United States: Are deaths from COVID-19 just more unintended, but acceptable, collateral damage for the capitalist state?

By Vince Montes

April 27, 2020 — Links International Journal of Socialist Renewal — The concept of collateral damage is the death and injury to civilians, or other damage inflicted, as the unintended result of military operations. In this conceptualization, collateral damage, similar to the military euphemism for the killing of civilians, is the idea that there is unintentional, but acceptable death, injury, and damage associated with the carrying out a stated goal. However, unlike the goal of winning a war or when this concept is used in an Orwellian way to describe the “unintended” deaths of non-combatants killed in counterinsurgency operations, designed to kill, injury, and ultimately terrorize a people into submission, the death, injury, and destruction of COVID-19 can be see as collateral damage because it is unintended, yet deemed acceptable for the continuation of U.S. capitalism. 

Amid, this pandemic, state officials and the corporate media have focused our attention on the “war” against the virus and have made questions and analysis about the failures of the market economy and the structure of society too abstract and incomprehensible to understand. As we will see below, what appears to be taking place is that the deaths, injuries and disruption of many people’s lives from COVID-19 will be considered as more collateral damage, as the needs for industry to get up and running, the restoration of gains in the stock market, and the needs for increase profits margins trump the quality of life in the United States. And lumped on top of this will be the sacrificial frontline healthcare worker and retail worker who appear to fit the category of collateral damage in this crisis.

The idea of acceptable collateral damage in the U.S. predates the COVID-19 pandemic. This can be seen when the state-corporate elite impose the market over the needs of society, causing society to become highly susceptible to not only a multitude of social ills such as high rates in crime, murder, suicide, mental illness, but also susceptible to high rates of cancer, high blood pressure, diabetes, depression, anxiety, obesity, liver disease and cirrhosis, deaths due to lack of access to adequate health care, or the death and injury due to a healthcare system based on a bureaucratic rationality, which is driven by economic gain and profit. 

The common citizen, has very little defense against the soft drink industry (obesity, diabetes), alcohol industry (high blood pressure, heart disease, stroke, liver disease, cancer of the breast, mouth, throat, esophagus, liver, and colon), tobacco industry (COPD - emphysema, and chronic bronchitis, and lung cancer), the sugar industry (obesity, diabetes), the big three U.S. auto industry (pollution that causes lung cancer and respiratory diseases), and petrochemical industry (various cancers) that kill people at alarming rates every day in this country, as well as around the world. These billion-dollar corporations not only receive government subsidies (from U.S. taxpayers) and generous tax breaks, but they are collectively culpable in the deaths of approximately 1,630,456 people who died in 2017 from heart diseases, malignant neoplasms (cancer), cerebrovascular diseases (stroke), diabetes. Not listed in the 10 leading causes of death in the U.S. is liver disease and cirrhosis, which also killed 47,743 people in 2017 (included in total figure).

Is it too speculative to make a correlation between the above industries and their products to the deaths of their consumers, workers, and society at large? Considering exceptions from genetic predispositions, many of these deaths and injuries were preventable, but since people live within a state-sanctioned social environment that worships the above toxic industries over the social wellbeing of the people, their lives have become collateral damage. Karl Polanyi (1944), a world-renowned political sociologist cautioned against the dangers that occur when there is an unembedded market superimposed on society, and when the interests of that market (more specifically, state and corporate elite) is elevated above the interests of nature and human beings. 

Of course, these figures are only meant to provide but a sketch of what collateral damage looks like outside of its military use. The figures in this context do not include all the people diagnosed with the listed diseases. For example, in 2017, there were 1,688,780 new cancer cases. One can only imagine all the new cases of heart disease, diabetes, and liver disease and cirrhosis. It is in these figures that one sees how some people have become collateral damage and have developed comorbidities that overtime, especially in their older years, have led to having compromised immune systems incapable of fighting against the COVID-19 virus. Couple this with a healthcare system and a multitude of essential service agencies that have been compromised by the needs of the perpetrators of the market have served to intensify this current crisis.

