BioCubaFarma guarantees production of 22 medications for the treatment of Covid-19

 Yaditza del Sol González

Although there is no preventive vaccine or specific treatment, at this time, for the new coronavirus SARS COV-2, which causes COVID-19, the Cuban pharmaceutical industry guarantees the production of proven, high efficacy medications, including recombinant human interferon alpha 2b, in addition to another group of drugs that are included in protocols for treating patients with this disease and the complications that may arise.

According to the president of Bio-CubaFarma, Dr. Eduardo Martínez Díaz, in this effort, the enterprise group has taken into account the experience of China, via a guide published by the country’s pharmaceutical association for the detection and treatment of the virus.

This guide, he noted, recommends interferon as the first choice medication, which we have the ability to supply to our public health system and internationally.

Cuba has been supplying interferon, produced with Cuban technology in the joint venture Changchun Heber Biological Technology facility, located in Jilin, China, and currently used for high-risk individuals and health care personnel, as a preventive measure, as well as i COVID-19 patients, via nebulization, the most rapid way to reach the lungs and have an impact in the early stages of infection, explained Marta Ayala Ávila, deputy director of the Center for Genetic Engineering and Biotechnology (CIGB).

At the same time, she said, we have been preparing for the use of interferon in Cuba, as we have capacity at the joint venture facility, but also within the country.

For his part, CIGB general director Eulogio Pimentel Vázquez reported that a supply of interferon is available to treat the estimated number of cases that could appear in Cuba over a period of three to six months. In addition, he said, “We have a total supply of the product in process that is practically equivalent to the amount needed to treat all those who were infected in China.”

Currently, this drug is included in protocols established by the Ministry of Public Health (Minsap) for the care of patients with the new coronavirus, and requests have been received from the Health Ministries of several countries. Pimentel said the center has the capacity, to respond not only to a possible increase in the country’s demand, but also to meet the 15 requests that have been received thus far from other nations, both for information and acquisition of the product.

Although recombinant human interferon alpha 2b has made headlines in the last few days in various international media given its efficacy in the treatment of patients infected with the new coronavirus, this is not the only medicine that Cuba has on hand to confront the global pandemic.

There are 21 other products included in Cuba’s protocol for treatment, among these are anti-virals, antiarrhythmicsand antibiotics, for the treatment of complications that may arise in patients with COVID-19, and the industry can guarantee their production, Martínez emphasized.

For example, AICA Laboratories manufactures 170 injectable medicines and sterile eye drops, and five of these are included in the basic protocol for patient care, stated the company’s general director, Antonio Vallín.

National availability has also been reviewed of intermediate materials and finished products, as well as the capacity to maintain production, while work continues on natural products to support the immune system and increase its response to any virus, he added.

Rita Maria García, BioCubaFarma’s director of Operations and Technology, reported that preparations for the current situation were begun well in advance and that the country’s health institutions have a stable supply of needed medications, although strategies to increase coverage are being implemented.

Drugs available include, for example, azithromycin in tablet and suspension form, injectable vancomycin, atenolol, methylprednisolone, diazepam, midazolam, paracetamol, ibuprofen, dipyrone, general anesthetics, as well as parenteral solutions needed for intensive care, such as dextrose, ringer and albumin, among others.

Regarding dipyrone, the BioCubaFarma president reported that 600 million tablets are required annually in the country and, although production capacity to ensure this amount does not exist today, coverage for hospital use is guaranteed.

We hope that the containment and epidemiological surveillance measures adopted by the Ministry of Public Health can have an impact limiting further infections in the country, he said, but BioCubaFarma is prepared to provide these 22 drugs for the treatment of thousands of potential patients.

Martínez Díaz acknowledged that 15% of medicines supplied by the industry are currently missing from pharmacies and that distribution cycles have been extended, as a result of difficulties in acquiring raw materials and the lack of spare parts for equipment used in the manufacturing process.

He noted that the U.S. blockade has a significant impact, as suppliers in that country have refused to sell Cuba equipment and supplies, citing the government’s financial persecution. Others do not want to sign new contracts, and those who have maintained commercial relations must face a number of obstacles.

In fact, we have significant financial resources that we are not able to deposit in the country because of the blockade’s restrictions on banks, he noted.

On the other hand, Biomodulin t is a drug s also considered an option to treat the new coronavirus. According to Mary Carmen Reyes, a specialist in immunology and head of clinical trials at the National Center for Biopreparations (BioCen), it is a modulator, included in Cuba’s basic inventory of medicines, used for recurring respiratory infections in older adults, to increase the patient’s defenses.

In the case of Covid-19, she said, data published in scientific journals points to how the virus affects infected patients immune response and decreases T-cells. This drug has the capacity to stimulate the production of such cells, she explained.

Given that elderly patients with weaker immune systems are prone to developing complications, the use of this drug is appropriate for both infected patients and those at risk, as well as health personnel.

The Cuban pharmaceutical industry is also emphasizing research and development, as a strategy to confront the pandemic, seeking new products that have the ability to inhibit reproduction of the virus.

According to Gerardo Enrique Guillén Nieto, director of Biomedical Research at the CIGB, two inhibitory peptides are currently being studied. One of these is CIGB 210, part of a project that has been under development for years as an antiviral to treat AIDS patients.

“Based on the evidence that exists in the literature, we are now experimenting with the effect of this peptide on a coronavirus of bovine origin, to evaluate its inhibition capacity. If it works, in collaboration with laboratories in China, we would analyze its effect against the new coronavirus.”

Another drug under consideration, coded as CIGB 300, is used to treat different types of cancer, including cervical and lung, and its antiviral capacity has been studied in patients with AIDS, Hepatitis C, and other viruses.

At the same time, a vaccine project is being designed, based on a platform of virus-like particles, with nasal immunization as a means of administration, a method used for the therapeutic vaccine against chronic Hepatitis B, developed at the CIGB. Data from this project has been made available to Chinese health authorities, to collaborate in its development, he concluded.

Pacific Islands nations threatened with disaster by coronavirus

John Braddock

The remote micro-states and island chains across the Pacific face a terrifying situation due to the global coronavirus pandemic. While geographically isolated, their impoverished, neo-colonial status, lack of health facilities and dependency on tourism make them particularly vulnerable to natural disasters and disease outbreaks.

On March 19, the number of confirmed cases had risen to 11; three in French Polynesia followed by five in the US territory of Guam, two in New Caledonia and one in Fiji. They included Tahitian parliamentarian Maina Sage, whose infection was discovered on her return from France. The Marshall Islands, Federated States of Micronesia and Samoa have one person each under investigation. The latter is a traveler from Auckland whose test samples were sent to Melbourne, with a possible 10–20 day turn-around time.

A widespread outbreak of the COVID-19 virus anywhere in the Pacific threatens a disaster for the indigenous populations. They already suffer from diseases associated with poverty and poor diet, such as obesity, heart disease and diabetes. In Fiji, diabetes-related amputations account for 40 percent of all hospital operations. Malaria, tuberculosis and HIV/AIDS are rife in Papua New Guinea (PNG), the largest Pacific country, where life expectancy is just 62.8 years.

