COVID-19, Capitalism and Public Health: What are the connections?


Note to readers: After a pause of several months, Corporations and Health Watch returns to its previous schedule of regular postings and monthly newsletters. A few new features  have been added: the web site is modestly re-designed to make it easier to read and navigate. Also, in addition to the usual coverage of the food, alcohol, tobacco, automobile, firearms, and pharmaceutical industries, two new themes have been added. The first, addressed in today’s post, is to explore the intersections between the COVID-19 pandemic, on the one hand,  and 21st century capitalism and the health of the public on the other. The second is a deeper exploration of how modern capitalism influences people’s search for well-being and the resistance and alternatives that social movements, health professionals, communities,  and others are creating to impact daily lives dominated by corporations. These are topics I examine in my new book At What Cost Modern Capitalism and the Future of Health to be published by Oxford University Press in early 2021.

As the COVID-19 pandemic dominates and disrupts the lives of billions of people around the world, public health professionals and activists need to combine two essential tasks. On the one hand, we need to contain the epidemic, predict its  path , and respond to the needs of those affected by the virus. Equally essential,  we need to understand the roots of the pandemic in the global political and economic system, its impact on that system, and the opportunities the crisis  presents for more fundamental transformations of a world characterized by inequality, ill health and missed potential.To contribute to such analyses, for the next several months,  Corporations and Health Watch will take on the limited role of serving as a collecting point for published articles, blog posts, and commentary on the intersections among the COVID-19 epidemic, 21st century capitalism and public health. To begin, I will offer brief comments, aggregate, and post  previously published materials that address this intersection. Since many others are aggregating and commenting on new developments in science, resources to assist communities and institutions to respond, and tracking country responses, this site will not duplicate that work. Please send suggestions for posting  that address this intersection to

Changes in 21st century capitalism are one cause of the rapid spread of COVID-19 around the world. In addition, the COVID-19 pandemic  is now a cause of additional pressures on capitalism. Understanding these complex reciprocal relationships is an urgent task for both public health professionals who seek to mitigate the adverse consequences of the epidemic and for social movements and  activists who seek to advance social justice, equity, and human and planetary health. In this post, I sketch some of these relationships and raise questions that require additional investigation and public conversations.

  How does capitalism contribute to the spread of COVID-19?

  1. Globalization of travel, labor, and exchanges of goods and services  facilitates spread of virus.

The hyper-globalization of recent decades created a world economy in which the virus could spread to every continent within a few weeks. International movements of low-wage labor within and between high, middle, and low-income countries; global tourism; and refugees fleeing violence, climate change and economic distress all contributed to the raid spread of the corona virus. Globalization has always contributed to epidemic transmission but the speed of movement, the reduced capacity of national governments to act quickly to counteract complex threats, and environmental changes precipitated by climate change have increased the threat of recurrent global pandemics.

Now, as Michael Klare writes  in The Nation, COVID-19 may contribute to “de-globalization”, a trend already underway as manifested by Trump’s trade wars, Brexit, and the diminished authority and capacity of the World Health Organization.  Klare speculates that new regional blocs may emerge—led by the United States, Europe, and China. These blocs will compete for business, hegemony, and new regional alliance. Governments will be judged by their capacity to handle crises such as COVID-19. Changes in the global economy may also lead to further  deterioration of global fossil fuel markets, disrupting economies but creating an opportunity for more  effective action to limit climate change.

Corporate managed globalization has also led to new rules on intellectual property rights, giving transnational pharmaceutical companies a powerful voice in deciding who has access to essential medicine. As Achal Prabhala and Ellen ‘t Hoen recently observed in The Guardian, scientists will find new treatments for corona virus but drug companies will determine who gets them when and at what price . 

How will these changes influence patterns of health and disease? Can public health professionals or reformers use the changes in the practice of corporate globalization that seem likely to address the previous or future health problems corporate-managed globalization has caused? What are strategies to advance a more humane, effective, and equitable approaches to addressing global problems?

  • Privatization and austerity diminish capacity of health and social service systems to respond effectively.

In every country, health care and social service systems have struggled to cope with the COVID-19 pandemic. Those countries that have aggressively pursued privatization of these services and used austerity to address government shortfalls caused by recessions and tax cuts have had particular difficulty launching comprehensive, coordinated, and effective responses. Where governments lacked the capacity to quickly mobilize public COVID-19 testing, education, and health care system preparedness saw the rapid spread of infection. In Jacobin,  Thomas J. Adams and Cedric Johnson describe how austerity fueled the spread of COVID-19 in New Orleans, arguing it was the dismantling of public services post Hurricane Katrina, not Mardi Gras culture, that facilitated rapid transmission in that city.

