Personal Health

Power, wealth and justice in the time of COVID-19: The global north returns to 'normal'

Fifteen months ago, the SARS-CoV-2 virus unleashed Covid-19. Since then, it's killed more than 3.8 million people worldwide (and possibly many more). Finally, a return to normalcy seems likely for a distinct minority of the world's people, those living mainly in the United States, Canada, the United Kingdom, the European Union, and China. That's not surprising. The concentration of wealth and power globally has enabled rich countries to all but monopolize available vaccine doses. For the citizens of low-income and poor countries to have long-term pandemic security, especially the 46% of the world's population who survive on less than $5.50 a day, this inequity must end, rapidly — but don't hold your breath.

This article originally appeared on TomDispatch.

The Global North: Normalcy Returns

In the United States new daily infections, which peaked in early January, had plummeted 96% by June 16th. The daily death toll also dropped — by 92% — and the consequences were apparent. Big-city streets were bustling again, as shops and restaurants became ever busier. Americans were shedding their reluctance to travel by plane or train, as schools and universities prepared to resume "live instruction" in the fall. Zoom catch-ups were yielding to socializing the old-fashioned way.

By that June day, new infections and deaths had fallen substantially below their peaks in other wealthy parts of the world as well. In Canada, cases had dropped by 89% and deaths by 94%; in Europe by 87% and 87%; and in the United Kingdom by 84% and 99%.

Yes, European governments were warier than the U.S. about giving people the green light to resume their pre-pandemic lifestyles and have yet to fully abolish curbs on congregating and traveling. Perhaps recalling Britain's previous winter surge, thanks to the B.1.1.7 mutation (initially discovered there) and the recent appearance of two other virulent strains of Covid-19, B.1.167 and B.1.617.2 (both first detected in India), Downing Street has retained restrictions on social gatherings. It's even put off a full reopening on June 21st, as previously planned. And that couldn't have been more understandable. After all, on June 17th, the new case count had reached 10,809, the highest since late March. Still, new daily infections there are less than a tenth what they were in early January. So, like the U.S., Britain and the rest of Europe are returning to some semblance of normalcy.

The Global South: A Long Road Ahead

Lately, the place that's been hit the hardest by Covid-19 is the global south where countries are particularly ill-prepared.

Consider social distancing. People with jobs that can be done by "working from home" constitute a far smaller proportion of the labor force than in wealthy nations with far higher levels of education, mechanization, and automation, along with far greater access to computers and the Internet. An estimated 40% of workers in rich countries can work remotely. In lower- and middle-income lands perhaps 10% can do so and the numbers are even worse in the poorest of them.

During the pandemic, millions of Canadians, Europeans, and Americans lost their jobs and struggled to pay food and housing bills. Still, the economic impact has been far worse in other parts of the world, particularly the poorest African and Asian nations. There, some 100 million people have fallen back into extreme poverty.

Such places lack the basics to prevent infections and care for Covid-19 patients. Running water, soap, and hand sanitizer are often not readily available. In the developing world, 785 million or more people lack "basic water services," as do a quarter of health clinics and hospitals there, which have also faced crippling shortages of standard protective gear, never mind oxygen and ventilators.

Last year, for instance, South Sudan, with 12 million people, had only four ventilators and 24 ICU beds. Burkina Faso had 11 ventilators for its 20 million people; Sierra Leone 13 for its eight million; and the Central African Republic, a mere three for eight million. The problem wasn't confined to Africa either. Virtually all of Venezuela's hospitals have run low on critical supplies and the country had 84 ICU beds for nearly 30 million people.

Yes, wealthy countries like the U.S. faced significant shortages, but they had the cash to buy what they needed (or could ramp up production at home). The global south's poorest countries were and remain at the back of the queue.

India's Disaster

India has provided the most chilling illustration of how spiraling infections can overwhelm healthcare systems in the global south. Things looked surprisingly good there until recently. Infection and death rates were far below what experts had anticipated based on the economy, population density, and the highly uneven quality of its healthcare system. The government's decision to order a phased lifting of a national lockdown seemed vindication indeed. As late as April, India reported fewer new cases per million than Britain, France, Germany, the U.K., or the U.S.

Never one for modesty, its Hindu nationalist prime minister, Narendra Modi, boasted that India had "saved humanity from a great disaster by containing Corona effectively." He touted its progress in vaccination; bragged that it was now exporting masks, test kits, and safety equipment; and mocked forecasts that Covid-19 would infect 800 million Indians and kill a million of them. Confident that his country had turned the corner, he and his Bharatiya Janata Party held huge, unmasked political rallies, while millions of Indians gathered in vast crowds for the annual Kumbh Mela religious festival.

Then, in early April, the second wave struck with horrific consequences. By May 6th, the daily case count had reached 414,188. On May 19th, it would break the world record for daily Covid-19 deaths, previously a dubious American honor, recording almost 4,500 of them.

Hospitals quickly ran out of beds. The sick were turned away in droves and left to die at home or even in the streets, gasping for breath. Supplies of medical oxygen and ventilators ran out, as did personal protective equipment. Soon, Modi had to appeal for help, which many countries provided.

Indian press reports estimate that fully half of India's 300,000-plus Covid-19 deaths have occurred in this second wave, the vast majority after March. During the worst of it, the air in India's big cities was thick with smoke from crematoria, while, because of the shortage of designated cremation and burial sites, corpses regularly washed up on riverbanks.

We may never know how many Indians have actually died since April. Hospital records, even assuming they were kept fastidiously amid the pandemonium, won't provide the full picture because an unknown number of people died elsewhere.

The Vaccination Divide

Other parts of the global south have also been hit by surging infections, including countries in Asia which had previously contained Covid-19's spread, among them Malaysia, Nepal, the Philippines, Sri Lanka, Thailand, and Vietnam. Latin America has seen devastating surges of the pandemic, above all in Brazil because of President Jair Bolsonaro's stunning combination of fecklessness and callousness, but also in Bolivia, Columbia, Chile, Paraguay, Peru, and Uruguay. In Africa, Angola, Namibia, South Africa, and the Democratic Republic of the Congo are among 14 countries in which infections have spiked.

Meanwhile, the data reveal a gargantuan north-south vaccination gap. By early June, the U.S. had administered doses to nearly half the country's population, in Britain slightly more than half, in Canada just over a third, and in the European Union approximately a third. (Bear in mind that the proportions would be far higher were only adults counted and that vaccination rates are still increasing far faster in these places than in the global south.)

Now consider examples of vaccination coverage in low-income countries.

  • In the Democratic Republic of the Congo, Ethiopia, Nigeria, South Sudan, Sudan, Vietnam, and Zambia it ranged from 0.1% to 0.9% of the population.
  • In Angola, Ghana, Kenya, Pakistan, Senegal, and South Africa, between 1% and 2.4%.
  • In Botswana and Zimbabwe, which have the highest coverage in sub-Saharan Africa, 3% and 3.6% respectively.
  • In Asia (China and Singapore aside), Cambodia at 9.6% was the leader, followed by India at 8.5%. Coverage in all other Asian countries was below 5.4.%.

