Socialist Demands for the COVID-19 Crisis

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blindpig
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Re: Socialist Demands for the COVID-19 Crisis

Post by blindpig » Tue Mar 24, 2020 4:25 pm

These are some weighty suggestions. While I don't put nothing past the bosses, they are capable of and executing every sort of crime, I also have a great suspicion of Very Big & Evil Plans. LIHOP as opposed to MIHOP, as it were. There's no doubt that the relations of some categories don't look right and inadequate sampling will definitely skew the fatality rate. In Italy air pollution and the deteriorated condition of health care certainly factor. Taking those(and others which we may not yet recognise) factors into account makes sense.

But what of China? Their actions are not what one would expect from 'just another virus'. They have treated this very seriously indeed.Besides the general disruption of society they voluntarily took the economic hit(because they could, 'we' can't). Unless they are in cahoots with US capital I do not see how this works. Also, they are sending aid all over the place. If this is a dog&pony show it's way too elaborate for me to grasp, it would require NWO....

That US capital would take advantage of the situation is a no-brainer, of course they would, in every which way. That the government is giving it's free enterprise partners' free rein is par, just as Obama let BP shit all over the Gulf not so long ago. They will take all they can, see that we get as little as possible, this is to be expected, they got away with it once, why not? But I think it garden variety opportunism, which among capitalists passes as genius. As a bonus to the grand theft they look to be creating a new normal of social spacing and sociability, throwing shade on any and all things 'mass', which is how the tech has been herding us as is. How ya gonna have demos & strikes if people are reluctant to get together in the 'real'?
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chlamor
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Re: Socialist Demands for the COVID-19 Crisis

Post by chlamor » Wed Mar 25, 2020 3:03 am

Report shows up to 88% of Italy’s alleged Covid19 deaths could be misattributed

The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus […] On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,”

- Professor Walter Ricciardi, scientific adviser to Italy’s minister of health

Report in English:

https://www.epicentro.iss.it/coronaviru ... zo_eng.pdf

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Re: Socialist Demands for the COVID-19 Crisis

Post by chlamor » Wed Mar 25, 2020 3:25 am

In the Swiss Propaganda Research webpage, they offer a link to a twitter thread by a doctor working in Malaga, Spain. It is chilling reading, very illustrative of how the crisis has been created by the hype, the hysteria, the corruption and the malice of those who today proclaim to be all about saving lives. I translated a few of her tweets:

HOSPITAL JOURNAL. State of my hospital: absolute chaos, without guidelines, without means. The staff themselves do not know what to do – I do and a few others, because we go beyond the non-guidelines of the institutional fools. Staff is working automatically, without stopping to think.

[They are] leaving suits where we wash, which is outrageous. There are no tests of any kind, all patients with respiratory pathology, even if it is mild, are admitted, even if they do not have a fever. All mixed in rooms, some with possible flu, colds and coronavirus.

THERE IS NO EPIDEMIOLOGICAL CRITERIA for admission. Operating rooms are closed except one, for emergencies – if a serious multiple traffic accident arrives, IAM, Hemorrhages, and other emergencies, they will die.

In summary. A COLLAPSED HOSPITAL WITH 99% OF PEOPLE ADMITTED discharged.
Nothing is planned. Lost staff without understanding of what is happening.
I REPEAT: 99% DAILY ADMISSIONS [sent] TO THEIR HOMES.

That said, more die and will die from the collapse than from the damn virus.

There is no hecatomb beyond the sanitary collapse and the terror that the situation has produced.

After learning yesterday about the state of the hospitals in northern Italy, well before the “pandemic”, a pattern starts to emerge. These deaths are 100% attributable to austerity, neoliberalism, and the policies that have decimated all public services in Europe (While Madrid is collapsed the largest Hospital in the continent, 70km away never opened!). These deaths are 100% attributable to the same gang of politicians who today are destroying the few public services still standing, by forcing the people into house arrest and proudly proclaiming a de facto police state.

As the same doctor in Málaga says “education has exterminated science and supplanted it with ideological sophisms, building anomic and infantilized societies.” The thunderous applause of 90% of the population for the so called “lockdown” is a grim testament.