Around the country, cuts in funding of local health departments delayed effective responses to COVID-19 and resulted in preventable deaths. The National Association of County and City Health Officials estimates that over the past decade, public health departments have lost about a quarter of their workforce, and funding for preparedness has also decreased. Does the COVID-19 pandemic provide a new opportunity to assess the costs of austerity and privatization? To spark a national conversation on taxes and fairness? To reconsider what we all pay when a small group tries to “drown government in the bathtub”. This “starve the beast” political strategy was proposed by conservatives to limit government spending by cutting taxes, in order to deprive the federal government of revenue in a deliberate effort to force it to reduce spending.

  • Rise of precarious, low wage and gig economy leaves many workers without benefits, job security or livable wages

In the last decade, in response to the changing needs of 21st century capitalism, the number of jobs with decent pay, benefits, job security and the protection of unions diminished. And the number of jobs lacking these protections grew precipitously. Now, as the pandemic requires people to stay home and  closes factories and other workplaces, more workers are forced to choose between protecting their own and their family’s health or losing the income that allows them to buy food, housing, and health care. And these Sophie’s choices endanger the well-being of all of us. Will the pandemic revitalize efforts to provide sick pay, family leave, fair working hours, livable wages, universal health care and labor organizing? Or will it become one more shock, as Naomi Klein has described, that enables corporations and the wealthy to further advance their power and control? What can social movements and health activists  do to increase the chances that the COVID-19 epidemic will open rather than close doors for progressive change?

  • Monopoly concentration consolidates supply chains, making them vulnerable in crisis.

When the manufacturers of face masks, heavily concentrated in China, could no longer produce to meet the growing global demand for face masks, it took weeks to develop alternatives, weeks that contributed to rapid transmission around the world. When Smithfield Foods was forced to shut its Sioux Falls, South Dakota, pork-processing facility, which accounts for 4% to 5% of U.S. production, officials worried about an impending meat shortage in the United States.  The closure came after more than 200 cases of COVID-19 for plant employees, adding to a spike in infections that is seen as hundreds of American meat workers get sick. The combination of highly centralized production, monopoly concentration, and lax enforcement of antitrust laws has made supply chains vulnerable. Monopoly has also contributed to the growing income inequality that puts so many of the world’s population at risk of COVID-19 infection and deprived of the protections that households and communities with more resources can muster.

What would an economy that was supple enough to respond to crises such as COVID-19 look like? How could a better balance of regional and global supply chains—in food, pharmaceuticals, and other necessities of life—better protect public health and social justice? These are the questions the COVID-19 epidemic forces our nation and the world to confront.

  • Deregulation diminishes capacity of governments to respond forcefully and effectively.

The COVID-19 epidemic illustrates some of the consequences of several decades of deregulation. Nursing home standards that could have protected older people against infection, air pollution rules that would reduce exposure to pollutants that increase risk or severity of infection, and occupational safety and health standards are among the rules the Trump Administration has changed, amplifying the reach and toll of the epidemic.  But deregulation has advanced at least since the 1980s, when corporations and conservatives allied to roll back the regulatory protections enacted by the environmental, labor, consumer protection and other movement of the 1960s and 1970s. Can the COVID-19 pandemic provide a forum for re-considering the costs and consequences of deregulation? Can movements on climate change, environmental protection, worker rights, universal health care, voter rights and others make revitalizing regulations an issue in the 2020 election and beyond?

  • Promotion of capitalist ideology reinforces individual and disparages collective responsibility for responding to crises.

The current debates about when and how to re-open the economy, what obligations individuals have to protect their community against infection, and what duties governments and communities have to make public health protection a priority illuminate the capitalist tenet of individual responsibility. Mobilizing effective responses to controlling the epidemic and restoring public life will require a deep re-examination of this belief. How can public health practitioners and researchers, social movements and others contribute to such conversations? What are the forums and spaces where this discussion can be pursued?

  • Domination of political processes lead to policy proposal that benefit the ultra-wealthy at expense of everyone else

Finally, the increased corporate domination of all levels of our political system, culture, and  media give Big Business a near veto power of any policies that threaten its interest. Paid sick leave for all, universal health care, employment security, fair taxation, all this and more will help this country overcome the challenges that COVID-19 imposes. Yet at every turn, Big Business has opposed these policies, even as the lack of such policies worsens the circumstances of their workers and customers.  As the nation and world consider new approaches to containing this pandemic and preventing future one, how can progressive forces connect discussions of democracy, voters rights, limits on lobbying and campaign contributions to the task of recovering from COVID-19?

In sum, this terrible epidemic puts questions that have long endangered the well-being of the public on the front burner. In the coming weeks and months, as public health practitioners or researchers, activists, and Americans, we have an opportunity and an obligation to spark new national and global conversations and action.