Let me begin on a personal note. This last week, my 88 year old mother-in-law had to be hospitalized for a novovirus. Before we knew it three other family members and a friend fell ill. My wife was hospitalized yesterday. While not nearly as deadly as the current coronavirus, COVID_19, or influenza, there's no vaccine to prevent novovirus outbreaks like this one. Here's what it looks like:

Though generally not that bad, novovirus infections can be dangerous for people who are elderly, have compromised immune systems, or like my wife, have serious underlying medical conditions (in her case Type 1 diabetes). The primary symptoms are fever, stomach cramps, vomiting and diarrhea. Most people get it from contaminated food and water, often at restaurants, from contaminated produce, and at long term healthcare facilities. Hospitals are also common breeding grounds for novovirus outbreaks.

Though the US has roughly 70,000 cases a year, most people recover within 2-3 days. Thus, no pharmaceutical company has bothered to create a vaccine for novoviruses, despite the fact they're highly contagious, because they're not as deadly as viruses that attack the respiratory system, with the exception of people over the age of 65. However,novoviruses are the leading cause of diarrhea illness among adults) with 21 million reported cases annually, and outbreaks have been on the rise. Mortality rates are very low compared to corona viruses and the flu (unless you live in a nursing home). So why am I talking about novoviruses aside from my family's recent experience?

Because it's a good example of how a weakened public health sector, privatized healthcare insurance, existing labor laws, climate change, institutional neglect and flaws in our political system all combine to make pandemic outbreaks more likely here. Indeed, novovirus epidemics are all too common.

Norovirus is commonly described as the Ferrari of the virus world. If improperly controlled, the virus can spread like wild fire and easily lead to an epidemic. According to the Center of Disease Control (CDC) the Norovirus is responsible for approximately 21 million cases of acute gastroenteritis, and accounts for more than 50 percent of food-borne diseases in America. [...]

It is estimated that Norovirus causes up to 71,000 hospitalizations in the United States annually. One would think that a hospital or a care facility is the last place they could contract Norovirus illness... [T]he virus is the leading cause of infection outbreaks in American hospitals. [...]

Norovirus is a food borne illness. Therefore, wherever food is being prepared, there is the possibility of an outbreak. From the dinner table, banquets and even restaurants, Norovirus has the capacity to create havoc, if care is not taken in food preparation. Statistics released by CDC showed that restaurants were responsible for 64% of Norovirus outbreaks that were related to food contamination.

So why do we see so many cases and outbreaks each year? One factor is that our privatized health insurance system dis-incentivizes people to see a doctor when sick. This increases the likelihood that any pandemic will be worse in the United States, because people cannot afford care even when they have health insurance.

An estimated 44 percent of Americans say they don't go to a doctor when they're sick because of cost. Another 40 percent have skipped medical testing, and about 30 percent said in 2018 that, over the past year, they had to choose between paying for medical bills or basic necessities like food or housing. In 2019, according to federal data, the number of Americans without health insurance increased to 27.5 million. Moreover, impoverished communities will be hit the hardest when, as Messonnier warned, the coronavirus spreads.

Obviously, when people are concerned about the cost of healthcare, they don't go to the doctor, whether they are moderately or even severely ill. And when people avoid diagnosis and treatment for infectious diseases, they're more likely to spread rapidly through a population. But that's not the only reason a pandemic of a highly infectious, deadly disease is more likely to spread rapidly in the United States.

For going on ten years now, not only the Federal government, but also state and local governments have been cutting back on public health services. These cuts began long before Trump took office.

(Reuters Health) - U.S. public health funding – which covers things like disease prevention, cancer screenings, contraceptives and vaccines – has been steadily falling in recent years and is expected to keep going down, a recent study projects. [...]

Public health’s share of total U.S. health expenditures rose from 1.36 percent in 1960 to 3.18 percent in 2002, then fell to 2.65 percent in 2014, the analysis found. [...]

The 2010 Affordable Care Act (ACA), commonly called Obamacare, promised a $15 billion boost in public health funding, note study co-authors Dr. David Himmelstein and Dr. Steffie Woolhandler of the City University of New York School of Public Health at Hunter College.

But a 2012 law cut funding for the ACA’s prevention and public health fund by $6.25 billion and subsequent legislative efforts reduced it even more, the researchers note.

Public health appropriations for the 2015 fiscal year are less than half of the $2 billion originally budgeted, they report.

Nonetheless. the Trump administration has made even more cuts to public health services, and has proposed even more, including cuts to the CDC. From a long term perspective, government at all levels now provides less care and employs fewer workers in the public health sector in America, a trend noted as early as 2011.

Perhaps the most tangible impact of budget cuts has been on the declining number of public health employees at the state and local level. Roughly 23,000 jobs -- totaling 15 percent of the local public health workforce -- have been lost since January 2008.4 Cuts to state and local budgets are exacerbating a longstanding downward trend in the state/local public health workforce. The US has 50,000 fewer public health workers than it did just 20 years ago.5 The strong possibility of future reductions in funding is poised to make current serious shortages even more acute. Approximately one-third of US public health workers will be eligible to retire in the next five years6; health departments are not developing a new generation of public health workers to fill this gap. Future departments may be lacking the same degree of institutional knowledge and experience that resides in today’s workforce.