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Re: Socialist Demands for the COVID-19 Crisis

Post by blindpig » Wed Mar 25, 2020 11:15 am

chlamor wrote:
Wed Mar 25, 2020 3:03 am
Report shows up to 88% of Italy’s alleged Covid19 deaths could be misattributed

The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus […] On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,”

- Professor Walter Ricciardi, scientific adviser to Italy’s minister of health

Report in English:

https://www.epicentro.iss.it/coronaviru ... zo_eng.pdf
Parsing direct cause from previous conditions is tricky and I dunno if it's useful. For example, I got COPD, had it for years & will proly live with it a while longer. If I get #19 and croak it would be ridiculous not to give #19 the primary credit. #19 is the proximate cause.
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Re: Socialist Demands for the COVID-19 Crisis

Post by blindpig » Wed Mar 25, 2020 11:42 am

chlamor wrote:
Wed Mar 25, 2020 3:25 am
In the Swiss Propaganda Research webpage, they offer a link to a twitter thread by a doctor working in Malaga, Spain. It is chilling reading, very illustrative of how the crisis has been created by the hype, the hysteria, the corruption and the malice of those who today proclaim to be all about saving lives. I translated a few of her tweets:

HOSPITAL JOURNAL. State of my hospital: absolute chaos, without guidelines, without means. The staff themselves do not know what to do – I do and a few others, because we go beyond the non-guidelines of the institutional fools. Staff is working automatically, without stopping to think.

[They are] leaving suits where we wash, which is outrageous. There are no tests of any kind, all patients with respiratory pathology, even if it is mild, are admitted, even if they do not have a fever. All mixed in rooms, some with possible flu, colds and coronavirus.

THERE IS NO EPIDEMIOLOGICAL CRITERIA for admission. Operating rooms are closed except one, for emergencies – if a serious multiple traffic accident arrives, IAM, Hemorrhages, and other emergencies, they will die.

In summary. A COLLAPSED HOSPITAL WITH 99% OF PEOPLE ADMITTED discharged.
Nothing is planned. Lost staff without understanding of what is happening.
I REPEAT: 99% DAILY ADMISSIONS [sent] TO THEIR HOMES.

That said, more die and will die from the collapse than from the damn virus.

There is no hecatomb beyond the sanitary collapse and the terror that the situation has produced.

After learning yesterday about the state of the hospitals in northern Italy, well before the “pandemic”, a pattern starts to emerge. These deaths are 100% attributable to austerity, neoliberalism, and the policies that have decimated all public services in Europe (While Madrid is collapsed the largest Hospital in the continent, 70km away never opened!). These deaths are 100% attributable to the same gang of politicians who today are destroying the few public services still standing, by forcing the people into house arrest and proudly proclaiming a de facto police state.

As the same doctor in Málaga says “education has exterminated science and supplanted it with ideological sophisms, building anomic and infantilized societies.” The thunderous applause of 90% of the population for the so called “lockdown” is a grim testament.
Went for bloodwork yesterday, some staff wore masks, some wore gloves, some neither...

No doubt about wholesale opportunism. The 'collateral damage' of grossly inadequate capitalist 'healthcare' also is not in doubt, whether that mortality exceeds that of #19 is possible but an unknown. I think we can attack capitalism without dismissing this bug as a 'red herring'.

But is the 'Chinese experience' due to austerity & neoliberalism? Have they been lying the whole time?

Small matter, Victory will be declared in 2 weeks in time for the Hallelujah choir, the cash will be in the bank(s), the juggernaut of capital will gear back up crushing all before it and mebbe as a bonus they'll 'save' Social Security by trimming the roles a bit.
"There is great chaos under heaven; the situation is excellent."

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Re: Socialist Demands for the COVID-19 Crisis

Post by blindpig » Thu Mar 26, 2020 1:03 pm

The Expert's Crisis

26 MARCH, 2020 · NEWS> GLOBAL SITUATION

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FERNANDO SIMON, THE "PET" EXPERT ON COVID OF THE SPANISH GOVERNMENT.

Spanish trade unions claim that they have to consult “the experts” before taking a position on the closure of non-essential companies. But who are “the experts”? Why are governments now turning to them? Why is there so much mistrust of them?


