and many other devices do exactly the same thing. It is one of the ways by which they artificially shorten the service life of their products with a view to ‘persuading’ consumers to buy new ones. The phenomenon is known as built-in obsolescence. It is a normal feature of capitalism and a major source of the enormous waste generated by that system.
A waste of labor, a waste of resources, and – as in this case – a waste of human life.
Added and updated April 4th
Figures that don’t add up
The prospects of the pandemic in the United States vary widely from one place to another, depending on the timing and strength of the response from city and state governments. At one extreme are places like Seattle and the San Francisco – Bay Area where strong measures were adopted at an early stage and have had stellar results, comparable with those achieved by South Korea and Hong Kong. Here the pandemic is already on the wane; numbers infected are relatively low; hospitals have coped well.
However, such ‘oases’ are few and far between. More typical are the many areas where measures, though in effect by late March, began only after significant delay. These include such cities as New York, Chicago, Detroit, Atlanta, Miami, and New Orleans. In quite a few of these ‘hotspots’ hospitals are already in crisis.
Even worse are likely outcomes in areas where in early April adequate measures had still not been taken. Most but not all such areas are in the Southern ‘bible belt.’ Here, for instance, religious services are still being held – sometimes for the explicit purpose of vanquishing the virus by prayer or exorcism.
For the time being, however, media attention has focused on the plight of New York City.
At a press conference on March 28, Andrew M. Cuomo, governor of New York State, stated that according to projections New York State was going to need 30-40,000 more ventilators by May 1. The Clown Prince responded that according to his projections New York did not need so many, though Dr. Anthony S. Fauci, MD, the immunologist who serves on the White House Coronavirus Task Force, said that he saw no reason to doubt Cuomo’s estimate. The Clown Prince urged Trump to ‘push back’ against Cuomo.
Where were the additional ventilators to come from?
Can they be purchased? The trouble is that high demand and short supply have created a seller’s market with sky-high prices. The situation is exacerbated by the lack of coordination at the national level, which forces state governments to bid against one another and against the Federal Emergency Management Agency. [3]
The Strategic National Stockpile is supposed to supplement local medical supplies during a public health emergency. And federal authorities have sent New York State 400 ventilators from this source – 200 earmarked for New York City and 200 for the rest of the state. ‘What am I going to do with 400 ventilators when I need 30,000?’ asked Cuomo. Not to mention that many have parts missing and do not work. It is unfortunate that New York State has a Democratic governor, as only Republican governors like Florida’s Ron DeSantis get their requests met quickly and in full by the Trump Administration. [4]
At a press conference on April 4, Governor Cuomo announced that 1,000 ventilators would be arriving by air later that day – a donation ‘facilitated’ by the Chinese government. The State of Oregon, which is now over the hump of the pandemic, is donating, unsolicited, another 140 ventilators to New York. [5]
Yet somehow these figures do not add up, though I have checked several times to make sure. 400 + 1,000 + 140 equals only 1,540, which is nowhere near 30,000.
Who will be left to die?
So it seems that hospitals in New York – and other places – are going to be overwhelmed – meaning, in particular, that they are going to run out of ventilators. What happens then? Who will be hooked up to a ventilator? Who will be left to die?
According to a TV talk show broadcast from New York on April 3, these life-and-death decisions will be based on ratings that combine three factors:
Those with the highest ratings get a ventilator all to themselves; those with the lowest ratings are left to die; those in the middle share a ventilator with other patients.
In other words, a class system has been devised – as befits a class society.
Added and updated April 4th
Figures that don’t add up
The prospects of the pandemic in the United States vary widely from one place to another, depending on the timing and strength of the response from city and state governments. At one extreme are places like Seattle and the San Francisco – Bay Area where strong measures were adopted at an early stage and have had stellar results, comparable with those achieved by South Korea and Hong Kong. Here the pandemic is already on the wane; numbers infected are relatively low; hospitals have coped well.
However, such ‘oases’ are few and far between. More typical are the many areas where measures, though in effect by late March, began only after significant delay. These include such cities as New York, Chicago, Detroit, Atlanta, Miami, and New Orleans. In quite a few of these ‘hotspots’ hospitals are already in crisis.
Even worse are likely outcomes in areas where in early April adequate measures had still not been taken. Most but not all such areas are in the Southern ‘bible belt.’ Here, for instance, religious services are still being held – sometimes for the explicit purpose of vanquishing the virus by prayer or exorcism.
For the time being, however, media attention has focused on the plight of New York City.
At a press conference on March 28, Andrew M. Cuomo, governor of New York State, stated that according to projections New York State was going to need 30-40,000 more ventilators by May 1. The Clown Prince responded that according to his projections New York did not need so many, though Dr. Anthony S. Fauci, MD, the immunologist who serves on the White House Coronavirus Task Force, said that he saw no reason to doubt Cuomo’s estimate. The Clown Prince urged Trump to ‘push back’ against Cuomo.
Where were the additional ventilators to come from?
Can they be purchased? The trouble is that high demand and short supply have created a seller’s market with sky-high prices. The situation is exacerbated by the lack of coordination at the national level, which forces state governments to bid against one another and against the Federal Emergency Management Agency. [3]
The Strategic National Stockpile is supposed to supplement local medical supplies during a public health emergency. And federal authorities have sent New York State 400 ventilators from this source – 200 earmarked for New York City and 200 for the rest of the state. ‘What am I going to do with 400 ventilators when I need 30,000?’ asked Cuomo. Not to mention that many have parts missing and do not work. It is unfortunate that New York State has a Democratic governor, as only Republican governors like Florida’s Ron DeSantis get their requests met quickly and in full by the Trump Administration. [4]
At a press conference on April 4, Governor Cuomo announced that 1,000 ventilators would be arriving by air later that day – a donation ‘facilitated’ by the Chinese government. The State of Oregon, which is now over the hump of the pandemic, is donating, unsolicited, another 140 ventilators to New York. [5]
Yet somehow these figures do not add up, though I have checked several times to make sure. 400 + 1,000 + 140 equals only 1,540, which is nowhere near 30,000.
Who will be left to die?
So it seems that hospitals in New York – and other places – are going to be overwhelmed – meaning, in particular, that they are going to run out of ventilators. What happens then? Who will be hooked up to a ventilator? Who will be left to die?
According to a TV talk show broadcast from New York on April 3, these life-and-death decisions will be based on ratings that combine three factors:
- age of patient (younger people have priority)
- the patient’s state of health prior to infection (people otherwise in good health have priority)
Those with the highest ratings get a ventilator all to themselves; those with the lowest ratings are left to die; those in the middle share a ventilator with other patients.
In other words, a class system has been devised – as befits a class society.
Stephen Shenfield
Notes
[1] This account relies mainly on three articles published in the Daily Kos on March 27: here and here and here.
[2] They do this both directly and through their lobbying group, AdvaMed. See Jason Koebler, ‘Hospitals Need to Repair Ventilators. Manufacturers Are Making That Impossible,’ Vice, March 18.
[3] Daily Kos, April 2.
[4] Daily Kos, April 2.
[5] See https://time.com/5815687/cuomo-ventilators-china-coronavirus/. It is not clear who in China is actually footing the bill.
[3] Daily Kos, April 2.
[4] Daily Kos, April 2.
[5] See https://time.com/5815687/cuomo-ventilators-china-coronavirus/. It is not clear who in China is actually footing the bill.
No comments:
Post a Comment