This north-south contrast matters because mutations first detected in the U.K., Brazil, India, and South Africa, which may prove up to 50% more transmissible, are already circulating worldwide. Meanwhile, new ones, perhaps even more virulent, are likely to emerge in largely unvaccinated nations. This, in turn, will endanger anyone who's unvaccinated and so could prove particularly calamitous for the global south.

Why the vaccination gap? Wealthy countries, none more than the United States, could afford to spend billions of dollars to buy vaccines. They're home as well to cutting-edge biotechnology companies like AstraZeneca, BioNTech, Johnson and Johnson, Moderna, and Pfizer. Those two advantages enabled them to preorder enormous quantities of vaccine, indeed almost all of what BioNTech and Moderna anticipated making in 2021, and even before their vaccines had completed clinical trials. As a result, by late March, 86% of all vaccinations had been administered in that part of the world, a mere 0.1% in poor regions.

This wasn't the result of some evil conspiracy. Governments in rich countries weren't sure which vaccine-makers would succeed, so they spread their bets. Nevertheless, their stockpiling gambit locked up most of the global supply.

Equity vs. Power

Tedros Adhanom Ghebreyesus, who leads the World Health Organization (WHO), was among those decrying the inequity of "vaccine nationalism." To counter it, he and others proposed that the deep-pocketed countries that had vacuumed up the supplies, vaccinate only their elderly, individuals with pre-existing medical conditions, and healthcare workers, and then donate their remaining doses so that other countries could do the same. As supplies increased, the rest of the world's population could be vaccinated based on an assessment of the degree to which different categories of people were at risk.

COVAX, the U.N. program involving 190 countries led by the WHO and funded by governments and private philanthropies, would then ensure that getting vaccinated didn't depend on whether or not a person lived in a wealthy country. It would also leverage its large membership to secure low prices from vaccine manufacturers.

That was the idea anyway. The reality, of course, has been altogether different. Though most wealthy countries, including the U.S. following Biden's election, did join COVAX, they also decided to use their own massive buying power to cut deals directly with the pharmaceutical giants and vaccinate as many of their own as they could. And in February, the U.S. government took the additional step of invoking the Defense Production Act to restrict exports of 37 raw materials critical for making vaccines.

COVAX has received support, including $4 billion pledged by President Joe Biden for 2021 and 2022, but nowhere near what's needed to reach its goal of distributing two billion doses by the end of this year. By May, in fact, it had distributed just 3.4% of that amount.

Biden recently announced that the U.S. would donate 500 million doses of vaccines this year and next, chiefly to COVAX; and at their summit this month, the G-7 governments announced plans to provide one billion altogether. That's a large number and a welcome move, but still modest considering that 11 billion doses are needed to vaccinate 70% of the world.

COVAX's problems have been aggravated by the decision of India, counted on to provide half of the two billion doses it had ordered for this year, to ban vaccine exports. Aside from vaccine, COVAX's program is focused on helping low-income countries train vaccinators, create distribution networks, and launch public awareness campaigns, all of which will be many times more expensive for them than vaccine purchases and no less critical.

Another proposal, initiated in late 2020 by India and South Africa and backed by 100 countries, mostly from the global south, calls for the World Trade Organization (WTO) to suspend patents on vaccines so that pharmaceutical companies in the global south can manufacture them without violating intellectual property laws and so launch production near the places that need them the most.

That idea hasn't taken wing either.

The pharmaceutical companies, always zealous about the sanctity of patents, have trotted out familiar arguments (recall the HIV-AIDS crisis): their counterparts in the global south lack the expertise and technology to make complex vaccines quickly enough; efficacy and safety could prove substandard; lifting patent restrictions on this occasion could set a precedent and stifle innovation; and they had made huge investments with no guarantees of success.

Critics challenged these claims, but the bio-tech and pharmaceutical giants have more clout, and they simply don't want to share their knowledge. None of them, for instance, has participated in the WHO's Covid-19 Technology Access Pool (C-TAP), created expressly to promote the voluntary international sharing of intellectual property, technology, and knowhow, through non-restricted licensing.

On the (only faintly) brighter side, Moderna announced last October that it wouldn't enforce its Covid-19 vaccine patents during the pandemic — but didn't offer any technical assistance to pharmaceutical firms in the global south. AstraZeneca gave the Serum Institute of India a license to make its vaccine and also declared that it would forgo profits from vaccine sales until the pandemic ends. The catch: it reserved the right to determine that end date, which it may declare as early as this July.

In May, President Biden surprised many people by supporting the waiving of patents on Covid-19 vaccines. That was a big change given the degree to which the U.S. government has been a dogged defender of intellectual property rights. But his gesture, however commendable, may remain just that. Germany dissented immediately. Others in the European Union seem open to discussion, but that, at best, means protracted WTO negotiations about a welter of legal and technical details in the midst of a global emergency.

And the pharmaceutical companies will hang tough. Never mind that many received billions of dollars from governments in various forms, including equity purchases, subsidies, large preordered vaccine contracts ($18 billion from the Trump administration's Operation Warp Speed program alone), and research-and-development partnerships with government agencies. Contrary to its narrative, Big Pharma never placed huge, risky bets to create Covid-19 vaccines.

How Does This End?

Various mutations of the virus, several highly infectious, are now traveling the world and new ones are expected to arise. This poses an obvious threat to the inhabitants of low-income countries where vaccination rates are already abysmally poor. Given the skewed distribution of vaccines, people there may not be vaccinated, even partially, until 2022, or later. Covid-19 could therefore claim more millions of lives.

But the suffering won't be confined to the global south. The more the virus replicates itself, the greater the probability of new, even more dangerous, mutations — ones that could attack the tens of millions of unvaccinated in the wealthy parts of the world, too. Between a fifth and a quarter of adults in the U.S. and the European Union say that they're unlikely to, or simply won't, get vaccinated. For various reasons, including worry about the safety of vaccines, anti-vax sentiments rooted in religious and political beliefs, and the growing influence of ever wilder conspiracy theories, U.S. vaccination rates slowed starting in mid-April.

As a result, President Biden's goal of having 70% of adults receive at least one shot by July 4th won't be realized. With less than two weeks to go, at least half of the adults in 25 states still remain completely unvaccinated. And what if existing vaccines don't ensure protection against new mutations, something virologists consider a possibility? Booster shots may provide a fix, but not an easy one given this country's size, the logistical complexities of mounting another vaccination campaign, and the inevitable political squabbling it will produce.

Amid the unknowns, this much is clear: for all the talk about global governance and collective action against threats that don't respect borders, the response to this pandemic has been driven by vaccine nationalism. That's indefensible, both ethically and on the grounds of self-interest.

