1. 19. 2023

What Happens if Long COVID Makes More & More People Too Sick to Work?

Daniel Sarah Karasik

The international business press
cites supply chain issues as a key cause of the inflation that today makes a block of butter sometimes cost eight dollars in Toronto. Yet relatively seldom do we hear much about the connection between those supply problems and the millions newly missing from the workforces on which supply chains depend.

Last January, a Brookings Institution study estimated that as many as 1.6 million American full-time equivalent workers may be out of work at any given time because of Long COVID, illness lasting longer than three months after COVID infection. The study accounted for the average time of recovery from the condition (among those who do recover; not everyone does) and the rate at which new cases develop. Another widely publicized Brookings report, published last August after multiple Omicron waves had swept the world, suggested Long COVID may be keeping out of the labour market as many as four million American full-time equivalent workers under the age of 65. A much more conservative estimate, from the National Bureau of Economic Research in September, still placed the US toll at a staggering 500,000 workers disabled following infection with COVID and off the job. Last spring, the Financial Times reported that 200,000 people in the UK had newly dropped out of the labour force during the pandemic for reasons of long-term ill health, and that a quarter of UK firms cited Long COVID as a top cause of extended staff absences. Statistics Canada reports that 10.5% of symptomatic confirmed or suspected SARS-CoV-2 cases contracted after December 2021, when Omicron began to predominate, developed into Long COVID – a lower proportion than in the pre-Omicron period (25.8%), though this decrease needs to be read in light of the vastly increased number of cases Omicron has caused.

Lockdowns in China and the war in Ukraine have doubtless played an important role in disrupting the global flow of goods. But perhaps more attention should be paid to the political economy of the local sick: our Long COVID-afflicted neighbours who, contributing to the near-record 959,600 job vacancies in Canada in 2021’s third quarter, have recently left their jobs, taking early retirement or relying on family or other care networks (if they’re lucky) because no longer able to work, or to work as many hours. Capitalist ruling classes normalized policies of mass infection with a new SARS virus in the name of saving the economy. But what if those policies meant, or may increasingly mean in the years to come, mass murder and self-sabotage all at once: the progressive decimation of the labour force that is the source of capitalist profit?


Capital producing its own gravediggers by many means

Central banks’ interest rate hikes, of which the past year has seen many, are not-so-secretly designed to increase unemployment and thereby discipline the working class. By spiking the cost of borrowing not only for individuals but also for businesses, those rate hikes cause firms to scale back investment, including hiring. Greater job scarcity, combined with a rising cost of living, erodes workers’ confidence and leverage, helping bosses get away with offering lousy pay and miserable workplace conditions. But what kind of wild card role might be played by the 20-25% of Long COVID sufferers who, according to large surveys conducted by state agencies in Canada, the US, and the UK, find their daily activities significantly limited by their chronic illness? What if a population pelted by wave upon unmitigated wave of SARS-CoV-2 is increasingly just too fucking sick to work?

Bosses can and often do coerce workers to show up sick, but workers too unwell to do the cognitive and physical tasks required will eventually need to limit their working hours or fall out of the workforce entirely. Though management is sure to try to compensate for these absences by intensifying work for those still employed, the experience of today’s vacancy-abundant labour market suggests such tactics may not avert supply chain problems and the inflation that in part results from them. Nor does states’ intensified reliance on temporary foreign workers appear to resolve those issues; the virus affects those workers’ bodies like any others. The capitalist normalization of the ongoing pandemic accelerates capitalism’s pre-2020 trajectory towards major crisis.

Of course we can’t know exactly how the pandemic will continue to play out. Maybe we’ll be lucky and the rate of debilitating Long COVID will drop, because of new COVID variants’ intrinsic properties or the population’s immune response to them. Maybe a majority of long-term sufferers will recover, at a rate faster than that at which the virus is causing new disability in others. Or maybe a big fraction of the population is simply not susceptible to Long COVID for genetic reasons; this is, after all, the tacit assumption governing many people’s behaviour today, the frequently raced and classed faith in one’s own biological superiority that the sentiment it won’t happen to me less or more consciously rests on.