A sharp reduction in tourist numbers, lack of air freight, and disrupted supply chains are already hitting the island states, prompting fears about how their fragile economies will weather a prolonged crisis. French Polynesia’s tourism minister, Nicole Bouteau, said the economy would go through “dark times” in the coming weeks.

To prevent the arrival of the virus, Papua New Guinea, Fiji, Vanuatu, New Caledonia, French Polynesia, Wallis and Futuna and Tonga have all implemented strict health checks and quarantine measures. Most countries had limited or suspended cruise ships before the industry announced a worldwide shutdown of operations on March 13.

The Marshall Islands National Disaster Committee closed the country to all incoming passengers for two weeks from early March. Health secretary Jack Niedenthal told Radio NZ the country’s health system had already been overburdened with an eight-month dengue fever epidemic.

Cook Islands Prime Minister Henry Puna said 11 cruise ships had been prohibited from the outer islands and travelers from 16 countries banned from entering. Each ship brings in hundreds of thousands of dollars, but Puna said the move was necessary to safeguard “the well-being of the people.”

Some of the strictest measures are in Samoa, which was devastated by a measles epidemic that originated in New Zealand last October and killed 83 people, mostly children. Samoa’s government is now urging anyone planning to go to the country to stay away, saying the risk to the country from Covid-19 is “very high.” A health ministry statement said, “all those intending to travel to Samoa to attend birthdays, weddings, reunions, funerals, conferences, sports, etc. to CANCEL their travel plans.”

Samoa Tourism Authority head Fa’amatuainu Lenata’i Suifua said he backed the government’s actions but the country’s biggest industry was in for “a tough time.” Tourism employs more than 5,000 workers directly, as well as others in supporting services.

The measles epidemic in Samoa, which was only brought under control after Christmas, shut down much of the economy and overwhelmed the impoverished country’s limited healthcare system. For the last quarter of the financial year, an estimated 20 to 25 percent drop was already expected for tourist arrivals and earnings.

Quarantine rules announced by Australia and New Zealand will exacerbate the disruption. Both countries, which supply significant numbers of tourists to the Pacific, have mandated that all travelers, including returning residents, self-isolate for 14 days. While New Zealand has exempted travelers from the Pacific Islands, Prime Minister Ardern told people not to undertake unnecessary travel overseas and all cruise ships were banned.

New Zealand’s Pacific Island community is particularly vulnerable. COVID-19 hits those with heart and lung disease and diabetes the hardest. Nine percent of Pacific peoples in NZ have been diagnosed with diabetes—three times the general population. The largely working-class Pacific community suffers from overcrowded and inadequate housing and has difficulty accessing health care. Thousands will be affected by looming job losses.

Among the earliest and worst hit islands were the Northern Marianas (CNMI), a US territory in the North Pacific. Beijing promptly suspended all tourist excursions, while South Korea declared quarantine zones. Fifty percent of CNMI’s visitors come from Korea and 40 percent from China.

The Saipan Chamber of Commerce declared that the CNMI’s tourist industry had collapsed within six weeks. Over 1,000 workers were laid off, while thousands more had hours reduced. The government revised its annual budget down to $US90 million, from $147 million. In 2018 the budget was $237 million. Harsh austerity measures have been imposed, including cuts to public sector pay and working weeks.

In a letter to US President Trump appealing for federal help, CNMI Governor Ralph Torres said the loss of the tourism market would result in the “unequivocal and complete collapse of the foundations of our private sector.”

Fiji’s government is introducing a supplementary budget this week which Attorney-General Aiyaz Sayed-Khaiyum declared was necessary to reduce the impact of the coronavirus. Fiji’s economy was already facing a major downturn, presaging further attacks by the authoritarian Bainimarama government on wages, social welfare and essential services. According to reports from the World Bank and IMF last October, a reduction in government expenditure of $394 million would sharply contract the economy. A liquidity crunch had seen banks struggling to get funds to finance loans while the vital sugarcane industry is battling falling global prices and declining production.

Neelesh Gounder, an economist at the University of the South Pacific in Suva, said the coronavirus outbreak would affect all island countries’ wider economic relationships with China, including aid projects and the Belt and Road initiative, which have been hit by delays and quarantine measures preventing Chinese labourers reaching building sites.

With governments around the world failing to act in any coordinated manner, the beleaguered Pacific Island nations will inevitably be left to sink or swim. The local imperialist powers, Australia and New Zealand, will only do what is necessary to protect their geo-strategic interests in opposition to China.

New Zealand Foreign Minister Winston Peters and Australian Foreign Minister Marise Payne said that the two countries would only jointly help to fund the World Health Organisation’s Pacific coronavirus response plan. They will assist with access to medical supplies from the WHO’s stockpiles and technical advice, including testing samples from the region free of charge.

These meagre undertakings are entirely hollow. New Zealand has had only two laboratories testing for COVID-19, producing about 500 test results in the past week. The ruling elites of both countries are meanwhile carrying through nationalist “fortress” measures and imposing the crisis on their populations. What will not be forthcoming are the billions of dollars in aid and health support desperately needed to rebuild the economies and sustain the health of the people in this fragile region.

Ukrainian government uses coronavirus crisis to pass IMF-backed reforms

Jason Melanovski

Ukraine, officially the poorest country in Europe according to the International Monetary Fund, is on the brink of an explosive outbreak of coronavirus cases that will bring about untold social misery and death in a country already devastated by years of oligarchic capitalist rule.

While the number of just 14 registered cases in Ukraine remains relatively low to the rest of Europe, the real number of coronavirus cases is undoubtedly much higher due to the totally inadequate testing efforts and the large number of Ukrainian migrant workers throughout Europe who have returned home after Europe began its own shutdown.

Approximately 70,000 Ukrainian migrant workers reside in the northern Italian provinces of Lombardy and Veneto, which have been particularly hit hard by the spread of the coronavirus.

Despite the likelihood of an already present widespread infection Ukraine痴 Ministry of Health has reported just two deaths due to the coronavirus to date. Last week, the Ukrainian government shut its borders to foreigners. The government has now also imposed a quarantine on the country, shutting down schools, domestic travel, bars, and restaurants. The new limitations came into effect on March 18 and are set to last until April 3.

National guard soldiers wearing face masks stand at the parliament building in Kyiv, Ukraine, Tuesday, March 17, 2020. (AP Photo/Efrem Lukatsky)

On Saturday, the Ukrainian health minister Ilya Yemets declared that “All pensioners will die” from the virus. After a public outcry, he was forced to apologize. However, the blunt statement is in line with those of German Chancellor Angela Merkel and UK Prime Minister Boris Johnson, both of whom have announced that 60-70 percent of their population will get infected, without taking the adequate measures to combat the spread of the virus and create the health care and social infrastructure desperately needed to mitigate its impact.

In fact, in Ukraine, the impact of the virus threatens to be particularly dramatic. An estimated 60 percent of the population live beneath the subsistence level, and health care spending per capita has been low, making any additional medical costs crippling for millions of workers and pensioners. The average monthly salary is just $200.

There are currently 11.3 million pensioners in Ukraine, in a country of approximately 40 million. The advanced age of more than one-fourth of the country will certainly exacerbate the severity of the coronavirus outbreak within Ukraine due to its high mortality rate among older individuals and those with preexisting health conditions.