COVID-19 surge overwhelms India: ‘The condition is so horrible’

India, according to Johns Hopkins University in Baltimore, is #4 in deaths from the COVID-19 coronavirus. More than 182,500 people have died from COVID-19 in India as of Wednesday morning, April 21. And the Financial Times is reporting that India's most recent wave of COVID-19 infections is its worst so far.

Financial Times reporters Benjamin Parkin, Jyotsna Singh, Stephanie Findlay and John Burn-Murdoch explain, "Every night, funeral pyres blaze on the banks of the Ganges — a grim symbol of the ferocious COVID-19 wave, sparking a health crisis and human tragedy in India that is far surpassing anything seen last year. Patients are dying while their families search in vain for hospital beds. Supplies of oxygen and medicines are running low, leading to robberies of drugs from hospitals. Crematoriums and burial grounds cannot cope with the sheer number of corpses."

India, the FT reporters note, has recently been averaging "about 294,000 infections and 2000 deaths a day." And a Twitter thread posted by Burn-Murdoch on April 21 lays out some reasons why the data is so grim.

Prime Minister Narendra Modi, a right-wing Hindu nationalist, and others in his Bharatiya Janata Party have drawn criticism from some health experts around the world for holding crowded events that did not adhere to social distancing guidelines. Two months ago, Bharatiya Janata officials were boasting that India had largely conquered COVID-19. But that was before the latest wave of infections.

K. Srinath Reddy, president of the Public Health Foundation of India, told Financial Times, "Health systems weren't better prepared for it this time around. Many people in the administration across the country did not expect that there would be a 'this time around.' It was somehow presumed that we had passed the pandemic."

Seema Shukla, a nurse at the Sanjay Gandhi Post-Graduate Institute of Medical Sciences in Lucknow, told Financial Times that what India is suffering now is much worse than what the country experienced in 2020.

According to Shukla, "None of us suffered the death and devastation that we are seeing now. It is much worse this time than last year. The condition is so horrible that so many people are dying on the street, in their houses, before they can see a doctor or even have a test. From early morning to midnight, my phone keeps ringing. Desperate relatives and friends are calling for help: 'Please help me find a ventilator, bed, a nurse, oxygen cylinder, medicine.'"

The COVID-19 pandemic, according to Johns Hopkins researchers, has killed more than 3 million people worldwide. The United States remains the country with the most COVID-19-related deaths — with more than 568,000 U.S. residents having died from the novel coronavirus. And Hopkins reports that other COVID-19 hotspots include Brazil at #2 and Mexico at #3.

Just 0.2% of COVID vaccine doses have gone to poor nations as rich countries shield pharma monopolies

The head of the World Health Organization estimated in a recent address that of the more than 700 million coronavirus vaccine doses that have been administered across the globe, just 0.2% have gone to people in low-income nations—inequity that experts warn will persist unless rich countries end their obstruction of an international effort to suspend vaccine patents.

Speaking to the media on Friday, WHO Director General Tedros Adhanom Ghebreysus warned that "there remains a shocking imbalance in the global distribution of vaccines" as pharmaceutical companies cling to their monopoly control over technology that was developed with large infusions of public money.

"On average in high-income countries, almost one in four people has received a vaccine. In low-income countries, it's one in more than 500," said Tedros. "Let me repeat that: one in four versus one in 500."

Tedros went on to lament the struggles of the global vaccine initiative COVAX, which he said "had been expecting to distribute almost 100 million doses by the end of March" but has instead only sent out 38 million due to "a marked reduction in supply." COVAX has partnered with several major pharmaceutical companies, including AstraZeneca and Pfizer, in an effort to ensure access to vaccines in developing countries.

"The problem is not getting vaccines out of COVAX; the problem is getting them in," said Tedros.

The Associated Press reported Saturday that "as many as 60 countries, including some of the world's poorest, might be stalled at the first shots of their coronavirus vaccinations because nearly all deliveries through the global program intended to help them are blocked until as late as June."

"COVAX, the global initiative to provide vaccines to countries lacking the clout to negotiate for scarce supplies on their own, has in the past week shipped more than 25,000 doses to low-income countries only twice on any given day. Deliveries have all but halted since Monday," AP noted. "During the past two weeks, according to data compiled daily by UNICEF, fewer than two million COVAX doses in total were cleared for shipment to 92 countries in the developing world—the same amount injected in Britain alone."

According to a recent Bloomberg analysis of vaccination data, "the world's least wealthy continent, Africa, is also the least vaccinated. Of its 54 countries, only three have have inoculated more than 1% of their populations. More than 20 countries aren't even on the board yet."

The ongoing struggles of COVAX and the inadequacy of bilateral vaccine agreements have only served to heighten calls for more sweeping action at the international level to redress inequities that could prolong and intensify the global pandemic.

One effort, led by South Africa and India, to temporarily lift vaccine-related intellectual property rights has gone nowhere due to wealthy World Trade Organization members such as the United States and the United Kingdom, whose opposition has left vaccine production largely under the control of major pharmaceutical corporations.

Proponents say South Africa and India's patent waiver—supported by more than 100 nations around the world and predictably opposed by the pharmaceutical industry—would accelerate production and distribution of doses by allowing manufacturers to replicate vaccine formulas.

Dean Baker, co-director of the Center for Economic and Policy Research (CEPR), wrote in a blog post Friday that "getting the world vaccinated is not about some feel-good gestures, like a few billion dollars for COVAX."

"It means pulling out all the stops to produce and distribute billions of vaccines as quickly as possible. To do this, we need the cooperation of the whole world and the elimination of all the barriers to the production and distribution of vaccines," Baker argued. "This would mean suspending intellectual property claims over these vaccines. From a moral standpoint, this should not be a tough call since governments paid for so much of the development costs."

"What are we going to do if a new and more deadly vaccine-resistant strain develops in Zambia or Burma? I don't want to hear another chorus of 'who could have known?' from our intellectuals who missed another huge one," Baker continued. "Let's get it right this time, even if it means having to do things a little differently. Our leaders are not forced to take a vow of incompetence."

A tiny group of anti-vaxxers are flooding the internet with misinformation

Despite the public health awareness–raising effect of the pandemic, anti-vaccine and vaccine-hesitant sentiments still run rampant in the United States. A recent PBS NewsHour/NPR/Marist poll found that 30 percent of those surveyed in March 2021 told pollsters that, if offered the COVID-19 vaccine, they would not take it.

The huge number of vaccine-hesitant Americans might give the impression that anti-vaccination propaganda is rampant. Yet it turns out that a select few very loud voices are responsible for a great deal of online misinformation regarding vaccines. Their disproportionate ability to spread disinformation should give social media platforms pause.

Indeed, according to the nonprofit Center for Countering Digital Hate (CCDH), a mere dozen individuals and their organizations are responsible for up to 65% of the anti-vaccine misinformation that is spreading on social media platforms.

