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Title: Survival is Resistance Author: CrimethInc. Date: 8th April 2020 Language: en Topics: health, COVID-19, interview, CrimethInc. Source: https://crimethinc.com/podcasts/the-ex-worker/episodes/76/transcript Notes: We compiled the following text from an interview we conducted with an emergency room nurse working on the front lines against COVID–19. Like many other healthcare workers across the country, they are unable to speak to the media directly for fear of losing their job, so we at the Ex-Worker collaborated with them to edit and narrate what you’re about to hear. We hope you’ll find it informative, both in its sobering assessments of the scope of what we’re facing medically and its nuanced approach to how anarchists can understand and respond to the situation we’re in.
I work as a nurse in the emergency room of a Level I Trauma Center in
the southwestern United States. We have not been hit hard by the
pandemic yet, but we are anticipating and preparing for that in the
weeks to come. Operational changes to our triage process have been made:
we are triaging patients in large tents outside, we have set up
dedicated COVID floors, and intensive care unit capacity is being
expanded. These things all happened later than they should have. We are
running out of tests and have a limited supply, so we’re only testing
healthcare workers who are sick, patients who are at high risk due to
their health history, and those in respiratory distress who require
hospitalization.
At first, my facility wasn’t implementing the necessary safety protocols
in response to patients who were coming in with some of the less common
early signs of COVID–19 (abdominal issues, jaundice, loss of taste and
smell). Because patients with these symptoms weren’t initially
identified as putting healthcare workers at risk when this all started
for us last month, we were all basically exposed before a more
regimented isolation policy was put in place. We are running low on
personal protective equipment (PPE). What kind of PPE we have access to,
and how we being told to use it, is changing daily. Right now I am
baking an N95 mask in my oven at 158 degrees Fahrenheit for 30 minutes,
in order to sterilize it for reuse. These are meant to be one-time use;
however, we are running low and I am preparing to no longer be given any
more protective equipment. As healthcare workers, we’re coming together
to do a hard job, in the way we always have. Morbidity, mortality and
trauma stewardship have always been a part of it. Really sick cases are
just beginning to show up in our ER. People who usually come into the
hospital with non-emergency issues are staying away; however, we are
getting a lot of patients from nursing homes, jails, and dialysis
clinics. These patients were already medically vulnerable and are very
ill when presenting. As the weeks pass, we are putting younger and
younger patients on ventilators. We have not run out of ventilators yet.
As nurses, we are being pressured to do more with fewer resources, and
there is no end in sight. I think it maybe seem easier for organizers in
other industries to propose things like strikes, but for healthcare
workers, it’s complicated. During previous nursing strikes the hospitals
have had the ability to pay travelers to fill in during strike days.
Even nurses out on strike want patients to have safe care while they are
away, most nursing strikes are not about money but about ratios, safe
working conditions and PPE supplies. Right now in a short staffed
environment getting enough travelers in to staff isn’t necessarily a
possibility. So while we are running out of PPE and going to work
involves risk to myself and my family, not going to work will also lead
to an increase in deaths. I think the thing that is yet to be determined
is if or when we will get to a point of system collapse and what that
will look like. When will my coworkers start getting ill and need to
stay home? When will they start to die? They have started to die in
other parts of the country; they have died in Spain, Italy and China.
When will people’s altruistic desire to stem this pandemic be
overwhelmed by their own utter exhaustion and moral crisis, or their
fear of their own death or the death of their loved ones? Total
healthcare system collapse can happen; it happened with during the ebola
epidemic in certain places, and it could happen with COVID–19. It seems
very likely that COVID–19 can be both airborne and transmitted through
droplets at this point. People can have very high viral loads before
becoming symptomatic. It is not just a disease of the old. Those over 65
are definitely more at risk, as well as those with comorbidities (i.e.,
other health problems) and people with suppressed immune systems.
However, teenagers and people in their 20s, 30s and 40s are being put on
ventilators. Some are dying. Your youth will not necessarily save you,
and even if you don’t die yourself, you may inadvertently infect someone
who does. Projections for my area predict that the healthcare system
will reach peak overload in late April to mid-May, if the only
collective effort to flatten the curve of infections we undertake is
social distancing. The difference in mortality between an approach of
just social distancing versus sheltering in place is stark: in my area,
the projected difference is over 100,000 deaths. That means that 100,000
lives could be saved if people STAY HOME over the next three months, and
only leave the house once a week for groceries, if possible. People need
to understand that healthcare is no great panacea. There are only about
100,000 ICU beds that can be safely staffed in the entire United States.