If we remember well, the “experts’ crisis” began during the Brexit referendum. The “remainer” campaign used all kinds of reports from institutions, university groups and organizations to predict the greatest evil should Britain leave the EU. An apocalyptic report from the Bank of England had just been made public when one of the spokesmen for “brexiter” conservatism, Michael Gove, claimed something that would be passed on to posterity:

The people of this country have had enough of experts from organisations with acronyms saying they know what is best and getting it consistently wrong.

Since then, the discredit of experts among the population has been one of the favorite topics of the “big media” in their attempt to demonstrate that “populism” is pure irrationalism. Several people pointed out at the beginning of this crisis that one of the few positive things it was bringing about was “the return of the experts”. But have we already forgotten what role they played in the stages that turned the epidemic into what it is today?

“The experts” and the spread of the disease

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PEDRO SÁNCHEZ CHAIRS THE FOLLOW-UP MEETING ON THE COVID-19 EPIDEMIC, WITH MINISTER SALVADOR ILLA AND FERNANDO SIMÓN, DIRECTOR OF THE HEALTH ALERT CENTER, AN “EXPERT” THAT THE GOVERNMENT HAS USED AS A “NEUTRAL” SPOKESMAN.

Johnson’s first strategy towards the coronavirus basically consisted in leaving the population to its own devices . And while the Prime Minister lamented that “many families will lose their loved ones”, “renowned experts” in British epidemiology came out to say that the best thing to do was to seek “herd immunity” based on mass contagion . Of course, there also were epidemiologists who denounced that little act as a farce. It was actually the beginning of a tragedy. But was it different in the rest of the world?

Not really, ranging from Chile, which up until today did not decree confinement to Japan, countries were reaching critical masses of community contagion and yet experts kept saying what governments wanted to hear: that we had to maintain “serenity” and keep going to work.

Remember Spain? We even had a congress of “experts” whose public results were headlines as biased as «“The seasonal flu has more incidence and mortality than the coronavirus” (incidence part true yet irrelevant, mortality one misleading) or «. Never had so many virologists been so concerned about this «“scaremongering that makes the Wuhan pneunomia worse than it is”. But let’s be honest, “scaremongering” affects governments and in the context of an epidemic it affects production and therefore the profitability of capital, while viruses affect all those people and families, mostly retirees and working families, who are now dying in field beds. Under state capitalismthe first group is what defines a successful political-academic career, the second is not.

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MADRID, MARCH 8TH: «THE ONLY DANGEROUS VIRUS IS YOUR MALE CHOVINISM», SAYS THE TEXT.

The “experts” performed so well that, Simón, the greatest expert of the kingdom, on the 7th of March and asked by the journalists what he recommended about the celebration of the following day, he answered : “If my son asks me if he can go, I will tell him to do what he wants”. The reality is that the figures of contagion in Madrid and Euskadi had been advising total confinement for days. But the priorities were different:

The March 8 demonstration has become an official liturgy in Spain, a way of implementing a new state ideology to which Sánchez’s “feminist government” is particularly committed. Last week it became obvious that the government’s so-called “containment phase” no longer contained anything, but they prioritized the demonstration over safety. The Health Minister urged the sick (!!) not to go to the demonstration. And the public television headlined the news with a triumphalist and ridiculous “Feminism resists the Coronavirus on the streets“, as if gathering masses of people in the middle of an airborne virus epidemic was nothing but recklessness.

The state, with the government at its head, set its priorities as expected in the face of the epidemic: “tranquility”, that is to say, in the first place giving media prominence to feminism and its pitiful petty fights imported from Yankee university debates, and once the state ritual was completed, keeping the productive apparatus up and running at all costs by minimizing losses, if necessary by increasing the budget and increasing the very deficit normally invoked to cut health spending.

“Coronavirus: lies and half-truths ” 10/3/2020

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MEXICO: «CORONAVIRUS IS NOT AN EMERGENCY» SAYS THE POSTER DISTRIBUTED BY THE GOVERNMENT.

And we could go on country by country. Even in the last ones where the epidemic has arrived, like Argentina, there has been no lack of reassuring experts. Even in Mexico, an obvious candidate for health system overload, there were television experts to support AMLO’s show with his “detente-virus” good luck charms purportedly devisind “strategies” where there was only neglect.

What does the “crisis of the experts” mean?