In their recent report, the CCDH revealed that these twelve people and their groups have disseminated nearly two-thirds of the anti-vaccine misinformation they have been tracing on Facebook and Twitter between Feb. 1 and March 16 of this year. Overall the CCDH found that the information they had been tracing was shared or posted on one of those platforms roughly 812,000 times, even though their inaccurate statements about vaccines violate those companies' terms of service. The most famous of the so-called "Disinformation Dozen" is Robert F. Kennedy, Jr., nephew of President John F. Kennedy. The CCDH also found a number of prominent anti-vaccine advocates and proponents of alternative medicine.

One of them, Rizza Islam, has argued that Bill Gates is behind the COVID-19 pandemic, claimed he "beat" the disease through a special diet, and repeated the debunked claim that vaccines cause autism. (Although his Facebook account has been removed, he remains active on Twitter and the Facebook-owned Instagram.) Anti-vaccine entrepreneurs Ty and Charlene Bollinger have used their Facebook, Twitter and Instagram accounts (all of which remain active) to denounce the "fake pandemic" and spread an inaccurate story claiming that a COVID-19 vaccine had killed seven children in Senegal. They have also established ties with the far right, repeating the disproved talking point that Joe Biden stole the 2020 election from Donald Trump. Another anti-vaccine entrepreneur, Joseph Mercola, has referred to the pandemic as a "scam" and argued that "hydrogen peroxide treatment" can successfully treat most viral respiratory illnesses, including the coronavirus.

"The Disinformation Dozen — including Robert F. Kennedy Jr., Joseph Mercola, and Ty and Charlene Bollinger, among others — continually violate the terms of service agreements on Facebook and Twitter," the CCDH explains in the summary of their report. "While some anti-vaxxers identified by CCDH have been removed from a single platform, comprehensive action has yet to be taken, and most remain active on Facebook, Instagram and Twitter."

In addition to political and cultural motives, anti-vaxxers are often driven by a mistrust of statistics and experts who they do not personally know, especially if they come from institutions that they have been trained to distrust. Instead they are more inclined to believe the opinions of people they personally know and stories that they have heard, regardless of whether those sources are reliable, according to a recent book by Jonathan Berman, a professor at the New York Institute of Technology's College of Osteopathic Medicine.

The case for wearing two masks

At President Joe Biden's inauguration last week, many viewers were keen to notice Sen. Bernie Sanders's (I-Vt.) mittens. But there was another inauguration fashion accessory sported by many that caught eyes: politicians donning not one, but two masks. The practice was quickly dubbed "double-masking." Indeed, former South Bend mayor and Transportation Secretary nominee Pete Buttigieg wore two facemasks, a white one beneath a cloth black one. His spouse, Chasten, sported a double-masked look as well.

Anecdotally, I have noticed more people opting to wear two masks instead of one in the Bay Area, which raises the question: Is two better than one?

On Monday, director of the National Institute of Allergy and Infectious Diseases and White House advisor Dr. Anthony Fauci weighed in on double-masking, stating, "it just makes common sense."

"If you have a physical covering with one layer, you put another layer on, it just makes common sense that it likely would be more effective," Fauci said. "That's the reason why you see people either double masking or doing a version of an N95."

However, the Centers for Disease Control and Prevention (CDC) has yet to officially recommend double-masking — and scientists who have been studying the coronavirus and its mitigation strategies tell Salon it's unnecessary for them to do so, for now, for a number of reasons. One being, that while it may be "common sense," the issue is nuanced. That's partly because the effectiveness of double-masking largely depends on the material of the masks, and how that material compares to the material of one really effective mask.

"More layers is probably better, that does make sense . . . if a droplet gets through one layer maybe you'll be stopped by the next layer — that to me is logical," said Dean Blumberg, chief of pediatric infectious diseases and associate professor in the Department of Pediatrics at the University of California, Davis. "But of course it would also depend on the material, and then the coverage of the mask."

For example, one N95 mask is better than two cloth masks.

Dr. John Volckens, a professor of Mechanical Engineering at Colorado State University, said that the take home message is certainly "any mask is helpful," but agreed that "double masking" is better than one because of the quality of masks that most of the public is wearing. Studies show the best protection against the coronavirus is an N95 mask. However, they are in short supply and prioritized for healthcare workers. Not only are N95 masks hard to come by, but they need to be professionally fitted to one's face to ensure a tight seal. When this happens, the mask can block 95 percent of very small particles— hence, the name. Even a "suboptimal" fit though can block more than 90 percent of small particles, according to research published before the pandemic. This is why healthcare workers wear N95 masks, which are often accompanied by face shields. But the public isn't wearing N95 masks—they're either wearing cloth masks, or disposable surgical ones.

"A lot of masks that I see out in the wild don't fit very well on people's faces, there are gaps in them, and this is especially true of those blue surgical masks," Volckens said. "Those aren't meant to seal against the face, and if they don't seal against your face, then they leak."

Volckens said after wearing an N95, a person has a ring around their face like they've been snorkeling. That's because the mask has created a seal around that person's face, protecting them from 95 percent of aerosols. Yet that doesn't happen when a person wears either a surgical mask or a cloth mask—there are gaps and leaks on the sides.

"Double masking is a way to combat that lack of protection," Volkens said, "because you have a good mask as the bottom layer like one of those blue surgical masks. The filters in those masks are protective, but they're not allowed to do their job if they're leaking on the side," he continued. "So the second mask you put on holds that filter closer to your face, and provides for a better seal."

The second mask, Volckens said, should be anything that helps press the first one around your face more tightly. He added that the second layer of protection could even be a "mask fitter" or "mask sealer" that holds the mask more tightly around a person's face.

While cloth masks aren't as effective as N95 masks in protecting the person wearing them and other people, they do provide a layer of protection that can have a profound public health impact on a community. For example, a study published in Health Affairs compared the COVID-19 growth rate before and after mask mandates in 15 states and the District of Columbia. Researchers found that mask mandates led to a reduction in daily COVID-19 cases; after five days, the growth rate declined by 0.9 percent. At three weeks, the daily growth rate slowed by 2 percentage points.

"A bad mask is better than no mask at all," Volkens emphasized.

Epidemiologist George Rutherford, MD, at the University of California, San Francisco, agreed that the more layers you have, the better. Rutherford emphasized that the public wears masks for three reasons.

"The first one is because 60 percent of people who transmit are asymptomatic when they're at their most infectious, the second is we also want to protect ourselves," Rutherford said. "And then the third is if people do manage to get infected, despite wearing masks, you probably get infected with smaller inoculums, fewer viral particles, and as a result they get less sick."

Rutherford said that wearing two masks is especially a good idea when you're on public transportation, or in any situation where can't control the people around you. But don't expect double masking to be a singular means to get us out of this pandemic— so as long as many people continue to refuse to wear masks.

"I'd rather spend my time getting people to wear masks who aren't wearing masks," he said. "Rather than getting people to wear double masks."