In addition, some 3.5 million people are already estimated to be in need of humanitarian assistance, due to the six-year-long civil war that was provoked by the US-backed far-right coup in Kiev in 2014. About 1.4 million people have been displaced, and many of them still don’t have permanent residence and safe shelter.

The Ukrainian oligarchy has no intention of saving the countless lives of pensioners and workers now at risk. On the contrary, Ukrainian President Volodomyr Zelensky has cynically used the opportunity to combine the imposition of far-reaching restrictions on public life with an appeal to parliament to swiftly pass a sweeping set of anti-working class reforms demanded by the International Monetary Fund.

Calling on the Ukrainian parliament to remain in session in the face of the crisis Zelensky stated: “Now in a situation of a global pandemic and the threat of a global financial crisis, the Ukrainian parliament must pass laws that are vital for the economy, introduce tax, land, labor reforms, appoint ministers of economy and energy, and the prosecutor general of Ukraine.”

In addition to calling for the passage of land and labor reforms which have been explicitly demanded by the IMF, Zelensky also stated that Ukraine’s finance ministry would hold additional talks with the IMF to secure even more financial support as a result of the crisis.

In December, Ukraine obtained provisional approval for a new $5.5 billion loan program, but the release of funds is dependent upon the passage of a widely opposed land reform bill that remains stalled in parliament and a labor reform bill that will severely undermine worker’s rights and make Ukraine Europe’s first “at-will employment” country. The labor reform bill deprives workers of any protection against firings by their employers. Both measures are directly targeted against the Ukrainian working class and have the potential to trigger mass opposition.

The Ukrainian state currently operates on a budget deficit of approximately $642 million and owes billions of dollars to the IMF in loan repayment.

Just prior to the coronavirus outbreak Ukraine’s GDP fell by 0.5 percent due to a downturn in industry as a result of the coronavirus outbreak in China and the Ukrainian hryvnia undertook a marked decline after improving for much of 2019.

By explicitly calling for approval of such anti-working class legislation while in the midst of an impending social and humanitarian crisis the Zelensky government is making clear that it seeks to use the pandemic to further the interests of Ukraine’s oligarchic capitalist ruling-class while ignoring the devastation the coronavirus will bring.

In the same address, Zelensky called for an additional meager $36 dollars per month for the country’s pensioners who currently earn less than $185 per month.

Just prior to his address on Monday, rather than calling for rapid expropriation of funds to combat the virus from the country’s obscenely wealthy oligarchs Zelensky met with Ukraine’s top oligarch criminals to beg for help. During the meeting, Zelensky reportedly asked for help obtaining 500 ambulances and $490 million in funds to fight the virus while stating “Business should be socially responsible during difficult times for the government. Ukrainians should feel protected when they go to state hospitals. And I insist that you help now.”

Among the attendees were Rinat Akhmetov, Ihor Kolomoisky, and Vikor Pinchuk—all billionaires many times over who obtained their wealth by stealing state assets after the dissolution of the Soviet Union in 1991 and the restoration of capitalism. Despite Zelensky’s begging and their immense wealth, these oligarchs mustered a pathetic 14 ventilators to donate to the country’s Health Ministry and Kiev-area hospitals—a slap in the face of the population, millions of whom now face the prospect of serious illness and death.

Hungarian government uses coronavirus epidemic to promote racism

Markus Salzmann

In common with the rest of Europe, the coronavirus is spreading rapidly in Hungary. The response of the ultra-right-wing government of Victor Orban is to promote racism in order to cover up its own inactivity and its responsibility for the spread of the infection.

The Fidesz government only took action against the spread of Covid-19 last week after Orban previously downplayed the crisis with a combination of stupidity, ignorance and audacity.

The country’s borders with Austria and Slovenia are now closed, and all other borders are due to be closed. Air traffic will also cease at the country’s international airports. Hungarians are still allowed to enter the country but are quarantined for 14 days. Travellers from Italy, China, South Korea and Iran are now prohibited from entering the country. According to Orban in a radio interview: “Foreigners have brought the plague to Hungary.”

Universities, theatres and cinemas have been closed, and there is a ban on any large gatherings. When asked why universities, but not schools, were being closed, Orban replied that there were “a lot of strangers” in universities and, in the event of school closures, teachers would have to be sent on unpaid leave and the school year would end.

Zoltán Lomnici, spokesman for the far-right Civilian Forum (CÖF), an organisation that is generously funded by the government, posted the following message on the CÖF’s Facebook page: “The virus is spreading faster in countries that allow immigration. This proves that Hungary’s immigration policy is right and that George Soros’ theory of an Open Society has failed totally.” The reference to the Jewish billionaire Soros, whom Orban has often personally insulted, is aimed at encouraging anti-Semitic, fascistic elements in the country.

The first person infected with Covid-19 in Hungary was an Iranian student who was also among the first group to be tested. Hungarians returning from northern Italy and South Tyrol as tourists or workers who wanted to be tested for the coronavirus have been turned away by the authorities. There are now 58 officially confirmed cases in Hungary (all figures from March 18), but given the lack of testing, it must be assumed that the actual number is far higher.

The case of two Iranian students shows the indifference and brutality with which the Hungarian government deals with the pathogen. According to the Interior Ministry last Friday, the pair were deported from Hungary for allegedly leaving a hospital where they had been quarantined for infection. Neglecting all infection control measures, the two were immediately transported by the national immigration authority to the Hungarian border, where no medical care is available. They were then deported and banned from returning to Hungary for three years.

The Orban government has barely undertaken any protective measures, but at the same time used the coronavirus to abolish the right of asylum at the beginning of this month. The country’s so-called transit zones on its border with Serbia are closed until further notice. More than 300 interned refugees remain there under intolerable conditions with their applications for asylum now rendered invalid. Orban and other government officials declared that it was “likely” the refugees would bring the coronavirus to Hungary.

“We have discovered a link between the coronavirus and illegal migrants,” stated Gyorgy Bakondi, national security official to the government. Orban made similar comments on Friday, declaring: “We are waging a war on two fronts. One front is migration and the other is the coronavirus, there is a logical connection between the two, as both are spread through movement.”

Fidesz spokesman Istvan Hollik said that immigrants not only pose a “risk of terrorism” but also come from coronavirus “hotspots.” One could not jeopardise the security of the Hungarian population and would therefore continue to say “No” to immigration, Hollik wrote on Facebook.

This statement is as repugnant as it is false. Of the 58 cases confirmed so far, only a small minority affect foreigners. At the border with Serbia, just a few metres from the Roszke transit zone, no tests have yet been carried out, although infections have been reported in Serbia. One of them involved a man who had recently traveled to Budapest several times.

“Hungary’s Prime Minister Viktor Urban is using the outbreak of the coronavirus to abolish the right to asylum in Hungary,” commented Gerald Knaus from the European Stability Initiative think tank. Human rights organisations regard the new ordnance as a continuation of the “hate campaign” against refugees that Orban has conducted for years.

Right-wing and widely despised governments in several other eastern and south eastern European countries are also trying to distract attention from their own responsibility for the developing crisis by scapegoating refugees.