What is presented as freedom and as an exercise of free choice is often just a choice between Coke Cola or Pepsi, and either choice often does kill you or a friend and family members. Herbert Marcuse’s astute observations of the acquiescence of this reality is that the individual’s desires to be free have been repressed psychologically and substituted by a series of false needs in which consumerism has come to be equated with freedom and equality, which mask a system that continues to be rooted in oppression and the exploitation of workers. It is in this context that such doublespeak like "What's good for General Motors is good for the country" or that somehow “we’re all in this together.” A more cynical, yet more accurate way of looking at this is to say that what is good for GM and all the other corporations and their political allies is not good for human life and the environment. Their practices enrich themselves and sprinkle just enough economic reward and prestige among the middle classes as to create the idea of acceptable collateral damage in order to maintain a vastly unequal society. As a result, it is very difficult to accept the latest slogan currently being propagandized by the media in the wake of this pandemic, that “we’re all in this together.” Do the “good people” of Walmart and Amazon (who are known for their notorious labor practices in the U.S. and the world) and the endless list of big pharma corporations such as Johnson & Johnson, Roche Holding, and Abbott Labs (who are working on vaccines, treatments, and testing) have society’s better interests in mind?

Unlike classic liberal economists such as Adam Smith, or contemporary proponents like Milton Friedman, who present the market as autonomous from the state and fully self-regulating, Polanyi saw the capitalist economy as a construction of the state, which regulates it (by setting prices, interest rates, labor-management contracts, laws, and the use of police and the military as enforcers of policies and laws). The idea here is that without the state, the so-called self-regulating free market would cease to exist. What is extremely important here is not an argument for resetting the clock back to the “good ole days” of embedded liberalism – i.e., the Keynesian New Deal policies that created the U.S. version of a social welfare state. These polices began their decline in the mid-1970s and accelerated in the 1980s under the Reagan administration in the U.S. and Thatcher administration in the UK and have not skipped a beat since, regardless of what political party, the Democratic Party or Republican Party occupy the White House. The Reagan and Thatcher administrations are credited with launching a movement for the deregulation of governmental oversight in economic affairs, which has meant that workers and the environment have increasingly been at the mercy of business interests as state intervention has diminished. The ideas that pushed forward the New Deal policies in the U.S. was the acknowledgement that capitalism, unchecked decimates societies and that people would rebel. According to Regulating the Poor (1971) by Piven and Cloward, the state was forced to intervene to mitigate the social cost of capitalism by ensuring that the social economic conditions would not lead to popular mobilization for radical structural change.

The New Deal welfare state brought about state intervention that neutralized dissent and made appeasements to labor by incorporating much of it into the state by brokering a labor-capitalists peace accord, and basically regulated the poor, undercutting their capacity to organize popular resistance. In addition, a whole host of safety net programs were implemented in order to mediate and smooth over the jagged edges of the “free market.” This has meant over time access to education, affordable housing and housing subsidies, and social aid. But from the mid-1930s to about the mid-1970s, a period of New Deal social welfare state, collateral damage was not eliminated. After all, oppression and exploitation continued to exist. There was and continues to be de facto segregation, institutional discrimination, the existence of an underclass that was and is politically and economically marginalized. However, the U.S. state, in that period, had ascended to military and economic dominance in the world, which meant that it could raise the standard of living for many people in the U.S. But this was at the expense of segments of its own population as well as people from around the world taking the blunt of the damages caused by capitalism. The neoliberal era emerged as a result of the U.S. capitalist-state’s prominence in the global world was in decline. As a means to return profit margins to the pre-New Deal social welfare state era (Harvey 2007), the U.S. capitalist-state offshored and outsourced most of manufacturing, making much of blue-collar labor superfluous. With deindustrialization and automation, many segments of the poor and racial minorities became trapped in an underclass whose conditions would no longer be seen as byproducts of the “free market”; they were now viewed as undeserving, and as members of the criminal element, requiring more policing and imprisonment, thereby negating a critical analysis of the structure of society. So, in this context, the marginality of the poor and racial minorities in society are the unintended, but acceptable collateral damage in the era of neoliberalism.

It is true, that neoliberal policies have increased deregulation, changed the perception of how the victims of capitalism are viewed, and has increased the privatization of essential services as we are witnessing. For example, neoliberal policies have substantially reduced the concept of a public health system, because it has been made too reliant on the private sector for not only essential equipment (such as PPE and ventilators), but it also depended on big pharma for testing, research, and the development of a vaccine. What should appear quite obvious is the conflict in interests here. After all, big pharma, for example, answers to their shareholders and as a result they are mandated to hold their shareholder’s interests above the public interests. In addition, the shrinking of funding or redirection of focus (such as toward Homeland Security and the military) may have reduced the capacity of such agencies like the Center for Disease Control or other government agencies that conduct research and screening on diseases. Had these agencies' resources not been reduced or redirected they may have been able to have detected COVID-19 in the U.S. as far back as November of 2019. Is it within reason to suggest that such agencies, that in theory, perform essential roles such as protecting the lives of people in the U.S. from health threats should not go underfunded or have key areas of their domain abandoned or farmed-out to corporations?