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NEW YORK GOVERNOR CUOMO PRESENTS LIVES AND INVESTMENTS AS OPPOSED ON A SCALE.

The recourse to the expert is a self-vindication of the bourgeoisie as a ruling class. It is a way to reinforce in moments of crisis that only the bourgeoisie holds social knowledge and that it uses it for the benefit of all. Of all the branches of knowledge, it was surely the birth of Epidemiology which expressed most clearly the moment in which the bourgeoisie was capable of thinking the social as something that aligned with its own interests as the ruling class of society.

But just as with Economic Theory and its experts, social knowledge and the needs of capital diverge because human needs and capital accumulation are increasingly antagonistic. The “expert” then becomes a stuntman whose task is to justify policies and to reassure the population. The discourse can only fall in a situation where the class that runs society declares, at best, that its objective is to seek a “balance” when faced with the alternative between saving lives and investments. In practice, the bourgeoisie shows that its priority was, is and will be to maintain economic activity as much as possible, even to keep political ceremonies running… and only later, to stop the spread to avoid the hospital collapse and mass deaths that are already being experienced in Italy or Spain.

http://communia.blog/the-experts-crisis/
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Re: Socialist Demands for the COVID-19 Crisis

Post by chlamor » Thu Mar 26, 2020 4:26 pm

Hey bp- hope you are well. From what I have been reading for yourself high doses of Vit. C, Vit D and Zinc are all important as a preventive.

Want to be clear that I'm not suggesting that #19 is a red herring. I tend to post things in such a situation as this in a "scattershot" manner and then go over them later in trying to understand this.

I do think it is important to separate things out- for example hospitals being overrun "as a result of #19" versus "as a result of austerity measures." Another bigger and more important example to my mind is what we might call those dying from #19 versus those dying with #19. There are a lot of big questions out there specific to the disease and mortality that it seems we will not know until a few months or even a year after the fact.

I would also say there is a possibility that you and I differ on how we view disease overall (maybe-maybe not?) as I see something like COVID (or each year's flu virus or cholera or...) as much as symptoms as they are a disease. I think we agree on what the disease is. How I view it in part is if everything is blamed on a "killer virus" each year, rather than the global mode of production that creates the environment in which viruses can flourish, then the actual culprit, the capitalist mode of production, is let off the hook and the robber barons get to keep soaking up the profits while destroying the planet.

Well anyway as an "interesting if you look back to 2007 the WHO changed it's definition of what qualifies as a pandemic. That needs to considered in the context of the WHO changing it's funding mechanisms in 2005- meaning they went from a member states funded entity to a "private/public" partnership. As you might imagine the pharmaceuticals became primary donors and began to influence and now control policy decisions that come down from the WHO. When a "global pandemic" is officially declared certain powers now become "legal" for governments. Now I will say that "they do what they want anyways."

Oh, and those opportunities for further profits and bailouts....

In any case take care of yourself my friend.

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Re: Socialist Demands for the COVID-19 Crisis

Post by blindpig » Thu Mar 26, 2020 6:31 pm

chlamor wrote:
Thu Mar 26, 2020 4:26 pm
Hey bp- hope you are well. From what I have been reading for yourself high doses of Vit. C, Vit D and Zinc are all important as a preventive.

Want to be clear that I'm not suggesting that #19 is a red herring. I tend to post things in such a situation as this in a "scattershot" manner and then go over them later in trying to understand this.

I do think it is important to separate things out- for example hospitals being overrun "as a result of #19" versus "as a result of austerity measures." Another bigger and more important example to my mind is what we might call those dying from #19 versus those dying with #19. There are a lot of big questions out there specific to the disease and mortality that it seems we will not know until a few months or even a year after the fact.

I would also say there is a possibility that you and I differ on how we view disease overall (maybe-maybe not?) as I see something like COVID (or each year's flu virus or cholera or...) as much as symptoms as they are a disease. I think we agree on what the disease is. How I view it in part is if everything is blamed on a "killer virus" each year, rather than the global mode of production that creates the environment in which viruses can flourish, then the actual culprit, the capitalist mode of production, is let off the hook and the robber barons get to keep soaking up the profits while destroying the planet.

