T H E T H I N K E R81 OUTSIDE AFRICA By Declan Kearney The ongoing human carnage and misery caused by Covid-19 was overshadowed last week by the wrongheaded decision of the US administration to withdraw funding f rom the World Health Organisation (WHO) in April 2020, whilst making unfounded allegations medical advice on how to combat the coronavirus pandemic. At the same time, the US itself now has the highest number of global deaths and cases, recording 40,000 fatalities, and approximately 750,000 detections. One writer in The Guardian federal and state governments publicly challenge each other over their powers and responsibilities, over which appropriate public health strategies to adopt, and on the lack of emergency medical supplies. It is now clear that the US acted too slowly when the evidence was already emerging that a global pandemic existed. New revelations have reported that the British government also failed to respond fast enough, with catastrophic consequences. The British approach has proved to be a disaster. Ten years of Tory austerity had already brought the health service in Britain and Northern Ireland to a crisis cliff edge. Britain’s health service was Economic Interests Must Not Take Primacy over Public Health EXITING THE COVID-19 LOCKDOWN © S h u tt e rs to ck .c o m 82V o l u m e 8 4 / 2 0 2 0 OUTSIDE AFRICA hugely underfunded, and did not have the beds or equipment to deal with a crisis of this magnitude. From the earliest indications, neither the leadership focus or necessary state of preparedness existed to face the onslaught of coronavirus. The British government’s pandemic policy was based upon planning for a flu pandemic and developing ‘herd immunity’, rather than focusing on the specificities of Covid-19. Even more alarming are the revelations that as early as 24 January 2020, a British government Cabinet Office Briefing Rooms (COBRA) meeting received a report which confirmed the virulent, contagious nature of Covid-19, and advised on the urgent need to achieve a 60% cut in the community transmission rate. This meant stopping contact between people and introducing a lockdown. This, however, was an economically unthinkable scenario for the British government, which on the same day had just signed the withdrawal agreement treaty f rom the European Union (EU). A picture was already being painted. From the very beginning, both the US and British administrations have failed to follow the international advice of the WHO – which urged that community testing, contact tracing and isolation strategies should be implemented on a vast scale to hunt down where the virus was most contagious. The WHO cautioned that ‘you cannot fight a fire blindfolded’, and yet only some countries – such as China, Germany, Singapore, Cuba, and South Korea – heeded that advice. The attempt to try and cause reputational damage to the WHO is therefore much more than just an impetuous outburst. Even in the eye of the coronavirus storm, some appear to be already shaping up for a later ‘blame game’. Last week, announcements were made that lockdown restrictions would be extended in Ireland and Britain until after 5 May 2020, when a further review would be conducted. That news follows the extension of lockdown measures in other European countries, Eurasia, the Middle East, and Af rica. Those decisions are correct, even though they will cause more economic and social hardships, as well as psychological and emotional pressures for us all. The anguish being caused for so many who have been unable to mourn and bury their loved ones with dignity, or to visit graves and places of worship for quiet moments of reflection, or to meet up with f riends and family, is without precedent. The effects of isolation and lockdown measures cannot be underestimated. It is therefore important to conduct f requent reviews, allowing for the opportunity to reassess the threat posed by Covid-19, giving some hope and reassurance that we may all eventually leave this tunnel, even if in a phased way. In the meantime, however, strong and united leadership across society which asserts the primacy of public health over all other priorities and political agendas is required in the fightback against Covid-19.  Any change or relaxation in restrictions before it is safe to do so will send out mixed messages, potentially resulting in complacency and our guard being dropped. The worst thing at this time would be to create the false impression that we, as a society in Ireland – north or south – have got to the other side. We have not. Covid-19 has not been beaten. Disturbingly, the extension of lockdown in the short-term masks an argument which is being encouraged by some right-wing elements in the British Cabinet, and also by some Unionists in the north of Ireland: that the lockdown measures should be relaxed, and that economic activity and productivity should be resumed. This is a typical capitalist reflex which puts the market economy first: corporate greed over public welfare, and the elevation of neo-liberal values and priorities above what’s actually needed at this time. It is precisely these contradictions which have taken centre stage in the US.  