In Croatia, Health Minister Vili Beros said that immigrants are a “potential” risk and the EU must find a solution. There are 65 confirmed coronavirus cases in the country.

In Serbia, President Aleksandar Vucic said the country would not be a “parking lot” for immigrants. The government instructed the Ministry of Health to quarantine all immigrants. Seventy-two people in Serbia had been infected with the coronavirus. The parliamentary elections scheduled for April 26 are likely to be postponed.

The widespread distribution of the Covid-19 pathogen will result in a social catastrophe for the states of former Yugoslavia. The country’s former well-developed health system has been systematically destroyed during the last 25 years. “Everything is missing in clinics, not just medication and cleaning agents but of course, staff. In the past few years, at least 50 percent of doctors and nurses have left the state system in almost all successor states,” reported the taz newspaper.

Clinics in the entire region lack any facilities to carry out adequate tests, and laboratory capacities are completely inadequate. There are only a few isolation rooms in some large clinics, and everywhere there is “a lack of protective clothing for staff. After Germany refused to export protective clothing and face masks to countries outside the EU, Serbia, Bosnia and Herzegovina, Montenegro, Kosovo, North Macedonia and Albania have been rendered virtually defenceless to the corona epidemic heading their way,” taz wrote.

As coronavirus pandemic grows, anger rises against German companies

Marianne Arens

According to the World Health Organisation (WHO), the spread of the coronavirus has officially been considered a pandemic for a week now. On Tuesday, Germany’s leading public health body, the Robert Koch Institute (RKI), announced that the health risk posed by COVID-19 is considered “high”. Meanwhile, the number of known infections is rapidly increasing in all Länder (federal states). According to the RKI, the aim must be to “detect the infections as early as possible and delay the further spread of the virus as much as possible”.

The Volkswagen Group’s initial announcement that production lines will not be shut down until Saturday posed a direct threat to the workforce. While the government has banned any kind of public assembly, more than 120,000 VW employees in Germany were set to continue working closely on production and assembly lines for three more days. At the main plant in Wolfsburg alone three workers have already tested positive for coronavirus. The total number of cases in the entire company is 25 so far.

Then on Tuesday evening, the board of directors brought forward the closing date by one day. Now plants will be shut down after the late shift on Thursday. Due to the coronavirus and unrest in the workforce, VW plants in Spain, Portugal, Slovakia and Italy have already been shut down. In Italy, spontaneous strikes forced a shutdown.

At German sites, the IG Metall union is struggling to keep the peace. VW’s top works council leader Bernd Osterloh (who is also a highly paid member of the supervisory board’s executive committee) warned in a letter on Tuesday that there were complaints about a “two-tier society”, especially from production on the assembly line. While in office areas, distancing rules applied due to the corona epidemic, workers in production were working shoulder to shoulder, he said. He now expected “an orderly exit from production”. In other words, the IG Metall considers it its primary task to keep workers on the assembly lines until the company’s official stop time, despite the massive risk of infection. On its website, the question, “Can I stay away from work for fear of infection?” is answered with a clear “No”.

VW is now using the crisis as an opportunity to put long-held radical restructuring plans and the elimination of tens of thousands of jobs into practice. In January, VW CEO Herbert Diess had announced the “slaughter of holy cows”. On Tuesday, the top manager, with a seven-million-euro annual salary, announced that the group had been able to increase its operating results by 600 million euros to 3.8 billion last year. The fact that the workers are paying for this with their health and their lives is now very clearly demonstrated by the decision not to suspend production immediately. VW subsidiary Audi too only wants to temporarily shut down its plants in Ingolstadt, Neckarsulm, Belgium, Mexico and Hungary at the end of the week. In Brazil, VW workers have been told that they will stay on the job until March 31, followed by a 10-day “holiday” shutdown.

Government employment offices are treating their job-seeking “customers” just as badly as most large industrial companies. Despite the urgent instruction to stay at home, the Federal Employment Agency website states, “If activities are organised, you must continue to participate. Staying away out of sheer concern about a possible infection cannot be accepted as a reason for non-attendance”.

In this way, hundreds of thousands of workers and the unemployed are being forced to expose themselves to the potentially fatal risk of infection every day. Significantly, one of countless Twitter messages states, “I have just about every known symptom—sudden fever, severe dry cough, aching limbs, extreme sore throat—not even been tested for influenza. The fact that I have to travel two hours a day across Berlin on public transport is ignored.”

Also on Tuesday, WSWS received new reports about the COVID-19 situation. A report from Dresden graphically describes how devastating the delayed precautionary measures in day care centres, schools and universities are. If these facilities had been closed early and consistently, an enormous spread of the virus could undoubtedly have been prevented.

In Dresden, the first day care centre (Kita) was closed last Friday, when a child tested positive. According to the health department, this child had been infected by a parent who had returned from vacation on March 8. This person had self-isolated, but had sent the child to the municipal facility with about 180 other children on Monday.

At the weekend, a case was confirmed in the after-school care centre, which was then immediately closed, along with the affiliated day care centre and associated primary school, with over 300 children. On Sunday, 15 March, confirmation of infection was received about another child in a day care centre with 84 places as well as a student from the 700-pupil St. Benno grammar school.

The latter case is particularly critical, not only because of the school’s size, but also because of its central location; in its immediate vicinity there are two vocational schools, several student dormitories and senior citizens’ residences, the campus of the College of Fine Arts, the subsidiary campus of the Technical University of Dresden and the campus of the Protestant College. The results of a test on another suspected case at Kreuzgymnasium, with 800 students, will only become known on Wednesday.

The Technical University of Dresden also reported the first infected employee on March 15. The doctoral candidate had returned from a business trip in France. His workplace, the Centre for Molecular and Cellular Bioengineering, with about 500 employees, was then closed. In parallel, the neighbouring Max Planck Institute reported a case among its staff.

It was only at the weekend that operations at the University of Dresden were also restricted. Now the Saxony State and University Library has been closed, affecting thousands of visitors every day, while refectories remained partially open. On Tuesday, all refectories were then closed after two further cases became known over the weekend. All public events were cancelled, many other public facilities on campus were closed and the start of the lecture period postponed to May 4.

These three examples alone show how important and necessary preventive containment measures would have been weeks ago.

On 12 March, the Saxony state government organised a crisis summit with business leaders and trade unions under the cynical slogan, “Secure employment, help companies in a targeted manner”. Since then, the number of those confirmed infected has increased almost eightfold within five days, from 5 to 39. From Monday to Tuesday alone, 14 cases have been added!

Despite this, on Tuesday, Dresden Mayor Kristin Kaufmann (Left Party), who bears responsibility for health, said the city was “well prepared”, and all known cases were mild. She pointed to the capacity of the municipal hospital of up to 80 beds with ventilation technology and up to 110 intensive care beds. With a population of over half a million people, of whom more than 150,000 are over 60 years old, this is just a bad joke.

It was reported from Chemnitz that the city had opened an emergency corona ambulatory station on Tuesday at the city’s trade fair grounds. There, in 140 treatment cabins with 50 couches, risk cases are to be tested—but “ONLY from Chemnitz”. Apparently, the authorities are assuming that the capacity of general practitioners and hospitals will soon be insufficient, despite their conciliatory speeches.