When vital agencies of the state such as the healthcare system, education, housing, employment or transportation are made subordinated to the market they cease to serve the collective interests of a society. For example, the subordination of the healthcare system to the market means that patient care is seen through the lens of the logic of the market – i.e., the cost-benefit rational bureaucratic model, which pervades decisions and practices. One example of this is the creation of health maintenance organizations (HMOs) in 1973. HMOs are said to have created organizations of managed care that mandate that physicians receive a flat fee for each patient visited regardless of time spent, which encourages physicians to spend as little time as possible with patients seeking health care. This could easily result in sick patients being sent home without proper diagnosis and treatment. Furthermore, it has also been reported that physicians receive bonuses for adhering to the guidelines of managed care, which has also meant vital testing such as a MRI or CAT scan were not ordered, for example. According to the findings of research by Johns Hopkins University School of Medicine, they discovered that 251,000 died from “human error” every year in U.S. hospitals. It is difficult to argue against the notion that human error is not responsible for deaths and injuries to individuals under the care of the healthcare system, but these actions take place within a cost-benefit system that pervades the healthcare industry. Of course, the changes brought about by the implementation of neoliberal policies did not only affect the healthcare system but most of what was once considered the public sector.

As of today, over 45,000 people have died in the U.S. from COVID-19. The people at the highest risk of dying are mostly the elderly with known comorbidities such as heart disease, lung disease, cancer, high blood pressure, liver disease, and diabetes. Keep in mind, it is not all elderly people, but those with known comorbidities are accounting for most of the deaths. Interconnectedly, the same health conditions or comorbidities outlined at the beginning of this article that were attributed to the state-sanctioned industries that place profit over the wellbeing of society have resulted in the high mortality rates. 

As information is slowly coming in, we are learning more about the demographics of those who are dying, and how they represent the most vulnerable in U.S. society. For example, African Americans appear to be hit the hardest. As we are more likely to see once the data becomes more available, poor Blacks will be joined by other racially oppressed and exploited groups who have a disproportionate amount of their populations living in poverty, as well as poor people generally. Some of the data that is available illustrate that in Chicago, “72% of people who died from COVID-19 were Black, although only one-third of the city’s population is. In Georgia, as of 17 April, white people accounted for 40% of COVID-19 cases where race was reported, although they represent 58% of the state.” Race and class play a tremendous role in one’s health. The article further states, that “African Americans are more likely than white residents to have diabetes, heart disease and hypertension – which weaken lungs and immune systems. And people with pre-existing health conditions are more likely to develop severe Covid-19 symptoms.”

Based on these preliminary accounts, the most oppressed and exploited tend to not only be economically marginalized, but as a result of this marginality tend to have compromised health. This marginality means that they have the least defense against the toxic market economy and the least opportunity to develop healthy immune systems, which is related to their low quality of life.

When social development efforts have been undermined by a blind and selfish devotion to the market, it will produce collateral damage. One could argue that it is the vulnerable segments in society, with known compromised immune systems have little or no defense against the peddlers of toxic products, exploitation, and polluted environments. As long as the cost is not felt throughout society it may not be viewed as a structural problem. However, the casualties of COVID-19 appear to not be completely confined to the most vulnerable with known comorbidities. Maybe this will move some people to understand that the market economy is a collateral damage producing machine, and that both versions of capitalism – the New Deal social welfare state variety or the neoliberal one – both produce collateral damage. 

What we are currently witnessing is a push to reopen the economy and to establish a new sense of normalcy, which will undoubtedly translate into viewing the dead and injured from COVID-19 as unintended, but acceptable collateral damage because nothing at this point in time suggests that serious structural change is in the works. What instead appears to be at play is an urgency to get the market economy up and running in order to restore gains in the stock market and profits. 

Vince Montes is a Lecturer in Sociology and earned a PhD. at the New School for Social Research