Pfizer vaccine gains emergency approval in UK — doses on their way for distribution next week

As it turns out, a COVID-19 vaccine really is going into almost immediate distribution … except it will be available on the other side of the Atlantic. Government authorities in the U.K. have provided emergency approval not to the Oxford/AstraZeneca vaccine that many thought would be the first released there, but to the vaccine developed by Pfizer and German firm BioNTech. The first doses are expected to be rolled out within a week.

When those doses go out, officials have developed a somewhat elaborate table of priorities that indicates the first doses should go to nursing home residents and caregivers at these facilities. Following this, the second set of doses will address front-line healthcare workers along with everyone over 80. This is similar to the likely order in the U.S., where a Centers for Disease Control and Prevention (CDC) panel voted on Tuesday to also put residents and caregivers at long-term care facilities at the head of the line.

Pfizer announced the end of their phase 3 trials on Nov. 18, marking a period from initial development to achieving the targets of human trials in just 10 months. That's remarkable in any case, but even more remarkable considering that this is the first completion of human testing of any coronavirus vaccine, and also one of the first human vaccines to use mRNA technology (the other being Moderna's vaccine).

So far, safety indications have been good. No serious incidents have been reported in phase 2 or phase 3 testing, through some of those receiving the vaccine reported fatigue or headache and many reported irritation around the site of the injection. That apparent safety, along with a nearly 95% efficacy rate (that appears to hold up across gender, race, and age categories), makes the vaccine extremely attractive.

Pfizer has also submitted its vaccine for emergency approval by the FDA, but that agency has not yet issued an emergency use authorization. Assuming that the data presented in Pfizer's application holds up to scrutiny, such an authorization is expected within a matter of days.

According to the BBC, doses are on their way to the U.K. and 800,000 doses are expected "in coming days." Since each person requires two doses, that would be enough to cover 400,000 people. According to MHA, there are approximately 418,000 people living in long-term care facilities across the U.K., so this initial dose might be just about the right number to check off the first goal on a nine-step list that would eventually see the vaccine made available to everyone.

Pfizer has indicated that they intend to manufacture 50 million doses before the end of 2020 (enough for 25 million people) and over a billion doses in 2021. So even if the U.K. gets their 800,000 doses before the U.S. approval comes through, it shouldn't significantly impact the number of doses available. Approximately 1.4 million people in the U.S. currently live in nursing facilities. Pfizer's vaccine requires special handling, including deep cold storage, which may limit its distribution in some areas.

Moderna has also submitted its vaccine for approval in the U.S. following trial results that were similar to those of Pfizer. In the U.K, AstraZeneca is also seeking emergency approval for its vaccine. However, AstraZeneca has not yet submitted its vaccine for approval by the FDA after their phase 3 trial was marked by errors that make the efficacy of their vaccine difficult to determine. Several other vaccines, including Johnson & Johnson's attempt to create a COVID-19 vaccine that requires only a single jab, are still in phase 3 testing.

Dr. Fauci warns of COVID 'surge upon a surge' after Thanksgiving

Appearing on ABC's This Week on the Sunday morning after Thanksgiving, the nation's top infectious disease expert and voice of reason amid the novel coronavirus pandemic dropped some harsh realities on viewers—but also reminded us that we can make better choices starting, well, today. In speaking to host Martha Raddatz about our rising case numbers, Dr. Anthony Fauci said "there almost certainly is going to be an uptick because of what has happened with the travel" over Thanksgiving. He also chatted with Raddatz about the COVID-19 vaccine, reopening schools, and the next stage of the holiday season: Christmas and New Year's.

Given that we already know people planned to travel and gather for Thanksgiving, many of us are wondering—and worried—that people are planning to repeat the pattern just one month from now. But as Fauci urged viewers, "We're going to have to make decisions as a nation, state, city and family, that we're in a very difficult time and we're going to have to do the kinds of restrictions of things we would like to have done, particularly in this holiday season." Basically, now is not the time to shrug our shoulders and admit defeat in the face of worsening numbers.

"We may see a surge upon a surge," a few weeks down the line, Fauci said, stressing that "we don't want to frighten people, but that's just the reality." Fauci shared that as we enter a colder weather season, as well as a bigger holiday season with people traveling back and forth, he doesn't foresee relaxed guidelines or restrictions when it comes to facing the virus.

Fauci also brought up hope for a vaccine in the near future, citing the end of December as a starting point for top priority individuals, and then progressively more people receiving vaccinations through March.

When asked about legal barriers in terms of pandemic restrictions, Fauci put it simply when he said there's nothing he personally can do about it. He stressed that no matter who you are, or where you are, if you have a congregate setting of people—especially if they are inside, and especially if they are not wearing masks—that's a "considerable risk" for getting or spreading the infection.

When asked how he would advise the Biden administration on getting a "unified response" in terms of COVID-19 closings, Fauci suggested to "close the bars and keep the schools open." He noted that there's no one-size-fits-all solution, but getting students back in school should be a priority, and in order to do that safely, we need to get our community spread levels low.

Fauci still wants to see more testing available for asymptomatic people, saying he hopes it's "sooner rather than later," especially when it comes to contact tracing and community spread tracking. He mentioned hope for at-home rapid tests, perhaps even without a prescription, for at least some circumstances.

Fauci also stressed that the process for developing the vaccine has been "scientifically sound." According to Fauci, "safety has not been compromised, scientific integrity has not been compromised and the process of determining whether it works, whether it's safe and effective has been independent by independent bodies and transparent."

'We're not able to process what's about to happen to us': Shep Smith highlights doctors' warnings on COVID

At several points during Salon's recent conversation with CNBC anchor Shepard Smith, he talks about noise. "The noise is just so loud. You've got have some quiet time," he said, referring to the space he carves out for himself during the workday when he retreats to his spartan office, puts his feet up and listens to music to harvest a little peace from the day's cacophony.

This philosophy also guides his approach to "The News with Shepard Smith," and it shows. Each weeknight at 7 p.m. Eastern since the program's Sept. 30 launch, Smith delivers the news of the day, regardless of what it may be, with an old-school broadcast anchor's mellow sobriety. Pressing events of the day top the hour and from there Smith and his correspondents zero in on an assortment of issues that stand to have significant local and regional impact.

"We try to find stories . . . tell them factually and dig into data a lot, and then hear from people about how they feel about the issues through their own personal experiences and how it's affected them," he explained. "And we're not looking for, 'How do you feel about what he said?' or 'How you feel about what she said?' We're trying to just seek the truth, find the truth and tell the truth in context and with perspective."

Having spent 23 years with Fox News, Shepard's new chapter at CNBC intentionally veers away from the argumentative clamor and enraged punditry that has defined cable news in the 21st century. Instead, "The News" offers something so rare and refreshing that people presumed it to be extinct: fact-based reporting, delivered calmly by a plain-spoken anchor uninterested in ginning up arguments.