Well anyway as an "interesting if you look back to 2007 the WHO changed it's definition of what qualifies as a pandemic. That needs to considered in the context of the WHO changing it's funding mechanisms in 2005- meaning they went from a member states funded entity to a "private/public" partnership. As you might imagine the pharmaceuticals became primary donors and began to influence and now control policy decisions that come down from the WHO. When a "global pandemic" is officially declared certain powers now become "legal" for governments. Now I will say that "they do what they want anyways."

Oh, and those opportunities for further profits and bailouts....

In any case take care of yourself my friend.
Fine as i'm gonna get, you and yours the same I hope. Ain't so bad down here yet but suspect it will spike

I know your style.) Quite correct as to conditions increasing likelihood of spread and lethality. My responses conditioned by life on Twitter, where every outrage is presented as an anomaly sans context, a fine nesting site for reformism. Every 'conspiracy' should be presented as an aspect of business-as-usual capitalism. My pleas for said context generally ignored or my intent questioned.

The Avatar of the Ruling Class has hinted, and some of his minions clearly enunciated, profits cannot be sacrificed to keep some old farts vertical, 'cause we cost a lot and don't produce nuthin'. The Dems of course will make that partisan even as they quietly agree. We should take issue with their duplicity in the most medieval fashion. When is it not a class issue?

Didn't know that about WHO but have considered the UN capital's tool for a good while. Never liked the Who anyways, they fucked up 'Summertime Blues'.
"There is great chaos under heaven; the situation is excellent."

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Re: Socialist Demands for the COVID-19 Crisis

Post by blindpig » Fri Mar 27, 2020 1:59 pm

Dozens of communist and workers' parties require urgent measures to protect the health and rights of peoples

Image

66 Communist and Workers Parties from around the world have signed a Joint Statement on the situation in the world caused by the pandemic of the new coronavirus. In a joint statement initiated by the Communist Party of Greece, the Communist parties, firstly, declare their support for doctors and nurses, as well as those who have become infected with this disease, and secondly, condemn the huge shortcomings of the public health system that are the result of an anti-people policy on commercialization and privatization of health care to support the profitability of monopolistic groups held by large-capital governments.

They emphasize that this situation shows the antisocial nature of capitalism, as well as the relevance and superiority of socialist society. Communist and workers' parties demand that all necessary measures be taken to combat the epidemic, by supporting and strengthening public health systems.

The following is the full text of the Joint Statement, as well as the signatures of the parties:




Communist and workers parties

Emergency measures to protect the health of the people and the rights of workers
We Communist and Workers Parties with a sense of responsibility towards our peoples declare that we are here, at the forefront of the struggle to take immediate measures to protect the health and rights of the working class and the people’s strata, we are everywhere!

We express our sincere gratitude to the doctors and nurses, the staff of hospitals, medical institutions who are struggling with this big problem.

We express our solidarity with those who suffered from the CoVID-19 pandemic and wish them a speedy recovery from this disease.

We welcome countries that are developing solidarity with countries most affected by coronavirus, such as sending defenses and medical professionals from countries such as China, Cuba and Russia, actions that counterbalance the inaction of the European Union.

The dangers of the CoVID-19 pandemic demonstrate the tragic and profound health system deficiencies in all capitalist countries that were known before the advent of coronavirus. These flaws did not arise by chance; they are the result of anti-people’s policies pursued by large-capital governments to commercialize and privatize the healthcare system, and to support the profitability of monopolistic associations. This policy negates the enormous scientific and technical potential available today to cover all the needs of the people for prevention and care.

Today's experience reveals the antisocial and parasitic nature of capitalism and demonstrates the superiority and relevance of socialism and centralized scientific planning, the criterion of which is people's needs, which can provide primary medical care and prevention, hospitals, medical and paramedical personnel, medicines, laboratories, laboratory research and all what is necessary to meet the constant and urgent needs of the people in the field of health.

The pre-existing slowdown in global economic growth continues today due to the spread of coronavirus, and this increases the risk of a new crisis in the coming period. Despite the call of unanimity among governments in the service of big capital, they are providing financial support to monopolistic associations and are once again striving to shift the burden of the crisis onto workers and other people. Workers and peoples cannot and should not pay further!