The lack of trained, skilled public health sector professionals will have devastating consequences on our population, particularly in times when severe pandemics are raging across the globe. The COVID_19 virus may not be as deadly as SARS or MERS, but there will be other pathogens for which our public health care system will be woefully under-prepared thanks to decades of budget cuts by both parties at the federal, state and local levels of government. We've chosen to increasingly invest in a overlarge military bloated with costly and unnecessary weapons systems at the expense of preventing far more dangerous threats to our population: pandemic diseases. I should note, as well, that our failure to address climate change, coupled with globalization of the world economy, has made such pandemics more likely.

Prof. Killewo warned that global warming – an increase in the average atmospheric temperature which is sufficient to cause climate change – was on the rise. [...]

“Some of the effects of climate change include rising seas, changes in rainfall patterns, drought and flooding, and the more frequent spread of diseases. These diseases include mosquito-borne diseases such as malaria, Dengue fever and encephalitis, and water-borne diseases such as cholera,” he said, adding that climate change would increase pressure on food security pushing more people to alternative food sources where they encounter new diseases.

He disclosed were coming up fast due to the rising global population, a surge in animal meat consumption, dramatic increases land use and agriculture, accelerated encroachment on natural habitats for wildlife, increased demand for natural resource. [...]

Prof. Killewo said that globalization had resulted in world travel which ensures that nothing was local anymore allowing diseases to spread very fast across borders.

Which brings me to the last factor that makes any pandemic likely to be more deadly in America: the increasing lack of paid leave for workers due to illness or family emergencies, another trend that did not begin with Trump, but has been ongoing over the past several decades, as governments have weakened protections for workers. From a 2011 article regarding the deleterious effects of the failure to provide adequate paid leave:

Millions of US workers - including parents of infants - are harmed by weak or nonexistent laws on paid leave, breastfeeding accommodation, and discrimination against workers with family responsibilities, Human Rights Watch said in a report released today. Workers face grave health, financial, and career repercussions as a result. US employers miss productivity gains and turnover savings that these cost-effective policies generate in other countries. [...]

According to the Bureau of Labor Statistics, only 11 percent of civilian workers (and 3 percent of the lowest-income workers) have paid family leave benefits. Roughly two-thirds of civilian workers have some paid sick leave, but only about a fifth of low-income workers do. Several studies have found that the number of employers voluntarily offering paid family leave is declining.

"Leaving paid leave to the whim of employers means millions of workers are left out, especially low-income workers who may need it most," Walsh said. "Unpaid leave is not a realistic option for many workers who cannot afford it or who risk losing their jobs if they take it."

These are the same workers who provide childcare services, work in factory farms, prepare your food, provide long term care to our elderly, etc. These are the low wage jobs that more and more people are forced to take, as fewer high-paying jobs with decent benefits are being generated by our economy.

In a recent analysis, we found that 53 million workers ages 18 to 64—or 44% of all workers—earn barely enough to live on. Their median earnings are $10.22 per hour, and about $18,000 per year. These low-wage workers are concentrated in a relatively small number of occupations, including retail sales, cooks, food and beverage servers, janitors and housekeepers, personal care and service workers (such as child care workers and patient care assistants), and various administrative positions.

These are not just teenagers or immigrants. In fact, "Two-thirds (64%) of low-wage workers are in their prime working years of 25 to 54." That's an astonishingly high figure. Coupled with ever increasing healthcare costs, housing costs, etc., it's clear that far too many people are working in jobs that do not provide a living wage, provide little if any benefits, and suffer under employers who require them to come to work, even if sick, or risk being fired.

In short, the dangers we face from pandemic diseases, now and in the the future, are emblematic of many crises our nation faces, as income and wealth inequality and corporate control of our political system work to devastate what remains of civil society. The rich are doing better than ever as the gap between them and the rest of us widens. The effect of such societal disparities, and the imbalance in power between those at the very top and everyone else continues to grow. This will generate more unwarranted misery and death among the working class and the poor, even as more wealth is distributed upwards to fewer and fewer individuals. Greater civil unrest is inevitable under such circumstances absent a drastic change in how people are rewarded for their labor, how they are protected from economic downturns and whether we choose to address the climate crisis. To be blunt, the status quo no longer works for the majority of Americans and hasn't for a long time.

We are rapidly barreling toward a future that will be marked by increasing political and civil strife if our political system is not fundamentally changed. We've already witnessed the beginnings of that process with the election of a right wing populist as President - Donald Trump in 2016. To believe that replacing him with a nicer, gentler figurehead, without doing what's necessary to address the root causes of our nation's ills, is a fool's errand. This is true even though the leadership of the Democratic Party, out of greed or wilful ignorance, refuses to accept that the many crises that have been building for the past forty odd years have collectively reached a tipping point. These dinosaurs in charge of both parties believe they can continue to kowtow to corporate power while paying lip service to the needs of our people. I fear that they are about to learn a terrible lesson if they persist in holding back the changes - political, psychological and financial - we so desperately require if we are to avoid falling into despotism, or worse, violent anarchy and chaos.