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How COVID, Inequality and Politics Make a Vicious Syndemic – Scientific American

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High COVID rates and high poverty overlapped in El Centro, Calif., in 2020. Credit: Mario Tama Getty Images
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It is folly to respond to COVID by focusing only on the coronavirus that causes it, because the virus alone did not dictate the catastrophic impact. For instance, in the U.S., the illness initially hit urban populations hard. But the virus has traveled to more rural areas over time, and recently the impact has shifted to Southern states. In those areas, people younger than 70 years old have been dying more frequently from COVID than they have elsewhere. These same states have had fewer people getting vaccinated and protected. The mortality trends are strongly tied to the increased burden of cardiovascular and metabolic illnesses in the American South, which existed before the virus hit but have made its impact worse. Poorer access to health care has also been a factor in these sad Southern numbers because many of these same states refused to expand Medicaid under the Affordable Care Act. Even before the pandemic, states that expanded Medicaid showed improved health; those that refused expansion did not. As COVID took hold, states with Medicaid expansions were better able to ramp up testing and tracing and to provide health care coverage to people who were suddenly out of work.

The larger lesson of COVID is that social and biological risk are deeply entangled. Viruses may cause disease in individuals, but pandemics play out in populations. This disease, like previous pandemics, reflects political, economic and social conditions. One way to understand these dynamics is through the concept of syndemics.

The term syndemic refers to the synergies among epidemics. The idea involves three claims. First, political-economic forces with historical depth lead to entrenched social, economic and power inequities. Second, those inequities shape the distribution of risks and resources for health, leading to the concentration of disease in specific parts of a population. And third, some overlapping diseases make one another worse because of biological interactions.

COVID is not inherently syndemic. Syndemics are not properties of diseases but rather of systems. Syndemics reminds us that, while we can understand viruses in the lab, the distribution of disease depends on complex, real-world interactions among political-economic structures, ecological contexts and human biology. In other words, context matters. Local histories and power structures influence where conditions cluster, how they interact and why some people suffer more.

In the U.S., conditions were ripe for a syndemic to emerge. A deep history of systemic racism and white supremacy in the country had two immediate consequences. First, race-based residential segregation, the racialized structure of the workforce, and racial inequities in the prison system, among other factors, meant that Black and Indigenous people and other people of color were more likely to be exposed to SARS-CoV-2, the virus that causes COVID. In contrast, the accumulated advantages of whiteness meant that white people were more likely to be in professions that allowed them to work from home, reducing exposure. Second, because of the same political-economic and social inequalities, Black and brown people were already suffering disproportionately from poor health conditions such as hypertension and diabetes. There are biological interactions between these conditions and COVID, such as when chronic inflammation from diabetes is augmented by acute inflammation from SARS-CoV-2, leading to an intense immunological reaction that can damage multiple organs.

Such syndemic interactions are likely one reason worldwide excess deaths in 2020 far outpaced the already shocking number of deaths directly attributed to COVID that year. These conditions made the anemic U.S. federal response to the disease in 2020 even more deadly. By continually downplaying the threat and moving to reopen crowded businesses while infections were still accelerating, the Trump administration allowed the virus to spread along the fault lines of society. Syndemic interactions with preexisting inequities in health and the conditions of life meant that the hardest-hit communities were already suffering from concentrated poverty, substandard housing, less access to health care, disproportionate police surveillance and incarceration, greater exposure to air pollution, less access to healthy food and higher rates of cardiometabolic disease. The pandemic made many of these conditions worse. For instance, there were unequal impacts of the economic fallout throughout 2020, and the current economic recovery continues to leave many Black communities and other communities of color behind. And earlier this year, failures to prioritize equity in vaccine distribution allowed glaring inequities to grow.

It didn’t have to be this way. Consider the case of New Zealand. There are many differences between that country and the U.S., but they share a common history of European settler colonialism and enduring social, economic and health inequities among white, Asian, Pacific Islander and Indigenous people. New Zealand had, and has, the background for syndemics. But when COVID brushed its shores, Prime Minister Jacinda Ardern closed down the country. Her “go hard, go early” approach, embodied in the nearly five-week lockdown that she instituted in March 2020, focused on protecting her “team of five million.” She also urged New Zealanders to care for one another, to be compassionate. The nation has been largely successful in keeping COVID under control. Drawing on long-standing pandemic preparedness plans, Ardern employed basic public health principles to stop the disease in this smaller, less dense population.

