In 1895, Cyrus Edson, the New York City health commissioner, published an article titled The Microbe as a Social Leveller. Edson, echoing the language of 17th-century English communist Gerrard Winstanley, wrote that “the microbe of disease is no respecter of persons”. He explained that while impoverished people would be most at risk from disease, the rich would never be entirely safe from infection. For Edson, the “socialism of the microbe … is the chain of disease, which binds all the people of a community together”.

In moments of collective threat, a clear political choice emerges. Either the rich try and separate themselves from the poor and secure their own safety, or there is a recognition that we have a collective interest in working for the good of all. Edson’s point was that when it comes to infectious disease, only the latter course of action is rational.

A global pandemic

Covid-19 is a potentially fatal, highly contagious respiratory syndrome. The World Health Organisation has formally declared it a global pandemic owing to its rapid spread and the destabilising impact it is having on daily life, from cancelled public events to enforced quarantines. The coronavirus crisis continues to escalate, with South Africa now reporting confirmed infections.

Pandemics have a long history. But in a globalised economy, they spread at previously unimaginable velocities. As we have seen with SARS, avian and swine flu, viruses can move rapidly through networks of trade and travel. This is especially dangerous when, as with the coronavirus, scientists are still scrambling to find a vaccine.

For months, the world media has been showing eerie photos of deserted cities in quarantine. Anxiety and panic are escalating as medical organisations call for calm and urge people to adopt pragmatic measures to stop the spread of the virus, such as regular hand-washing.

But paranoid anti-Asian conspiracy theories are circulating, such as the belief that the virus already has a cure that the Chinese state is withholding. These pernicious rumours fuel racism and xenophobia, and lull people into a false sense of complacency about taking measures to prevent the disease from spreading.

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Unscrupulous airlines are offering cheap flights to countries with high infection rates. And the ultra-privileged are trying to insulate themselves from the epidemic, with reports of the super-rich fleeing to yachts and remote holiday homes.

The virus has also exposed the most cynical aspects of late capitalist culture. Pharmaceutical companies are hoping to make big profits off the pandemic. Right-wing political leaders have not responded in a rational manner. United States President Donald Trump has framed the pandemic in xenophobic terms and made the wildly irresponsible claim that “it will go away. Just stay calm. It will go away”.

Public health is a common good

A socially just response to Covid-19 means putting human lives first, from providing access to sanitary facilities and hospital care to governments ensuring that any vaccines or antivirals are kept cheap and readily available. If new medication takes the form of private property and is used to generate private profit, the poor will be hard hit. In China, it costs $6 (about R100) to test for the virus. In the US, the test costs $2 600 (about R42 800). The dangers of a medical system rooted in private profit are clear.

In South Africa, the outbreak poses a severe challenge to an already dysfunctional and systemically underfunded public health sector. A recent survey showed that only 46% of people living in South Africa have access to running water in their homes. In many shack settlements, hundreds of people share a single tap.

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The failure of the state to meet the urgent and basic needs of South Africans after a quarter of a century of democratic rule now places us all at serious risk, with impoverished people facing the most acute risk. This, along with the existing health crisis, which has left millions of people with compromised immune systems, could facilitate the rapid and wide spread of the virus.

The situation is urgent and reminds us that despite the inequalities that scar our society, our lives and futures are ultimately entwined. We have a shared interest in ensuring that everyone has access to decent municipal services and healthcare.

Economic crisis

The impact of the coronavirus around the globe intersects with an entrenched economic crisis. With the huge Chinese economy frozen and restrictions on international trade, many economists predict a global recession.

This has been looming since the financial crash of the late 2000s. Rather than enacting structural reforms to create inclusive economic growth and stability, governments responded with corporate bailouts, tax breaks for the uber-rich and austerity programmes. These, among other disastrous social costs, have degraded public health systems. Now, the microbial world is landing like a bomb on the political economy of global capitalism.

Covid-19 is not just a natural disaster. The threat it poses is facilitated by the highly unequal world that neoliberal capitalism has created. The destruction of environmental habitats, corporate farming, rapid urbanisation and weakened social safety nets create the conditions for viral outbreaks. The growing reality of global warming and ecological breakdown is a further petri dish for disease, creating the real possibility of ancient bacteria being released from melting ice.

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As political economist Grace Blakely writes, the coronavirus is exposing the ongoing stagnation of global economic systems. For a long time, the stock market has been booming on paper. The dominant neoliberal orthodoxy holds that if the market is flourishing, so will the rest of society. But in reality, wages and living standards have been dropping, and life is becoming more difficult and precarious for ordinary people. In a country as rich as the US, health has been worsening and life expectancy for the majority is dropping.

This pandemic could be a historic opportunity for governments to enact reforms to stimulate the economy, deal with urgent environmental threats and affirm healthcare as a public good rather than another arena for the manic pursuit of private profit. We need transparency, the democratic use of science and open communication with the public.

Unfortunately, with right-wing demagogues in power in many countries there is a real risk that the response will be informed by panic and take authoritarian forms, resulting in repression. The police and military tactics and technologies used to enforce quarantine today may well be used during protests and strikes in the near future. It is also likely that a globally emboldened far-right will use this crisis to whip up ethno-nationalism and anti-immigrant sentiment.

Health as a common good

Viral outbreaks are harrowing reminders of the fragility of human life. In popular culture, viruses are depicted as apocalyptic threats that overwhelm and destroy society, leaving desperate survivors to pick through the ruins of the old world.

The more prosaic reality is that plagues map on to existing social inequalities. While the poor and marginalised suffer the worst, the wealthier retreat to private healthcare and luxury bunkers. What is especially disturbing is that this latest outbreak comes during a terrifying global moment, when our existing systems are evidently incapable of addressing urgent socioeconomic and ecological crises. The ruling elite seem more focused on kleptocratic self-enrichment, hoping to wring the profits out of social collapse for as long as possible.

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But while illness and disease are a constant facet of human life, science is forever progressing. In most cases, including that of the current pandemic, we have the medical and technical capacities to reduce harm and treat people who are infected. The problem is a political and economic system that prioritises private profit over human lives and social wellbeing. Rather than making us safer or healthier, the for-profit health system is biologically unsustainable and focused more on rent-seeking than quickly and effectively responding to outbreaks.

The current model of expensive private healthcare and underfunded government hospitals is not adequate to face the viral risks and hazards of the contemporary world. Ultimately, it places everyone at risk, including those with access to private healthcare. This pandemic is an urgent reminder of why we need to fight for universal healthcare, to ensure that the power of contemporary medical technology is used for the benefit of all. The urgent imperative of the present, as we confront the “socialism of the microbe”, is to affirm community and to work together for the common good.