At a time when approximately 24%  of all global deaths have occurred in America, the corporate, industrial and financial elites are trying to lift lockdowns across the US, and to push for a return to the preCovid-19 status quo. Talk of getting back to normal, however, is completely misplaced. There will of course need to be preparations for economic reconstruction, It is now clear that the US acted too slowly when the evidence was already emerging that a global pandemic existed. New revelations have reported that the British government also failed to respond fast enough, with catastrophic consequences. T H E T H I N K E R83 OUTSIDE AFRICA but that must not take place separate to, or in isolation f rom, a strategic debate about the future of public health. Free market economic interests must not be allowed to take primacy over the health priorities and wellbeing of wider society. This is one of the big ideological challenges which faces Irish society beyond Covid-19. Irish republicans and other progressives need to shape discussions on how to democratise economic reconstruction, and how to guarantee the future of public health on an egalitarian basis. Protection of the environment and ecology must also be central to these discussions. All of these issues will also be key priorities for the international, progressive left more generally. For now, more investment is still required to try and get on top of the immediate Covid-19 emergency. However, even greater investment will be required to put in place universalised community testing and contact tracing programmes, underpinned by enabling technologies. In order for us to contain the pandemic for the foreseeable future, however, manual testing will be necessary – something which can only be staffed by a large cohort of public health workers. In the north of Ireland, this is an area of work where the available staff and expertise of our largest sporting organisations, and most experienced community-based health projects, could and should be effectively mobilised. In Wuhan, China, for example, there were 81 public health workers available for every 100,000 of the population.  Research by Johns Hopkins University in the US has concluded that to bring a health crisis under control, where extreme transmission is occurring, a region would need 15–30 public health workers per 100,000 of the population. In the immediate term, we need to begin a detailed public health discussion on the use of masking, as well as the utility of temperature testing and swabbing checks in all public spaces, such as hospitals, care homes, community centres, shopping malls, airports, and ferry ports. It is obvious that our current model of public health will have to be completely overhauled, with a new emphasis placed on sustainable strategic investment, in all aspects of health and social care, staffing levels and training, equipment and resources. Covid-19 has moved us beyond the two-tier health and social care systems. The major lesson f rom our experience of the coronavirus pandemic is that Irish society, north and south, and indeed societies everywhere, should have access to universal, high-quality, properly-funded healthcare systems, which are f ree at the point of access. Standards of care for all citizens must no longer be subordinate to the demands of f ree market interests. The future of public health in Ireland depends on an all-island strategy, in the same way the fight back against Covid-19 demands a common north/ south approach. Just as Brexit demonstrated that it is impossible to pull the north of Ireland out of the EU without causing massive, negative repercussions and disruption for the regional and all-island economies, the challenge of economic reconstruction, north and south, beyond the pandemic, will require an all-Ireland road map to sustainable economic recovery. The modern-day contradictions of Ireland’s partition prove the negative impact of this island’s division upon the wellbeing, prosperity, and progress of |our citizens. Coronavirus has changed everything. It will force us all to rethink how public health and economics are managed, not just in Ireland, but across the globe. It has made the world a much smaller place. In recent months, all of us have been sharply reminded of how interdependent we are upon each other as individuals, regions, and nation states. This reality needs to be embraced.  Our global community does not have the resilience to absorb continuous international power plays, economic blockades, sanctions, sieges, and conflicts. The only way forward should be on the basis of peaceful coexistence, global solidarity and international diplomacy. It is finally time to start shaping our collective future with new values which prioritise public health, economic justice, sustainable ecology, and multilateralism. ■ Free market economic interests must not be allowed to take primacy over the health priorities and wellbeing of wider society. This is one of the big ideological challenges which faces Irish society beyond Covid-19.