“Individual responsibility” cannot be used as an excuse to ignore the responsibility of the state and government. Today, the adoption of the necessary measures requires the struggle of peoples against a policy of supporting monopolistic groups, placing the needs and health of peoples on the altar of capitalist profit.

Communist and workers parties require the immediate adoption of all necessary measures to combat the epidemic, including the following:

Immediate state funding of public health systems, the appointment of permanent doctors and nurses, who will have a full set of rights. Meeting all needs in intensive care units and intensive care units (ICU) and providing the infrastructure necessary for the full functioning of public health services and research.
Immediate free issuance by the state of the population of all necessary means of prevention and protection (masks, gloves, antiseptics, etc.) and the fight against speculation. Immediate provision of protective measures for all medical personnel who risk their lives and health by fighting coronavirus in hospitals.
Protecting the income and rights of workers. To stop the arbitrariness of capital, which, under the pretext of the CoVID-19 epidemic, is carrying out mass layoffs and is trying to violate the rights to wages, working hours, leave and other rights of workers. Take immediate measures to protect workers in the workplace.
· No - infringement of the democratic rights of peoples under the pretext of a coronavirus.
To abolish all sanctions and measures of economic isolation, which in this situation are even more unfair and criminal and complicate the lives of the peoples of the countries against which they are directed, take all necessary measures to protect the health and lives of peoples.
We say no to imperialist interventions and military exercises, such as those carried out by NATO, and demand that government resources be redirected to the needs of peoples, i.e. to finance health systems and social security


Communist Party of Albania
Communist Party of Argentina
Communist Party of Armenia
Communist Party of Australia
Party of labor of austria
Communist Party of Azerbaidjan
Communist Party of Bangladesh
Communist Party of Belgium
Brazilian Communist Party
Communist Party of Britain
New communist party of britain
Union of Communists in Bulgaria
Party of the Bulgarian Communists
Communist Party of Canada
Communist Party of Chile
Socialist Workers Party of Croatia
AKEL, Cyprus
Communist Party of Bohemia & Moravia
Communist Party in Denmark
Egyptian Communist Party
Communist Party of Finland
Pole of the communist revival in france
Unified Communist Party of Georgia
German communist party
Communist Party of Greece
Hungarian workers party
Communist party of india
Communist Party of India (Marxist)
Tudeh Party of Iran
Workers Party of Ireland
Communist party of ireland
Communist Party of Israel
Communist Party (Italy)
Jordanian Communist Party
Socialist Movement of Kazakhstan
Workers Party of Korea
Lebanese Communist Party
Socialist Party (Lithuania)
Communist Party of Malta
Communist Party of Mexico
Popular Socialist Party - National Political Association, Mexico
Nepal Communist Party
Communist Party of Norway
New Communist Party of the Netherlands
Communist Party of Pakistan
Palestinian People's Party
Palestinian Communist Party
Paraguayan Communist Party
Communist Party of Poland
Portuguese Communist Party
Philippines Communist Party [PKP 1930]
Romanian Socialist Party
Communist Party of the Russian Federation
Russian Communist Workers Party
Communist Party of the Soviet Union
New Communist Party of Yugoslavia
Communists of serbia
Communist Party of the Workers of Spain
Communists of catalonia
Communist Party of Swaziland
Communist party of sweden
Syrian communist party
Communist Party of Turkey
Communist Party of Ukraine
Union of Communists of Ukraine
Communist Party of Venezuela

https://inter.kke.gr/ru/articles/--01253/

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"There is great chaos under heaven; the situation is excellent."

chlamor
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Re: Socialist Demands for the COVID-19 Crisis

Post by chlamor » Fri Mar 27, 2020 2:51 pm

Covid-19 — Navigating the Uncharted
List of authors.
Anthony S. Fauci, M.D., H. Clifford Lane, M.D., and Robert R. Redfield, M.D.

The latest threat to global health is the ongoing outbreak of the respiratory disease that was recently given the name Coronavirus Disease 2019 (Covid-19). Covid-19 was recognized in December 2019.1 It was rapidly shown to be caused by a novel coronavirus that is structurally related to the virus that causes severe acute respiratory syndrome (SARS). As in two preceding instances of emergence of coronavirus disease in the past 18 years2 — SARS (2002 and 2003) and Middle East respiratory syndrome (MERS) (2012 to the present) — the Covid-19 outbreak has posed critical challenges for the public health, research, and medical communities.