Many other countries responded with strong public health leadership, implementing swift lockdowns and controlling the disease. For example, Rwanda’s government shut everything down and tightly controlled the spread of COVID in 2020, in part through established trust within the system and what the country’s former minister of health Agnes Binagwaho described as “compassionate leadership” in a 2020 International Journal of Health Policy and Management paper. A national lockdown ensued a week after the first case was confirmed, followed by extensive contact tracing and testing. Today Rwanda is fighting a new spike in cases by pushing to vaccinate as many citizens as possible, but accessing enough vaccines is difficult because of global inequities in immunizations.

Inequality takes lives. Demographer Elizabeth Wrigley-Field recently showed that Black people in the U.S. experience pandemic-scale premature mortality every year. Like the influenza pandemic a century ago, COVID exacted a staggering toll, instantly reducing life expectancy in the U.S. by more than a year. Yet even the reduced life expectancy of white Americans remains higher than it has ever been for Black Americans, and the reductions in life expectancy for Black and Latino populations are expected to be three to four times greater than for white people.

When a novel coronavirus is introduced into that context of inequality and allowed to spread, it is a recipe for disaster—and not only for the targets of racial oppression but for everyone. Another recent study estimated that, if the U.S. government had paid reparations to descendants of enslaved people—an essential step toward liberty and justice for all—then the overall transmission rate of the virus, regardless of ethnic or racial background, would have been between 31 and 68 percent lower than it was. Everyone would have been better off.

If the pandemic begins to recede, we hope the world will not return to a “normal” that was not working for everyone. COVID will not be the last pandemic threat we face. To reduce the suffering from the next one, we must reduce the suffering people experience now. The larger lesson of syndemics is that a more equal society is also a healthier one.


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Women in politics | Watch News Videos Online – Globalnews.ca

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Historically, women have been chronically under-represented in politics. Many are saying have two women in the race to become the next Manitoba PC Leader and Premier is a step in the right direction. But as Marney Blunt reports, there’s still a long way to go for equity in the political world.

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Texas politics takes over American politics – POLITICO

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A strict new abortion law kicked off a huge national backlash. Thousands of Haitian migrants seeking asylum prompted mass deportations and scrutiny on Border Patrol policy. State officials announced four new reviews of the 2020 vote.

And that was just in September — and just in Texas.

The massive, Republican-controlled state has dominated the national political spotlight this year, driving increasingly conservative policies into the heart of big debates over everything from voting to public health initiatives, critical race theory and more. These legislative moves have positioned Texas as a counterweight to Democratic-dominated Washington — and a leader charting the potential course of the Republican Party nationally.

This year, the state was one of the first to reverse mask mandates and block local Covid-19 vaccine requirements. In the summer, Democratic state lawmakers fled Texas for a month to delay GOP voting legislation, which passed shortly after they returned. Laws that allowed carrying a gun without a permit, penalized reducing police budgets in large cities and limited discussion of systemic racism in classrooms went into effect on Sept. 1.

And other times, big events in Texas took center stage: A massive winter storm exposed the state’s weak energy infrastructure in February, and Texas’ southern border has been at the front of this month’s national news.

Even for a big state, Texas has seen an outsized amount of political attention as conservatives try to break new ground, expanding on decades of GOP control and a national political environment that tilts toward Republicans. Two more key trends are also behind the attention-grabbing policy drive: The Republican governor is preparing to face primary challengers in his 2022 reelection race and potential presidential run, while conflicts are mushrooming between diverse, liberal cities and the Republican-dominated state government — mirroring the same tensions animating national politics.

“You put all those things together, and I think there’s been basically no lane markers for Republicans in this session,” said James Henson, director of the Texas Politics Project, which conducts public opinion polling in the state. “They’re very confident about the 2022 election given recent precedents and… a Democrat in the White House, so there have been no natural checks.”

Former President Donald Trump’s influence still looms large in the state’s politics — as seen in his open letter to GOP Gov. Greg Abbott last week. Trump demanded the state legislature pass House Bill 16, which would allow state officials to request an electoral audit for future elections as well as for 2020.

Despite Trump’s nearly 6-point win over Biden in Texas last year, the secretary of State’s office soon announced a “full and comprehensive forensic audit” of Collin, Dallas and Tarrant counties in the Dallas-Fort Worth area, as well as Houston’s Harris County. The release did not provide any details but said the agency expects the state legislature to fund the effort.

Former Texas Secretary of State Ruth Hughs, who previously called the 2020 election “smooth and secure,” resigned in May when the state Senate did not take up her nomination. The Texas secretary of State’s office is currently helmed by a former Abbott staffer on an interim basis.

In a Fox News Sunday interview, Abbott said election audits by the Texas secretary of State’s office already began “months ago.”

“There are audits of every aspect of government,” Abbott said when asked about the potential waste of taxpayer money. “Why do we audit everything in this world, but people raise their hands in concern when we audit elections, which is fundamental to our democracy?”