When developing each day's story slate, Smith says he and his staff adhere to a set of sensible axioms: Get it right. Add in whatever context is important. Explain why the story they're covering matters because of what the consequences will be, if those are known consequences. Then put it into perspective, historical and otherwise.

His show intentionally declines to participate in the cycle of back and forth fueled by false equivalency and both sides-ism.

"We have to ignore the signal and focus on the prize," Smith told Salon. "There's a lot of, 'Look over here!' in life, and there's always been a lot of 'Look over here.' But 'Look over here' gets a lot more juice than it ever did before because of all of these media ecosystems. And it can overtake you."

"This other stuff is going to fade away at some point," he added, referring to the poisonous politics of the last five years and the amplified flurry of lies and hyperbole accompanying it, "and we'll cover the trials and tribulations along with it, we'll cover the uprisings and the demonstrations. And we'll hear from people about how they think about things. But we're on a different road. It's the road less traveled, and I'm enjoying it."

In case you've forgotten, as so many have, that metaphorical road to which he's referring is that it used to be the main road. The road. In the days of broadcast anchor supremacy and CNN's earliest era, the news was a straight-laced enterprise guided by policy, data and expert insight, and what leaders said and did received more space than broad interpretations of the meaning of what they tweeted.

When Smith was first rising through the cable news ranks, he distinguished himself during Hurricane Katrina by careful reporting what he saw on the ground, allowing his emotions to show through at times when the horror overwhelmed him.

I pointed that out to him as an asset. He views the memory differently.

"My goal is always to not let emotions get in the way. Recognize them, use them as inspiration and guidance sometimes, but not to express them," he said. "I like to get excited about things when there are things about which everyone should be excited, and to be sad about things, about which everyone should be sad, but in measured ways."

"And you said that just now, you said, 'You let your emotions take over,'" he continued. "They didn't. They won."

In his view, emotions got the best of him because what he was seeing and reporting starkly contradicted the party line that was coming out of the White House and being repeated by other reporters and pundits, including those at Fox News.

In recalling the memory, Smith is passionate as he describes witnessing firsthand the dire suffering in his midst and his shock at hearing officials tell the public that the cavalry had arrived, that people where getting food, medical attention and water when that simply wasn't true.

"I know New Orleans. I'm a child of Mississippi. And I know its greatness and its horrors. There are so many dynamic cities around the world that are both things. And I know the Lower Ninth Ward. I know the poverty and I know how it is systematic and systemic. And I know that certain categories of people have been kept in a place and they don't have a way out and now they're flooded and dying."

He continued, thinking back to what he may have said at the time, "'All of you, maybe you're mistaken, maybe you're misled, but you are telling untruths about what's happening here. And as a result of your untruth, more people are dying.' I couldn't believe it was happening. I couldn't believe that people in a building thousands of miles away were telling me that what I was seeing wasn't true."

"And I'm like, 'Wait, wait, wait, no, no, I'm here. You're reading, but I'm seeing and smelling. I don't need the Associated Press to tell me what's happening here, because I happen to be in the right place.'"

For the better part of the last quarter century, the route Smith has chosen for his program has been all but abandoned on cable. Early on in "The News" run, critics predicted Smith's show would be trounced in ratings. They were right. While October ratings for Fox News and MSNBC surged with the rising excitement and anxiety leading up to the presidential election, the audience for "The News with Shepard Smith" averaged around 272,000 viewers between Sept.30 and Oct. 22, coming in behind its 7 p.m. competitors on MSNBC, CNN and Fox News.

For a bit more perspective on Fox News, both "Hannity" and "Tucker Carlson Tonight" broke the 6 million viewer threshold in October. Carlson's ratings even beat "The Masked Singer" on Fox – that's Fox broadcast, not cable – in broadcasts that aired during the last week of October.

However, let's add a bit of context as well: Carlson's and Sean Hannity's programs are the linchpins supporting Smith's former home, the dominant news network for a decade and a half. CNBC is a small business news network powered by "Shark Tank" and "Jay Leno's Garage," and whatever attention it snagged in the mediasphere tended to be the result of something terrible that Lou Dobbs said.

According to Nielsen ratings data, over the first month that "The News" has aired, it increased the audience by 120% year over year, when "Shark Tank" reruns aired in its timeslot. And its audience may be small, but it is slowly growing. On Nov. 16 the program enjoyed its highest viewership yet in it's the 25-to-54 target demographic. It's been averaging around 268,000 viewers over the last eight weeks.

A CNBC spokesperson stated that the network is pleased with the progress "The News" has made thus far.

"Not only is CNBC a new entrant in the general news genre, but news viewers are creatures of habit, and it takes a long time to change those habits," the spokesperson shared in an emailed statement, adding that Smith's audience far exceeds that of the last regular news program to air on CNBC in the 7 p.m. ET timeslot, which was "The Kudlow Report" way back in the first quarter of 2014.

And lest viewers be tempted to write off Smith's classic approach to TV news, the cable news field has entered a period of flux. Numbers for "The News" may never approximate Fox News, MSNBC or CNN audience levels, but even their ratings are coming off the historic highs they rode during Donald Trump's presidency.

Much has been reported about disillusioned Fox News viewers migrating over to more far-right leaning and conspiracy theory-driven outlets such as Newsmax and One America News Network, and if that is the case, then surely there must be a commensurate number of viewers seeking out the kind of straight, no chaser delivery that Smith purveys.

Because as many people are realizing, and Smith told me, there's too much noise. "And all of that noise is destructive."

Not all of that destruction he's talking about is figurative. The biggest challenge Smith foresees in the immediate future isn't ratings, which don't trouble him owing to his sense of perspective. He says he's steeling himself for the time leading up to Christmas and into what he describes as "the cold, cold, beginning of 2021, when it's unimaginably sad and horrible everywhere."

"Because I talk to doctors – I talked to Dr. [Scott] Gottlieb, I talked to Dr. [Anthony] Fauci. I talked to a lot of doctors who I don't talk to on the air and they all say the same thing: We're not able to process what's about to happen to us."

This is Smith coming to me, from his personal space – not the on-air figure, but the person who railed at the irresponsible distortion of facts as he watched bodies float by in Katrina's floodwaters. Over Zoom you can see the humanity and concern registering on his face and perhaps hear it catching in his voice a bit. "Death and suffering is horrible in the little places where I've been and experienced them. You know, Columbine, the Oklahoma City Bombing, 9/11, they were all in one place – 9/11 was in a few places and certainly affected everyone. But they cried for us. It didn't happen in their town."

"Now," he continued, "It's going to be happening every town. And we're going to be so sad, if the doctors are right. And sadness is so destructive."

During those times, he said, the role of "The News" will be to find the heroes in the chaos. We have to give some people who are inspiring, and who doing it in their own little way, to more people in order to inspire them to inspire.