In their Journal article, Li and colleagues3 provide a detailed clinical and epidemiologic description of the first 425 cases reported in the epicenter of the outbreak: the city of Wuhan in Hubei province, China. Although this information is critical in informing the appropriate response to this outbreak, as the authors point out, the study faces the limitation associated with reporting in real time the evolution of an emerging pathogen in its earliest stages. Nonetheless, a degree of clarity is emerging from this report. The median age of the patients was 59 years, with higher morbidity and mortality among the elderly and among those with coexisting conditions (similar to the situation with influenza); 56% of the patients were male. Of note, there were no cases in children younger than 15 years of age. Either children are less likely to become infected, which would have important epidemiologic implications, or their symptoms were so mild that their infection escaped detection, which has implications for the size of the denominator of total community infections.

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On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%.4 In another article in the Journal, Guan et al.5 report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.2

The efficiency of transmission for any respiratory virus has important implications for containment and mitigation strategies. The current study indicates an estimated basic reproduction number (R0) of 2.2, which means that, on average, each infected person spreads the infection to an additional two persons. As the authors note, until this number falls below 1.0, it is likely that the outbreak will continue to spread. Recent reports of high titers of virus in the oropharynx early in the course of disease arouse concern about increased infectivity during the period of minimal symptoms.6,7

China, the United States, and several other countries have instituted temporary restrictions on travel with an eye toward slowing the spread of this new disease within China and throughout the rest of the world. The United States has seen a dramatic reduction in the number of travelers from China, especially from Hubei province. At least on a temporary basis, such restrictions may have helped slow the spread of the virus: whereas 78,191 laboratory-confirmed cases had been identified in China as of February 26, 2020, a total of 2918 cases had been confirmed in 37 other countries or territories.4 As of February 26, 2020, there had been 14 cases detected in the United States involving travel to China or close contacts with travelers, 3 cases among U.S. citizens repatriated from China, and 42 cases among U.S. passengers repatriated from a cruise ship where the infection had spread.8 However, given the efficiency of transmission as indicated in the current report, we should be prepared for Covid-19 to gain a foothold throughout the world, including in the United States. Community spread in the United States could require a shift from containment to mitigation strategies such as social distancing in order to reduce transmission. Such strategies could include isolating ill persons (including voluntary isolation at home), school closures, and telecommuting where possible.9

A robust research effort is currently under way to develop a vaccine against Covid-19.10 We anticipate that the first candidates will enter phase 1 trials by early spring. Therapy currently consists of supportive care while a variety of investigational approaches are being explored.11 Among these are the antiviral medication lopinavir–ritonavir, interferon-1β, the RNA polymerase inhibitor remdesivir, chloroquine, and a variety of traditional Chinese medicine products.11 Once available, intravenous hyperimmune globulin from recovered persons and monoclonal antibodies may be attractive candidates to study in early intervention. Critical to moving the field forward, even in the context of an outbreak, is ensuring that investigational products are evaluated in scientifically and ethically sound studies.12

Every outbreak provides an opportunity to gain important information, some of which is associated with a limited window of opportunity. For example, Li et al. report a mean interval of 9.1 to 12.5 days between the onset of illness and hospitalization. This finding of a delay in the progression to serious disease may be telling us something important about the pathogenesis of this new virus and may provide a unique window of opportunity for intervention. Achieving a better understanding of the pathogenesis of this disease will be invaluable in navigating our responses in this uncharted arena. Furthermore, genomic studies could delineate host factors that predispose persons to acquisition of infection and disease progression.

The Covid-19 outbreak is a stark reminder of the ongoing challenge of emerging and reemerging infectious pathogens and the need for constant surveillance, prompt diagnosis, and robust research to understand the basic biology of new organisms and our susceptibilities to them, as well as to develop effective countermeasures.

https://www.nejm.org/doi/full/10.1056/NEJMe2002387

"The flu has a mortality rate of 0.1 percent. This (COVID-19) has a mortality rate of 10 times that. That's the reason I want to emphasize we have to stay ahead of the game in preventing this."

- Anthony Faucci, Congressional Hearing 3/11/20

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