Those in power—who swiftly move from exercising criminal negligence to dictatorial police state measures—have long been preparing to enforce curfews, as in France. The grand coalition of the Christian Democrats and Social Democrats are seeking to keep the population quiet through emergency measures and to release billions of euros to save the banks.

The sensible, considered and social-minded attitude of hundreds of thousands of ordinary workers and young people stands in striking contrast to this response by the ruling elite. There are many reports of spontaneous neighbourhood help initiatives. Many tweets contain passages such as, “I myself work in the public sector (university administration), and since yesterday, we’ve had to work from home... But I’m thinking of those in manufacturing companies. The situation there is going to be much, much worse now, because no real protection has been taken so far.”

A doctor reports, “I am overwhelmed. My patients give me their gloves and disinfectant so I can protect myself and others at work. They know that there are no more suppliers.”

The head of a nursing home, himself a nurse, posted a video on the internet showing quite graphically how the current situation is pushing him and his colleagues to their limits. The nurses have no idea how they should care for their own children now, the young man said. They are left alone in all decisions. “With this video, I would like to show what kind of work these people are doing right now”, who are now experiencing an “extreme balancing act”.

On Tuesday, a “joint appeal by active carers” turned into a petition in no time at all, with signatures arriving every second. Within a few hours, it had received tens of thousands of signatures. The petition is addressed to the Federal Minister of Health, Jens Spahn (Christian Democrat), with the words, “We have to talk!” The government’s policy of downplaying the situation so far was “a tragedy”, and conditions in hospitals were devastating.

The text is full of sarcasm about government’s plans to involve and “train” pensioners and students as nursing staff. “We are already looking forward to seeing the high-risk group standing at the ventilators of highly infectious patients. An incredibly promising, well thought-out measure!”

It goes on to say, “We nursing staff should have expected a little more substance in recent years rather than warm words, thank-you chocolates and parties for the functionaries. No, you can’t shift the blame onto the contract negotiating partners, cost bearers and us nursing staff, because one thing is clearer than ever: you have the responsibility for ensuring the nursing care of the population”.

Nursing staff point to a directive issued by the Baden-Württembergische Krankenhausgesellschaft e.V. to nursing institutions, which states that they are to make an effort to obtain protective material, “and if none can be organised, we should simply continue working without protection”. This instruction “was obviously coordinated with the Ministry of Social Affairs in Baden-Württemberg”.

Nursing staff comment, “That’s not how it works!” and set out a list of demands ranging from the “immediate organisation of the procurement of effective protective materials, taking all possibilities into account” to a “reliable promise of a substantial, state-funded wage supplement for all those who can hold out in this situation, those who take their children to emergency care groups, work overtime, cannot take breaks, cannot take rest periods”. The starting salary for all carers should be at least 4,000 euros and, if necessary, the “nationalisation of manufacturers and their suppliers” must be enforced for the procurement of materials.

The petition ends with the words, “We urgently warn you! Without these measures, the ventilators will soon stand around useless, because there will be nobody left to operate them!”

The petition underlines the urgency of the WSWS’s call for all workers to form independent action committees and take their fate into their own hands. As stated in the recent WSWS perspective: “The fact is that the demand for a serious effort to fight the pandemic is inseparable from the struggle to end the capitalist system and reorganize society on a socialist basis.”

Canadian government’s Coronavirus response: Tens of billions for business, a pittance for healthcare and workers

Roger Jordan & Keith Jones

Prime Minister Justin Trudeau unveiled yesterday morning what he called an $82 billion aid package for Canadian “workers and businesses” aimed at sheltering them from the economic fallout from the global coronavirus pandemic. In fact, the lion's share of the money will go to propping up business so as to ensure the profits and investments of the corporate elite.

Trudeau's announcement came as the number of coronavirus cases in Canada, the US, and Europe continued to surge. By yesterday evening, there were 666 confirmed coronavirus cases in Canada, more than quadruple the number last Friday, and a further 39 “presumptive cases.” The official death toll stood at nine.

With global financial markets reeling and economic life rapidly shutting down across North America as the result of hastily improvised government orders to close schools, services and non-essential businesses, the corporate media is full to the brim with worried commentary. Numerous economic analysts are warning that the coronavirus risks provoking an economic slump that will dwarf that triggered by the 2008 financial collapse, and are urging the federal and provincial governments to funnel unlimited resources into bailing out big business.

Nowhere near as much alarm has been expressed by the corporate media about the thousands or even hundreds of thousands of Canadians who could die due to the failure of the federal Liberal and various provincial governments to take serious steps, prior to last week, to halt the spread of the coronavirus and to save those who contract COVID-19, and the Canadian elite's decades-long healthcare austerity drive.

The aid to business outlined in yesterday's announcement is only the latest in a flurry of government measures aimed at propping up corporate Canada. Moreover, Finance Minister Bill Morneau has promised that in the coming days he will provide additional government assistance for the airlines, oil and gas, and other particularly hard-hit industries.

Last week the Bank of Canada and Office of the Superintendent of Financial Institutions announced a $300 billion scheme to prop up the country's banks by buying $50 billion of their mortgages and halving their bank capitalization requirements. The banks, in turn, are expected to step up their lending, helping businesses weather the economic storm, all the while turning a handsome profit.

While the Liberal government is handing out lavish sums to corporate Canada, it is placing workers and their families on rations amid a raging global pandemic. A key element of Trudeau's “aid” package for workers is an “emergency care benefit” of just $450 per week. It will be made available to workers who are sick, have to stay home to care for a sick person, or are ordered to self-isolate and who have no income-support from their employer.

The government also announced a modest temporary top-up to the existing child benefit, at a cost of $2 billion, and a one-time hike in the GST (Good Services Tax) rebate for lower income Canadians. Payments of an undetermined amount will be provided to the large number of contract, gig-economy and self-employed workers who do not qualify for Employment insurance, but the application process for this new “emergency support benefit” will only be launched in April.

Like those receiving employment insurance, recipients of the “emergency support benefit” will get no more than 60 percent of their normal paycheck. This under conditions where numerous studies have shown that a large percentage of the workforce, and above all the lowest paid workers, live from paycheck to paycheck and have little to no savings.

Trudeau also announced yesterday an agreement with the United States to limit cross-border traffic to essential travel. The deal aims to secure business supply-chains, including those of the large corporations that operate on just-in-time production, so as to guarantee they can continue to operate and make profits during the pandemic. The bilateral agreement was hailed by US President Donald Trump, who stressed it is being implemented “by mutual consent.” For his part, Trudeau emphasized that corporate Canada’s access to its most important export market would be guaranteed by the deal. “Supply chains, including trucking, will not be affected by this new measure,” Trudeau reassured the corporate elite. “Trade will not be affected,” Trump added on Twitter.

A top priority of the Liberal government since it came to power in 2015 and throughout the coronavirus crisis has been to maintain and expand Canadian imperialism's military-strategic partnership with Washington. Under last week's deal to suspend parliament, the Trudeau government, joined by all four opposition parties, rushed into law the US-Mexico-Canada Agreement, which replaces NAFTA and will strengthen North America as a US-dominated trade bloc capable of waging economic warfare and military conflict against rival powers, above all Russia and China.

