America’s Invisible Poor

Contagion is remarkably prescient in its imagination of how global capitalism’s environmental devastation creates the conditions for a disease pandemic. Big business, the film implies, is literally making the world sick. A fictionalized mining company’s clearing of trees for a construction project in China is shown to unsettle a bat population, which then moves out of its natural habitat to infect pigs and eventually humans. Interestingly, the “index patient” — who contracts the virus and spreads it to residents of Hong Kong, Japan, Britain, and the United States — is an American executive, employed by the same mining company that is destroying China’s ecological balance. Moreover, the setting for the outbreak is a casino in Macau.

Despite these astute observations about global capitalism, the film has nothing to say about class and inequality — a glaring absence given its release in the same year as the launch of the Occupy movement. A senior CDC official, Dr Cheever — played by Lawrence Fishburne — briefs a gathering about how lack of nutrition, underlying health conditions, and socioeconomic factors compound vulnerability to the disease. Cut with visuals of a world map, Cheever’s speech is one of the few times that the film prompts us to consider the socioeconomic factors contributing to the outbreak; but these factors nonetheless remain abstractions.

As the disease spreads, and its effects hamper society’s normal function, class antagonism remains notably absent. Everyone — including the middle-class, white suburban protagonist (Matt Damon) — is shown waiting in line at a food bank. Everyone is eligible to get the vaccine that is eventually produced (even though government officials may enjoy special privileges): you simply have to wait your turn in a lottery system. The casting of Fishburne as the CDC official, moreover, enables the film to gloss over racial inequality as well. When the film briefly touches on inequality — for instance, in the scene where Dr Cheever gives his government-allotted vaccine to his janitor’s son — it suggests that the pandemic is producing opportunities for leveling rather than exacerbating existing disparities.

The realities of America’s poor and working class are ultimately invisible in Contagion. When the pandemic erupts, hordes of people go about rioting and looting, but we know little about these people’s lives. We see isolated, garbage-strewn streets in San Francisco, but no garbage collectors; we see looted and depleted grocery stores, with no cashiers; shops burn as a result of arson and are unattended to by the fire department. The only people seen working are the health workers and military personnel distributing ready-to-eat meals — all of whom wear protective equipment.

Contagion’s classless and race-neutral representations are of course far from today’s reality, where so many — health care and sanitation workers, grocery store employees, warehouse workers, farm laborers, food delivery workers, and others —  have no choice but to go to work under threat of infection, often without basic protections, and in many cases without health insurance and paid sick leave. We may all be to some extent vulnerable to the disease, but some are more vulnerable than others. There is now ample evidence of much higher rates of infection and fatalities among people of color and African Americans in particular, owing to long-standing inequities in privatized health care and also the fact that a large number of people in these communities are “essential workers” who are being exposed to the virus in their workplaces.

The vulnerability experienced by America’s poor and marginalized communities is in many ways akin to what their counterparts in the Global South are experiencing at this time. Whether in New York, or in Indian slums like Dharavi, or in South African townships like Alexandra, for many precarious workers, social distancing is often impossible. Across these cities, poor people are receiving inadequate health care. Moreover, as the economy partially shuts down, many workers globally are facing sudden unemployment — and with it, hunger and homelessness. The pandemic has exposed the shared fate of the world’s poorest people — often doing some of the most essential work.

Core Inequality

A number of social theories have pointed to the gap between emerging economies of the South and advanced capitalist economies of the North. World-systems theory, for instance, frames Southern economies as “peripheral” because of their dependence on demand from the “core” Northern nations. While this theory helps us analyze global inequality in the past and present, its framework also risks erasing poverty and deprivation within the “core” nations. There is a tendency in this sort of theorizing to frame poverty as a problem of the peripheral states or “Third World” nations.

Some theorists of neoliberalism, too, have overemphasized the separation between the North and South. In Undoing the Demos, for instance, Wendy Brown argues that neoliberalism in the South was “violently imposed” through “hard power,” whereas in the North its values were disseminated through “soft power” — or “consensus and buy-in.” This, she argues, ultimately results in a more internalized individualism in the North.

This kind of opposition downplays the extent to which neoliberal policies and practices have everywhere been imposed on people. How else to understand the constant cuts to and steady erosion of America’s health infrastructure?

As Mike Davis notes, to raise profits and ensure 90 percent occupancy, “the number of in-patient hospital beds declined by an extraordinary 39 percent between 1981 and 1999.” Moreover, in the last two decades, emergency medicine in the United States has been steadily downsized in the private sector and subjected to austerity cuts in the public sector, chipping away at the health system’s capacity to respond to epidemics and emergencies. Clearly, in the North, too, neoliberalism has entailed “violent imposition,” experienced most acutely by the poorest sections of the population.

There is no doubt that Southern nations have weaker health infrastructures than their Northern counterparts. Consider the example of a Southern economy like India. Despite its much-touted economic growth of the last couple of decades, government spending on health care has remained abysmally low. The wealthy rely on private medical facilities, while the poor are forced to make do with highly inadequate public hospitals and clinics that are regularly overextended and lacking in beds and medical supplies. Many therefore fear a health crisis of giant proportions, should the virus spread in India at the rate at which it has spread in the United States.

But despite material differences in the quality of health care, in both India and the United States, an inadequate public health system puts decent care out of reach for many. Over the last two decades, the availability of free medicines in Indian public health facilities has dramatically declined, plunging large numbers into poverty. Similarly, in America, hundreds of thousands of people file for bankruptcy annually, owing to debt accrued from medical bills.

In the richest country in the world, a profit-driven system means the United States trails almost all other advanced capitalist countries in terms of doctors and hospital beds per capita. The sheer scale of the crisis brought on by the current pandemic has prompted many in recent days, including Joseph Stiglitz, to compare America to a “Third World” country.

Left Internationalism

It is precisely the continuities in experience across the North and South that make it necessary to imagine a left internationalist response to the current pandemic. Films like Contagion and Outbreak provide little in that respect. In these films, angry, rioting mobs can only be disciplined by military power — a representation that feeds the neoliberal view of humans as ultimately selfish and competitive. But despite neoliberalism’s global reach, its ideas of privatization and individual responsibility remain unpopular, especially for the working poor.

In recent weeks many have written and commented about what this pandemic means for the state of economic globalization. Some are rightly anxious about the ways that a global pandemic is being used by authoritarian governments to shore up power and to justify parochial nationalism. Others have suggested a decline in US supremacy and a blow to the mythology of American exceptionalism. But the devastating loss and deprivation experienced globally should prompt us to think not just of the fate of capitalist globalization but also of international solidarity.

Such an internationalism does not mean disavowal of the very real differences in the nature of precarity and poverty in countries of the Global South and North; it asks rather that we hold these differences together with an understanding of their shared origins and effects. The pandemic’s fallout has made clear that America’s poor and working class are struggling far more than those who are shielded from the worst of the crisis. And in that fate, they are very much linked to that of the working class all over the world.