Which is why he stressed his program's dedication to finding the light, not to goose ratings. The vaccines, he said, are a light. So is the culture's renewed focus on women's issues and its nascent efforts to take an anti-racist stance. "Everyone seems to agree that we cannot continue to exist this divided. It will conquer us. We have to find ways to come together. And, you know, as a gay guy, I've always known that if we know get each other better, it's all going to be easier."

Amazingly the CNBC anchor has a hopeful view of what lies ahead for TV news. I feel like eventually we're going to look back and this will be just a little blip in time when people got confused about what was true and what wasn't . . . They got distracted and didn't realize, and, ' I really was misinformed. And I need to go back to a trusted source. And I need to be more careful about how I consume,'" he said.

"But we're in the middle of it and we have to figure out how to get out of it. I don't know what the answer is . . . I don't know how it's all corrected. I don't know what policies and changes need to be made. But I know that we're trying to do it, just ourselves, and we begin by focusing and tuning it out."

Fauci warns pandemic not ​expected to ease for holidays as US hospitalizations hit new record

After millions of people crowded into airports in recent days despite public health experts' warnings against traveling for Thanksgiving—the Thursday holiday that coincided with a record number of coronavirus-related hospitalizations in the United States—the nation's top infectious disease doctor expressed concerns that conditions could continue to worsen through the end of the year and beyond.

"If the surge takes a turn of continuing to go up and you have the sustained greater than 100,000 infections a day and 1,300 deaths per day and the count keeps going up and up... I don't see it being any different during the Christmas and New Year's holidays than during Thanksgiving," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told USA TODAY.

In his interview with the newspaper last week, published Friday, Fauci shared how his own family is handling the winter holiday season in the midst of a deadly pandemic:

Fauci said he's most likely scrapping Christmas plans this year as he did for Thanksgiving. Instead of receiving his three daughters this year, who live in different parts of the country, he opted to send his love over Zoom and enjoy a quiet dinner with his wife.

"For my own family, I'm saying we had a really great Thanksgiving and Christmas last year. We're looking forward to a really great Thanksgiving and Christmas in 2021," he said. "Let's now make the best of the situation and show our love and affection for people by keeping them safe."

Newsweek noted Friday that despite the Centers for Disease Control and Prevention's recommendation against traveling around Thanksgiving, "nearly three million people passed through airport security checkpoints the Friday, Saturday, and Sunday before the long weekend, according to the Transportation Security Administration."

As of Friday afternoon, the U.S. death toll topped 264,000 and the nation had seen more than 12.9 million confirmed cases, according to Johns Hopkins University's global tracker. Thanksgiving marked the country's 24th consecutive day of over 100,000 new daily cases in the United States, with 110,611 infections and 1,232 deaths.

Ali Mokdad, professor of health metrics sciences at the Institute of Health Metrics and Evaluations (IHME) and chief strategy officer for population health at the University of Washington, told USA TODAY only about a fourth of all Covid-19 cases are reported in the United States due to testing limitations and undetected infections.

"We should prevent getting Covid-19 especially at this time when we're about to get a vaccine rolling out," Mokdad told the newspaper, referencing recent promising results from multiple late-stage vaccine trials. "We need to be extra careful these upcoming extra couple of weeks in order to avoid pain and suffering."

The IHME currently projects more than 336,800 total deaths from Covid-19, over 2,500 daily deaths, and 441,254 daily infections—including those who aren't tested—for the United States alone by the end of the year. The institute also projects a rise in the demand for hospital beds, including in intensive care units, by December 31.

The Covid Tracking Project, a volunteer group launched by The Atlantic, reported that hospitalizations due to disease in the United States hit a record of 90,481 on Thursday, with 17,802 people in ICUs and 5,979 requiring ventilators. The Hill noted that the project "expects states to report fewer testing, case, and death statistics on Thanksgiving and the weekend after as people are focused on the holiday. The experts predict that the numbers will then 'catch up' in the following days."

The rest of the world is "watching with trepidation—and at times disbelief—as coronavirus cases surge across the United States, and masses of Americans are choosing to follow through with plans to visit family and friends for this week's Thanksgiving holiday anyway," according to the Washington Post, which cited experts and media reports from Australia and Cameroon to Germany and the United Kingdom.

"From Australia, this looks like a mindbogglingly dangerous chapter in the out-of-control American Covid-19 story," Ian Mackay, an associate professor of virology at the University of Queensland, told the Post in an email. "Sadly, for some, this will be a Thanksgiving that is remembered for all the wrong reasons."

COVID-19 breathalyzer could be a game-changer for coronavirus detection

As more Americans are having to take COVID-19 tests due to the rapid acceleration of coronavirus cases across the United States, many will welcome a new form of technology that could revolutionize the country's pandemic response.

According to NBC-DFW, a new state-of-the-art breathalyzer device has been developed to detect COVID-19 in approximately 15 seconds to one minute, solid. Dave Copps, CEO of Worlds Inc., an artificial intelligence firm, released a statement about the revolutionary device known as "Protect." He also discussed the device's capability.

"It's a welcome change when people have to blow into a machine rather than have a swab stuck up their nose," Copps said. "You simply breath into Protect and receive results in about 15 seconds, in less than a minute."

He also highlighted what makes the device special and how it differs from standard COVID-19 testing. Protect can be used to determine whether or not a person should be tested for the virus which could ultimately save time and money for those trying to decide whether or not they should be tested.

"What makes Protect unique is that it doesn't directly detect the virus but rather the body's unique chemical reaction to the virus," Copps said.

According to Copps, the results from the Protect kiosk device have a level of accuracy that is comparable to PCR nasal swab tests.

"For us, we're doing this because we want to help. We think we have the people and the technology to do that. So we're running as fast as we can with great partners to see if we can get there," Copps said.

Texas A&M System helps develop new COVID-19 breathalyzer kiosk with results in seconds

The development of the Protect device comes the United States battles an alarming uptick in coronavirus cases, reporting nearly 200,000 cases each day over the last week. As of Friday, Nov. 27, the United States has confirmed more than 13.2 million coronavirus cases. The country's death toll now stands at 269,802.

Our worst pre-existing condition: Big Pharma

Before COVID, the headlines you might read about the pharmaceutical industry tended towards corporate malfeasance — violations of the Foreign Practices Corruption Act, insider trading, abusive mass marketing of opioids or predatory pricing, that sort of thing. Few think of such a notoriously manipulative industry as heralding medical breakthroughs.

But with a quarter of a million American deaths and another 12 million COVID cases, we are being told by the corporate news media these same companies are going to save life on the planet as we once knew it pre-pandemic.

Several months of worsening news about the pandemic, including decimating personal tragedies and loss on a scale not seen since the beginning of the last century, has reduced us to a childlike state looking for our parents that may already be dead.

Lost in transit

The mainstream news media agrees that Donald Trump's attempts to derail the peaceful transition of power is reckless. Yet they have failed to critically examine his decision to have our nation defer to the profit-driven pharma sector the efforts to beat COVID. Indeed, the research to create a vaccine is almost entirely publicly-funded, though the effort has entrusted to the private sector with little oversight.