While no effort is being spared to safeguard the interests of the corporate elite, the government’s measures to strengthen Canada’s dilapidated and overcrowded healthcare system to combat the pandemic have been both paltry and dilatory.

Last week, as coronavirus cases were spiking, Trudeau announced just $1 billion in additional spending to fight the pandemic. This includes $500 million for the provinces, who are responsible for managing most of the country's healthcare system, as well as money for research into vaccines and other treatments, and the purchasing of medical equipment.

Only last week did Trudeau and Deputy Prime Minister Chrystia Freeland even bother to write to the provinces to request information about the state of their medical supplies and what equipment they require.

Even today there is no accurate census of the vital medical supplies needed to fight the pandemic, such as masks and ventilators. As many as 20 percent of COVID-19 patients may need the help of a ventilator to survive. Yet nothing was done over the past ten weeks to augment Canada's estimated supply of just 5,000 ventilators.

The delay in mobilizing resources to fight the spread of the pandemic, including the organization of systematic testing is proving disastrous. According to data available on the Public Health Canada website, some 20 percent of all COVID-19 cases as of Tuesday resulted from community transition, underscoring that the authorities have failed to contain the disease.

According to Michael Warner, medical director of critical care at the Michael Garron Hospital in Toronto’s east end, the emergency measures announced in recent days by provincial and federal governments haven't gone far enough to halt community transition. Warner said his department is preparing for “combat medicine,” and warned that frontline physicians fear that Toronto is heading for a situation like northern Italy. There hospitals have been overwhelmed by the crush of new coronavirus patients and doctors have been forced to choose between which patients should be treated and which left to die. As of yesterday, close to 3,000 people had died in Italy due to COVID-19.

Canada’s unpreparedness for the pandemic—for which the ruling elite and its political representatives are wholly responsible—is all the more scandalous given that apart from several countries in Asia, Canada was the hardest hit by the SARS outbreak in 2002-03. Whereas China, Taiwan, and Singapore adopted measures based on this experience, including widespread testing programs, early quarantining of suspected cases, and a massive expansion of hospital capacity, Canadian governments learned nothing.

On Tuesday, Eric Gjerde, CEO of Airon Corporation, a US-based manufacturer of ventilators, expressed his astonishment that Canada had not stockpiled ventilators following its experience with SARS in 2003. Forty-four people died during the outbreak across Canada, including at least 32 in Toronto. “Your government and Ministry of Health should have hundreds of ventilators in storage,” he wrote in an email to CBC. “These ventilators can sit in boxes for years, with no maintenance. When they are needed, you just attach oxygen and you are good. It is just frustrating that governments can't think ahead and be prepared!”

The Globe and Mail reported last week that a ventilator, which can save the life of a seriously ill COVID-19 patient by helping them breathe, costs just $10,000. Canada thus could have purchased 1,000 ventilators for a mere $100 million—a drop in the bucket compared to the billions showered on the corporations with no strings attached.

The Trudeau government only issued initial tenders for urgently needed medical supplies last Thursday. Exploratory talks with private businesses about transitioning to the production of medical equipment were launched Tuesday.

Working class in China bears brunt of Beijing’s COVID-19 response

Ben McGrath

As the number of confirmed cases of COVID-19 falls in China, the Beijing regime is holding up its belated response to the pandemic as a model to be emulated by the rest of the world. In doing so, the Stalinist Chinese Communist Party (CCP) is attempting to use nationalism to deflect attention away from the social disaster that its weeks-long denial of the virus caused for the Chinese working class, as well as from the police state measures that it has implemented.

China’s National Health Commission reported on Monday there had only been 21 new cases of COVID-19 and 16 the previous day. Of the 21 new confirmed infections, 20 were detected in people arriving from overseas. As of Tuesday, 143 cases of COVID-19 in China came from abroad.

By comparison, Italy, which has become the new epicenter of the virus outbreak, reported 2,989 new cases on Tuesday alone, as well as 345 deaths. In total, there have been more than 191,000 cases and over 7,700 people have passed away. The majority of confirmed cases are now outside China.

The Chinese government has imposed strict travel bans in attempt to prevent new outbreaks. International travellers arriving at Beijing, Shanghai, and Guangzhou will be medically evaluated and then escorted to a quarantine site where they will be placed under observation for two weeks. Those arriving from Italy, Spain, Iran, the United States, the United Kingdom, Switzerland, Sweden, Belgium, Norway, the Netherlands, Denmark and Austria face additional checks.

While testing and quarantines are a necessary measure to deal with the COVID-19 pandemic, the harsh measures imposed by Beijing have added to a growing social crisis in China, which was in part exposed by the collapse on March 7 of a hotel used as a quarantine site.

Residents under quarantine in cities like Wuhan have complained that they have been neglected by the government and limited access to basic food supplies and other necessities. Millions of workers have lost their jobs and no serious compensation has been provided. Large parts of the country are still under lockdown.

There is growing anger among the Chinese working class, which Beijing is attempting to contain with nationalist rhetoric. A commentary in the official state Xinhua news agency on Tuesday stated: “Under the leadership of Chinese President Xi Jinping, the whole nation has been mobilized in the fight against the virus. People from all walks of life made concerted efforts and fought in unity.” The official rant declared: “With the full practice of collectivism and patriotism, the Chinese people have shown national unity and cohesion.”

The reality is that the Chinese capitalist class, and the CCP regime that serves it, has imposed the full burden of the massive economic cost caused by the COVID-19 outbreak on workers and the rural poor.

Goldman Sachs on Tuesday stated it believes China’s economy is likely to shrink by 9 percent in the first quarter—the largest decline since 1990. It further stated that China’s annual gross domestic product will grow by 3 percent rather than its previous estimate of 5.5 percent. Even such estimates of growth are questionable, given industrial output fell by 13.5 percent in January and February, as factories in the major export regions were largely closed.

Chinese officials, however, claim that the economy is likely to return to normal in the second quarter. “Over 90 percent of large-scale industrial companies in regions outside of Hubei have resumed production, and resumption rates for places including Zhejiang, Jiangsu and Shanghai are close to 100 percent,” said Meng Wei, spokeswoman for the National Development and Reform Commission.

However, China’s Ministry of Industry and Information Technology said last week that small and medium-sized businesses have only resumed work at a 60 percent rate.

Workers face mass job losses and huge wage cuts. Nine million workers are predicted to lose their jobs in the coming year, according to the Economist Intelligence Unit. The official urban unemployment rate is set to rise to 6.2 percent, the highest on record. An additional 18 to 30 million workers could see their wages slashed by as much as 50 percent.

Smaller businesses in China employ as many as 200 million people. Many of these are restaurants or bars that were forced to close. In many cases, they employ migrant workers who have been unable to return to work. Approximately 20 percent of people have been unable to return to their workplaces.

Migrant workers in general have been hard hit. When belated quarantine measures were taken to halt the spread of COVID-19 in late January, many migrant workers were visiting their hometowns for the Lunar New Year, often located far from their place of employment. Only those with a formal job were able to travel while others were unable to afford the costs of high-speed trains that remained open for the wealthy.

“There is nothing I can do except wait,” Zhang Yanwei told the Financial Times at the beginning of March. Zhang, a plumber, expected to find work outside his hometown of Zhumiao, in Shandong province, but has been unable to travel without a formal job contract.