There are only two categories of people right now: healthcare workers
and other essential workers like grocers, and everyone else buying us
time… Testing capacity is not high. The US government turned down $17
World Health Organization testing kits in order to make their own more
expensive tests that did not initially work. Don’t get fixated on being
able to be tested; it’s a viral illness, so knowing for sure that you
have it won’t necessarily change what you should do to manage it. It
takes supportive care, lot of fluids, temperature management and so
forth. If you start showing symptoms like a fever and a dry cough,
assume that you have it and quarantine. Only go to the hospital if you
are in respiratory distress. If you do go to the hospital and they send
you home, GO BACK if you are having increased shortness of breath or
difficulty breathing. People who initially present with mild symptoms
may still need oxygen and respiratory support later in the course of
their illness. This is an illness that will touch all of our lives by
the time the pandemic ebbs. We all know someone who will die, we just
don’t know who yet. Despite the urgency we feel to do something to
support the most vulnerable right now, we need to be very careful and
thoughtful about how we participate. I am trying to get the anarchist
mutual aid collectives here to conceptualize themselves as potential
vectors between vulnerable populations that wouldn’t otherwise
cross-pollinate. We all have to consider ourselves as potential vectors.
Well-meaning anarchists might inadvertently infect house-less folks, IV
drug users, HIV-positive home meals recipients, undocumented families,
and elders on the reservation. Some of those are pretty distinct
populations that might not ordinarily overlap much. But the needle
exchange, food programs, home wellness visits, and childcare offered by
our friends could get everyone infected. I think our friends are smart
and they will mitigate risks, but I am worried about cleaning protocols
when supplies start running low. Whatever project you are putting your
time into just be sure you have functional protocols and you are holding
one another accountable to them. Please DO NOT accept well-meaning
frontline workers who want to show up physically in your projects right
now. As a hospital worker the LAST thing I should be doing on my days
off is interacting with high risk populations.
I think anarchists are tenacious, and have understood the limits of
capitalism and how to survive during moments of system collapse for a
long time. We’ve had experience preparing for social emergencies, and
this pandemic is providing opportunities to help others reframe the
social contract. We have a lot to offer! However, I think anarchists
need to be careful to not equate quarantine or lockdown with government
repression. Our natural inclinations to shirk authority may not serve us
in all cases. I think there is a tension between the need to follow a
reasonable public health approach, and the fact that this is being
implemented by local, state and federal government actors. We need to be
nuanced, pragmatic, and thoughtful about all of this. Take the advice
and assess what it means to you. Should we push the state to let our
friends out of detention facilities and jails? Hell, yes! Should we push
back about curfew, shelter in place orders and shutting down our daily
lives? NO, WE SHOULD NOT. We need to shelter in place.
I know that being advised to only see immediate family and your closest
monogamous partner just isn’t advice that works for our community. But
please try to follow some version of shelter in place and limit contacts
with others. Do not equate quarantine with government repression; this
time the state is trying to kill us by getting us to loosen our
isolation practices and go back to work or out into the world as
consumers too soon. For my part, I am working overtime and I have made
other living arrangements for those closest to me in my life. I am
seeing my kids once a week outside for a few hours and I am not touching
them. My life is very physically isolated right now, but I have friends
who have done way more time in solitary confinement than this, and it is
worth it to keep my community safe. I promise to keep going to work well
past the point of madness; just try to do your part and stay home. The
pandemic is showing everyone how desperately we need a fundamental
change in our approach to healthcare. This may not sound very radical,
but so long as the state exists, I do think that healthcare needs to be
a universal right, in order for us to survive to fight on for a better
world. I think the experience of the pandemic may be enough to finally
get a single payer healthcare system in place in the United States—one
of the only silver linings of this awful situation. A profit-driven
system cannot accommodate strategic long-term pandemic planning. I think
that we will finally see some change around this. Of course, it will be
too late for the hundreds of thousands who will die in this pandemic,
but it may save lives in the future. The last few weeks have taught
others what we as anarchists have already known for a long time: we
don’t have to live this way. We don’t need to kill ourselves working
full time to pay rent; our kids should have decent schooling and food on
the table; our employers should care if we have childcare; society
should give a shit if people can access healthcare. We don’t have to be
enslaved to the neoliberal death machine. Rent strike is real. People
are giving to others and of themselves in the unique way they do during
a pandemic. We can take care of each other, even after this is over. We
can check in on our neighbors, free people from prisons, do political
solidarity work. We can be more present with our family, live life at a
slower pace and pool resources. I hope, despite all the death that is to
come, that people hold onto the small but meaningful things we can do
for one another. Let’s act as though our individual survival depends on
the survival of all people in our communities. Let’s NOT conceptually
see ourselves as the other. Anarchists often tend towards
exceptionalism, identifying ourselves as outsiders in relation to
society. That isn’t going to work right now. You may get sick; you are
not immune. You may need assistance. We are all in this together. Thank
you for everything you’re doing. May we all survive this intact. More
than ever resistance is survival. Survival is resistance. Love and
health.