As Michael Hiltzik recently wrote in his Los Angeles Times op-ed entitled "The Colossal Problem of Publicly Funded Vaccines in Private Hands," the Trump junta's blank check is going to an industry that has long "profited from billions of dollars in government scientific research without returning anything to taxpayers."

The U.S. Treasury's largesse towards the multinational pharma profiteers includes not merely billions of dollars in taxpayer funded-research for them to profit off of, but also guaranteed orders for the millions of doses of vaccine from the government.

Hiltzik quotes Peter Maybarduk, director of the Access to Medicines Program at the non-profit Public Citizen, who suggests the US has "considerably slowed the global timetable" in the COVID fight "by bestowing billions in grants to companies "and asking them to develop manufacturing arrangements that are in their interest rather than pooling resources saying we're going to teach the world how to make these vaccines and using all the available manufacturing capacity."

There's a tragic irony that we are relying so heavily on an industry that's a pillar of our for-profit health care system — one that rations care and feeds off of scarcity and disease — to deliver us from a pandemic.

The multinational pharmaceutical industry is the foundation of the American health care system that rations medical care based on the ability to pay. It has been its own kind of killer virus, and the industry permitted the proliferation of chronic diseases in the ranks of the poor and working classes — in turn serving as a form of race- and class-based social control, one that is increasingly revealing itself with each day's new COVID body count.

As Reverend William Barber pointed out during the Democratic primary campaign of 2020, there was, long before COVID, a raging pandemic that fed off of poverty playing out daily. This pandemic lived below the corporate news media radar, and prematurely claimed the lives of 250,000 Americans every year.

Big pharma, and our winner-take-all economic system, is implicated in those deaths. Back in 2018, a report by the Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, and the London School of Economics found that the US paid twice as much as other high-income countries for health care only to get poorer population health outcomes.

"The main drivers of higher health care spending in the U.S. are generally high prices — for salaries of physicians and nurses, pharmaceuticals, medical devices, and administration," the report's researchers say.

Making a killing

It's been the pharma companies, along with big tech firms like Amazon and Google, that have perfected the legal three-card-monte of profit-shifting to offshore jurisdiction hundreds of billions of dollars annually that starves public health care systems globally.

For decades, economists and public interest tax experts have flagged this accelerating "race to the bottom," where multinationals and the holders of vast personal fortunes reduce or eliminate entirely their tax bill by pitting the nations of the world against each other.

This continued beggaring of local, state and national governments by the wealthiest, including pharma companies, comes as our public health sector crumbles under the weight of the resource scarcity that resulted from generations of this hoarding and hiding of profits often generated by taxpayer-funded research.

A nurse's pay a second

Last week, thanks to the research generated by the international Tax Justice Network (TJN), we were able to quantify the scale of the impact of how pharmaceutical (and other) corporations have rigged tax codes to their advantage across the world.

TJN reports that even as the world's "pandemic-fatigued countries… struggle to cope with second and third waves of coronavirus," they have been losing "over $427 billion in tax each year to international corporate tax abuse and private tax evasion, costing countries altogether the equivalent of nearly 34 million nurses' annual salaries every year – or one nurse's annual salary every second."

"Pharma companies like Pfizer, along with software and internet companies, have been the major players in global tax dodging and designing the new mechanisms since the later 1990s that move lots of profits to low tax jurisdictions in the form of untaxed royalties that they pay themselves to offshore companies that they own," explains James Henry, a New York based economist and lawyer who is a senior advisor to TJN.

There are surely tens of thousands of committed scientists and technicians working at "warp speed" to develop a safe and effective vaccine out of a sense of moral duty. But we would be foolish to forget that big pharma itself is fueled by a maniacal pursuit of profits. And as an industry, it has shown the same kind of contempt for the law as the current occupant of the White House.

Above and beyond the law

Like Trump, Big Pharma are ruthless and unrepentant. Yet, because of the scale of the money involved in their crimes, our legal system actually shields them from personal criminal prosecution — as it did with the Wall Street banks in the Great Heist of 2008.

As it turns out, the most important duty for our Department of Justice, no matter which party controls the White House, appears to be to twist the law to preserve capital and keep great fortunes intact, while feigning to prosecute the corporate shell in the public interest.

This is critical, because today's federal prosecutors and regulators are all-too-often the farm team for tomorrow's over-compensated captains of industry.

Take Purdue Pharma, whose predatory marketing of the highly addictive opioid Oxycontin helped set off double-digit percentage spikes in drug overdose deaths that have killed more than 400,000 Americans since 1999.

In 2007, Purdue Pharma entered into a Department of Justice deal that required they plead guilty to a felony and pay a $600 million dollar fine for misleading and defrauding the public, including physicians, about their signature drug OxyContin.

Yet, some members of the bulletproof Sackler family, some of whom were heirs of the Purdue fortune, were allowed to transfer $10 billion out of their accounts between 2008 and 2018, according to an audit that was released while Purdue sought bankruptcy protection in September.

Last month, serial offender Purdue Pharma agreed to plead guilty to three federal crimes including producing highly addictive drugs "without legitimate medical purpose" in a deal with the Trump/Barr Department of Justice that was denounced as a "failure" by Massachusetts Attorney General Maura Healey.

"DOJ failed," tweeted Healey. "Justice in this case requires exposing the perpetrators accountable, not rushing a settlement to beat an election. I am not done with Purdue and the Sacklers, and I will never sell out the families who have been calling for justice for so long."

Walking wounded

Even before COVID, 140 million Americans struggled week to week trying to make ends meet, which they often did by cutting health care corners.

For three years before COVID hit, America's life expectancy was on the decline. How many members of Congress sounded the alarm? The last time such a demographic event happened was in the years leading up to the First World War and the Spanish Flu epidemic, when 675,000 Americans, and 50 million people worldwide, died.

Currently, with more than 250,000 deaths here in the U.S. and 1.2 million globally, there seems to be something truly exceptional about America's bout with the COVID scourge.

In the post-election interregnum, the prognosis is bleak. The U.S Treasury is sending out billions to Big Pharma, while rushing to close off access to Federal Reserve borrowing for small businesses and local governments. Unemployment benefits for 12 million Americans sidelined by COVID are set to run out the day after Christmas.

Just as individuals may have preexisting conditions that make them more susceptible to COVID-19, so does our economic system, which lets tens of millions of families teeter on the edge so as to provide the cheap labor on which billionaires' fortunes rely.

There can be no honest critique of how we got here without noting "the gross failure of the U.S. private, profit-driven, capitalist medical-industrial complex (four industries: doctors, drug and device makers, and medical insurance firms)" who "decided not to prepare for a serious virus problem," writes economist Richard Wolff in his latest book "The Sickness is the System."

Our only enduring remedy is radical change.

Don't Sit on the Sidelines of History. Join Alternet All Access and Go Ad-Free. Support Honest Journalism.