In some cases, workers who were able to return to their job sites were forced into quarantine in their dormitories, sharing rooms with other workers, risking a wider infection while going unpaid. In the worst cases, workers were thrown from their accommodations and rendered homeless and unable to travel to their hometowns, forced to live on the streets.

Contrary to Beijing’s claims that the entire country has rallied together, the working class has been made to endure incredibly harsh conditions. The ability for China to contain the spread of COVID-19 was only the result of police state measures that imposed the full burden of the health crisis on workers and their families. The Chinese capitalist class, embodied by President Xi Jinping, has paid basically nothing. Most of the Chinese rich have simply escaped to their luxury homes in suburbs of the major cities, or in other countries, and are riding out the crisis.

The Chinese experience is only a “model” to the extent that it serves to underscore the necessity for the working class internationally to take direct control over the COVID-19 response. Only the independent action of workers can guarantee that all measures are implemented with respect for basic democratic rights and the social right to a decent income, housing and essential services.

Markets plunge again in rush to cash

Nick Beams

The turmoil in global financial markets made a qualitative turn yesterday with a massive sell-off in all asset classes, stocks, bonds and precious metals, as confidence in government and central bank measures to halt the crisis disintegrated.

Selling on Wall Street went across the board, with the Dow losing around 6 percent, taking the index to below 20,000. It has now dropped by around one-third since the market high in mid-February. All the gains in the market since the election of Donald Trump to the presidency have been wiped out.

The Financial Times (FT) described it is a “panic-ridden day of forced selling and a loss of faith in government intervention.”

The Wall Street Journal said the rush for cash “shook the financial system … as companies and investors hunkered down for a prolonged economic stall, taking the recent market turmoil into a new, more troubling liquidation phase.”

But even more significant were events in government bond markets. Normally the price of these bonds rises in a market sell-off, sending their yields lower, as investors seek a safe haven.

But the reverse is happening. Bond prices are falling, and their yields rising, as funds sell them off in a desperate effort to obtain cash either to stay afloat or pay back investors.

The sell-off means that efforts by the Fed and other central banks to lower interest rates and ease the constrictions in credit markets are being undermined by the rise in interest rates in the bond market.

As the Financial Times noted: “Higher sovereign yields at this juncture only tighten financial conditions and compound the pain from sharply weaker equity and credit prices, together with a strengthening dollar. That compromises the monetary easing policies of central banks.”

Interest rates are also coming under upward pressure because of the recognition that the measures being prepared by the Trump administration for a stimulus package, almost entirely aimed at trying to prop up corporations, will lead to the issuing of more government bonds, sending their price down and the yields higher.

Consequently, there have been calls for the stepping up of quantitative easing—the purchase of government debt and other financial assets by central banks—in order to lower interest rates.

This would lead to the extension to the US and other major economies of the conditions that have prevailed for some time in Japan, where new government debt is largely purchased by the Bank of Japan.

Such a move, which would amount to the stateisation of the entire financial system, was foreshadowed in an editorial in the Financial Times, which asserted “we may be witnessing the biggest dash for cash the world has seen.”

Praising the actions taken so far by the Fed, the FT said more was needed. The US Treasuries market was “too important to rely only on private market-making,” especially because after 2008 the major banks have played a less significant role and there has been a shift to “less scrutinised operators such as hedge fund groups.”

Under these conditions, the FT declared, the Fed “must assume the role of market-maker of last resort” and could adopt the “yield control” policy developed by the Bank of Japan. “The Fed would target the 10-year Treasury yield directly, committing to buy or sell bonds in sufficient quantity to achieve that rate.”

Such a policy would mean that rather than the Fed acting as a market setter of “last resort,” it creates a situation where one arm of the state issues debt and another arm buys it.

Moves in this direction are already underway. In a day where UK financial markets took a hammering—the pound tumbled by 5 percent against the US dollar to reach its lowest point since the 1980s—the Bank of England (BoE) announced what amounts to unlimited quantitative easing.

Incoming BoE governor Andrew Bailey said the central bank would print money to provide short-term loans to investment-grade companies in the form of a new commercial paper facility. “We didn’t want to put a limit,” he said.

The European Central Bank (ECB) is also escalating its quantitative easing measures. In an emergency call by the rate setting committee yesterday evening, it announced plans to buy an additional €750 billion worth of bonds.

The new purchases, adding to the ECB’s stockpile of more than €2 trillion, would be carried out over the course of this year and involve both government bonds and corporate debt.

The actions by the major central banks, however, will do nothing to revive the real global economy, as it plunges into a deep recession or even depression. They are entirely aimed at providing support for finance capital.

Such so-called stimulus measures cannot lift the real economy because economic activity is being wound down as part of measures to prevent the spread of the coronavirus.

The deepening crisis is now leading to a wave of job losses, some of the most significant of which are in the airline industry.

Reflecting the position of all airline companies, the Australian carrier Qantas has announced it is halting all international flights and will stand down 20,000 workers, two thirds of its workforce, until at least the end of May.

CEO Alan Joyce said efforts to contain the coronavirus had led to a “huge drop in travel demand, the like of which we have never seen before.”

A wave of job destruction is now sweeping the world. In the UK it is estimated that 200,000 workers in the leisure and hospitality industry have been laid off since mid-February, with many more to be hit.

According to the chief executive of the trade group UKHospitality, Kate Nicholls, in excess of one million jobs are on the line. “Job cuts are extraordinarily deep and they are happening now,” she said.

In the US, a survey released earlier this week found that 18 percent of American workers had either been laid off or had their working hours cut, with the proportion rising to 25 percent for those earning under $50,000.

The inexorable slide of the world economy into a deep slump is reflected in the ongoing fall in oil prices. The prospect of rapidly falling energy demand yesterday sent the US oil benchmark, WTI crude, down by more than 15 percent to $23 a barrel, its lowest level in 17 years. Brent, the international benchmark, dropped 9 percent to $25 a barrel.

Front-line nurses and doctors face dire shortages of personal protective equipment

Benjamin Mateus

Nurses and doctors in the United States are facing dire realities of shortages of personal protective equipment. Many are voicing concerns over the ability to protect themselves under conditions of a surge of infected patients that will overwhelm hospitals.

An emergency room physician wrote on a COVID-19 Facebook post hosting over 100,000 nurses and doctors, “We have run out of most of our supplies because they have run out of N95 masks. I refuse to intubate patients without a mask. They scolded me about this, but we have the most confirmed cases at our hospital in our State.” Physicians and nurses on the front-line of the pandemic are voicing concerns over their safety, given the shortage of personal protective equipment.

Spontaneously, communities of health providers have organized several online groups that allow nurse practitioners, family medicine physicians and specialists to interact and share experiences and communicate directly, ask questions or share insights. The posted comments have provided an even clearer picture of the disorganized and chaotic response by the health care system and federal government to the developing pandemic.

One nurse practitioner from Tennessee wrote, “My urgent care clinic is going to start offering COVID-19 testing here soon. We do not have proper PPE [personal protective equipment]. No N95 masks or safety goggles or enough gowns. What is the CDC saying about proper PPE? What are the alternatives to N95? If you don’t have proper PPE and you get a positive, is the whole clinic have to be tested? I am not getting answers from my company. What are some of your clinics doing in this situation?”