But the top executives in three of the four counties have called the move unnecessary: “It’s time to move on,” Republican Tarrant County Judge Glen Whitley told the Texas Tribune.

After thousands of Haitian migrants fled to Del Rio this month, Abbott directed hundreds of state troopers and Texas National Guard members to create a “steel wall” with patrol vehicles to prevent more people from entering the country. The state has budgeted more than $3 billion over the next two years on border security, adding nearly $2 billion of that funding earlier this month.

“Because the Biden administration is refusing to do its duty to enforce the laws of the United States, they have left Texas in no position other than for us to step up and do what we have to do,” Abbott said of his decision to forcibly stop and imprison migrants this month.

“As much as these issues are in the national news, they’re very, very local,” said GOP state Rep. James White. The national attention after the recent border struggles, for example, could “move the discussion where we need it. … Maybe it moves [Biden] to really pick up his game.”

The past few months have also stirred up new engagement among Democrats, said Democratic state Rep. Ron Reynolds, one of the more than 50 lawmakers who walked out of the first special session in July to meet with federal lawmakers in Washington.

“All of these things play out, people really understand like, ‘Oh, this isn’t normal? You mean other states aren’t doing this?’” Reynolds said. “It helps lay people understand that this isn’t just politics, this isn’t normal.”

The scale of conservative policies has been a “game changer” for Democratic state Rep. Erin Zwiener’s constituents, she said. Legislation like Senate Bill 8, which allows virtually anyone to sue someone who had assisted with an abortion after six weeks, didn’t get as much fanfare during the regular legislative session this year because of the baseline confidence in Roe v. Wade.

Her district’s mix of suburban and rural constituents didn’t think they needed to vote on issues like those, Zwiener added. The onslaught of agenda items about gun control, voter rights and other Abbott priorities didn’t help, she said.

“It’s hard for anybody to decide what to pay attention to when there’s a new crisis every day,” the state representative said. “People just had a hard time keeping up with which thing they should be angry about that day.”

As for the governor’s seat, many in the state are still skeptical of the possibility of ousting Abbott, especially since assumed candidate Beto O’Rourke hasn’t even made an announcement yet. Reynolds said if O’Rourke maintains a centrist message, he could be in a good position to win over vulnerable moderates and independents that are increasingly disappointed in Abbott’s performance.

While some Democrats in the state are cautiously hopeful about a changing tide, Zwiener said it will take a much more concerted effort to prove Texas is more of a swing state than others assume.

“Democrats have been out-organized by Republicans, and we’re not going to start to win and win sustainably until we match them for that organizing and think beyond the next election,” Zwiener said.

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Letter: Playing politics with the virus – Cowichan Valley Citizen

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Playing politics with the virus

Have always been of the opinion that politicians worldwide chose to play politics with the COVID-19 virus instead of stopping it from spreading by closing their respective international borders. Either they learned nothing from the Spanish flu pandemic which spread worldwide via the soldiers returning from the First World War or they chose to ignore it?

It appears that these viruses have a definitive life cycle. The Spanish flu faded into oblivion after the forth wave. The P.H.O for B.C informed us that all pandemics have four waves. So if they knew how the COVID-19 virus would react, how many waves there would be etc. why did they not take steps to prevent it from arriving in Canada? Politics, is my opinion. How many elections have we had in Canada, called by political parties whose only ambition is extending their power base and time in office?

My cynicism and distrust of the motives for the handling of this virus were confirmed while reading the following.

Dame Sarah Gilbert, the lead scientist from Oxford University, and the brain behind the vaccine manufactured in India as Covishield, stated the following: “The virus cannot completely mutate because its spike protein has to interact with the ACE2 receptor on the surface of the human cell, in order to get inside it. If it changes its spike protein so much that it can’t interact with that receptor, then it’s not going to be able to get inside the cell. So, there aren’t many places for the virus to go to have something that will evade immunity but still remain infectious.”

Dr. Gilbert is reported as saying that the virus that causes COVID-19 will eventually become like the coronaviruses which circulate widely and cause the common cold.

She also stated, “What tends to happen over time is there’s just a slow drift, that’s what happens with flu viruses. You see small changes accumulating over a period of time and then we have the opportunity to react to that.”

“It has been pretty quiet since Delta emerged and it would be nice to think there won’t be any new variants of concern. If I was pushed to predict, I think there will be new variants emerging over time and I think there is still quite a lot of road to travel down with this virus,” she said.

So thanks to our political masters, we are going to have this virus around for some time. Wonder if they think the cost in financial and human terms was/is worth it?

Ian Kimm

Duncan

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