A certified nurse-midwife asked, “What are your mitigation plans for providers/staff that are unable to fit for N-95 masks? Our leadership doesn’t have a plan at this point other than regular surgical masks.”

Another nurse wrote, “My clinic won’t get us N95 masks, but masks patients with symptoms. I’m going to start wearing a mask in the clinic, so I don’t infect patients in case I’ve already been exposed. I wish our clinic would provide us with better masks.”

Another emergency room physician wrote, “In this pandemic, the most important specialties are those that can manage airways and vents—ER, Critical Care, Anesthesiology. I have been issued ONE disposable N95 to be used continuously till they can find a replacement. The most high-risk situation is to manage a patient where I have to intubate. I save the single N95 for the high-risk situations and go naked for all the minor flu-like cases … it’s my honest belief that at this rate, I will likely get infected well before the point where I am needed most. Losing even one physician who has airway skills is a huge loss, there are not many of us.”

In a show of solidarity, Primavera Alessandra Spagnolo wrote to the group, “Colleagues: I am a member of the homologous Italian group of Covid-19 physicians. There is also an international group. My point is: many of the questions you have regarding symptoms and therapies have already been discussed/answered by Italian physicians. If there is a way to open a communication channel between these groups, let’s do it. We need to share experiences, knowledge, and support each other.”

These initiatives on the part of health care workers should be applauded as they provide a concrete example of the necessity to organize global resources from an international perspective. These workers have set out to create a multinational forum to address the most urgent concerns facing the health care establishment and the patients they are treating. Pediatricians, anesthesiologists and an assortment of subspecialists are sharing data from their respective hospitals, providing guidance on strategies to extend resources, offering their best practices and indicating the obstacles and challenges they face.

Their comments also indicate the tremendous anxiety and fear that exists. Many express their frustrations with their hospitals’ lagging and constantly changing policies. Frustrations also arise when administrators downplay the risk to health care workers. Lack of ability to get testing also extends to health care workers who are at greatest risk due to their exposures. Now, shortages of long nasal swabs for the COVID-19 test kits are making headlines.

A pregnant physician from Idaho wrote, “I have been isolating at home with my husband and 22-month-old. Both have demonstrated a very mild fever one day and nothing else. Given the shortage of viral media [test kit solution], we have elected not to test them at this time … what I am reading here is alarming—multiple providers with much higher exposure risks than myself with more symptoms who are being denied testing. I have more questions than answers. I am patient number 6 in my State. I’m shocked; I feel so alone.”

The COVID-19 pandemic in the US is entering an accelerating phase with 7,301 cases. New York now has 2,480 cases, while in Washington, there are 1,014 cases. Every state has been impacted. The number of daily new cases on March 17 rose by 1,748 with reports of 23 more deaths.

This week, the Imperial College COVID-19 Response Team published their modeling of the trajectory for the epidemic utilizing various strategies of containment and mitigation. Under the most optimal measures, they provide a dire estimate of the number of fatalities expected in Great Britain and the United States.

The surge is expected to commence in late April and peak in June. However, the authors note that the health resources of both nations will be inundated, and they believe that social distancing, mitigation and suppression measures will have to be extended for many more months than is being reported.

The Harvard Global Health Institute released data this week that provides a glimpse into which regions will be impacted worst based on various estimates of infected population and containment strategies. The estimates are bleak at best, indicating that the nation has done little until now to prepare for this pandemic. “Vast communities in America are not prepared to take care of the Covid-19 patients showing up,” according to Dr. Ashish Jha, director of the Harvard Global Health Institute.

In their best-case scenario, where the “curve is flattened” over an 18-month window, under the premise that only 20 percent of Americans are infected, hospitals in the US would operate at full capacity. Under a more realistic assessment that has been made by multiple models of the pandemic, if 40 percent of the population became infected, the US would have to double bed capacity to absorb the surge.

Additionally, if all ICU beds were made available to COVID-19 cases, the total capacity would have to be increased by 74 percent, and this does not consider that hospitals may have a limited supply of ventilators as well as respiratory therapists who would manage this equipment.

Regional variations and flexibility will inundate communities differently. Urban centers like New York City would be hit hardest, but their health systems can adjust by releasing non-urgent admissions to accept new cases. Still, Governor Cuomo admitted at a press conference this week, “You will have people on gurneys in hallways. That is what is going to happen now if we do nothing.” He has urged the White House to deploy the Army Corps of Engineers to build field hospitals to absorb the surge numbering in the tens of thousands.

Rural communities will face challenges relating to the lack of resources and expertise. Over the last fifteen years, 155 rural hospitals have closed. Of the remaining 1,821 hospitals, 40 percent operate at negative margins, and 20 percent are nearing financial collapse.

There are almost 60 million people living in geographically isolated regions of the United States. They also have poorer health than their urban counterparts, suffering from COPD, obesity, diabetes and heart disease, with higher mortality, making them even more vulnerable to the impact of the pandemic.

In rural medicine, one physician may fill multiple roles. There are usually no intensive care beds, and standard protocol would be to stabilize the patient and transfer them to larger centers. If these communities are overwhelmed by local surges, there may be little alternative for these patients but to weather the infection in place. Eighty-five percent of rural communities are already facing physician shortages. Transmission of the coronavirus to health care workers in these regions would exhaust the trained staff immediately. Just last week in Berkshire County, Massachusetts, 54 nurses were furloughed after possible exposure to COVID-19.

West Virginia reported its first case on Tuesday, distinguishing themselves as the last state impacted by COVID-19. Joe Manchin, the state’s senior US senator, speaking on the possible impact, said, “I have over 720,000 elderly. I’ve got over 220,000 that are critically ill under 60 years of age. If you put all this together, of the 1.8 million people living in West Virginia, I have over a million that could be devastated by this virus if it hits.”

The WSWS spoke with Christine Pontus, associate director in Nursing/Occupational Health at the Massachusetts Nurses Association (MNA), about the concerns of nurses during the coronavirus outbreak.

“I won’t say all the health care facilities, but I’m saying this is one of the concerns we have—that if the hospital follows the CDC definition right now, of droplet transmission, it doesn’t address more specifically the positive or presumptive [COVID-19] patient. Without guidelines, it creates confusion. They’re making up the rules at the last minute. They’re not supposed to be doing that. That’s not professional, that’s not proper planning.

“So, for me to have a labor representative come in and voice his opinion with two ER nurses, that’s a concern. The hospital was not giving them the N95 masks in a room where patients were not confirmed [COVID-19] cases, but they were being tested for it.

“Some hospitals are handing out one N95 every three days [to nurses], one every week, one a shift. These are the kinds of things we’re hearing. We’re in interim recommendations here. But in the original manufacturer’s recommendation, those N95s were meant to be used once and disposed of.

“Much of this planning ought to have been happening a long time ago,” Christine said of the lack of preparedness. “If people were listening to what the epidemiologists and the scientists were saying—we knew what was happening in Italy. They were saying quarantine; they were saying isolation. This, to me, is kind of a no-brainer.”