But for argument’s sake, suppose we make the unsensational, not particularly doomer-ish assumption that current trends in COVID mortality and morbidity, including Long COVID’s approximate current incidence rate, might continue without major near-term changes. In this scenario, a significant number of people will be newly ejected from the labour market because of illness over the next decade. Even more than is already the case, bosses will coerce workers to work sick, and will seek to extract as much labour as possible from the diminished number of workers on their payrolls. Recessions triggered by central banks to combat inflation will destroy jobs, threatening to swell unemployment at the same time as capitalist public health policies (no ventilation upgrades in workplaces, no indoor N95 mask mandates) push in the opposite direction by shrinking the number of people healthy enough to be employed. Many workers still earning a wage will likely also have increased unpaid caregiving responsibilities; those made unable to work by sickness will depend – as now, but with that population’s numbers dramatically increased – on care from those able to provide it.

What might resistance look like in that context?


Binding hidden publics into fighting coalitions

There are so many vacant apartments in the city where I live, and in many big cities in North America. There’s no supply shortage of bread or many other food staples. The cop who now stands sentinel at my local supermarket guards a surplus, abundance, the profits of the few. A mass politics for an era in which masses of people become sicker than ever must break the link between labour power and deserving, an ideological trap coiled at the heart of the wage, perceptible whenever we talk about “earning” a living. Everyone deserves a comfortable home and enough to eat; everyone deserves pleasure and access to purposeful activity. The universality of that deserving means deserving isn’t even an especially relevant concept here. The idea that people should have what they need to live, and to live well, may draw some of its emotional charge from moral intuitions about goodness and justice, but fundamentally it’s a normative claim backed up by nothing more – though nothing less – than the existence of a “we” composed of those willing to fight for it.

The squatted apartment block, the Robin Hood of the billionaire-owned grocery store aisle – though individual or small collective interventions can prefigure a broader redistribution of hoarded goods, they’re often extremely vulnerable to violent repression by capital and the state. How might they scale and persist, lift more than individuals or small collectives out of desperate circumstances, and lastingly? What are the organizational mechanisms, and the foreseeable igniting sparks, of a mass politics for a time in which many more workers are likely to be thrown out of work by sickness than was the case before 2020? 

Perhaps we might expect wage struggles to become less decisive, relative to struggles centred on workers whom infirmity has expelled partially or totally from waged work. Fights for improved disability benefits, employment insurance, and paid sick leave – already vital – might activate more people than ever and escalate, along with efforts to win collective agreements that guarantee better protections in the event of long-term disability. Tenants’ organizing, fights for access to healthcare, and struggles led by comrades institutionalized by the state – in long-term care homes, asylums, prisons – might proliferate and become visible to more of the public.

The state does its best to hide those struggles and thereby limit their ideological impact. It buries institutionalized people’s suffering and resistance, for example, in the black boxes of the institutions themselves. Prisons are absolutely full of sick people – yet when the sick in prisons riot, few beyond prison walls hear about it, most of the time. What coalitions with other masses of desperate people can be built when both the suffering and the struggle against it are so successfully swept from view? Perhaps it’s that problem, the prisoner’s problem, that most convincingly makes the case for political representation: for some kind of organized force – potentially engaging electoral tactics, but by no means limited to them – whose role it is to bind those hidden publics into a more visible bloc and assert their will in places where they can’t be.

AIDS activism in its radical forms must continue to be a key inspiration, the ongoing work of groups such as ACT UP providing models of grassroots struggle in defence of public health and against state abandonment. Some Long COVID sufferers might attempt actions like disabled people’s famous 1977 occupation of the federal Department of Health, Education, and Welfare building in San Francisco, which lasted longer than three weeks and was supported, as Raia Small recounts in this magazine, by the Black Panther Party and elements of the labour movement – the kind of coalition that glints with revolutionary possibility. It’s also true that many of those afflicted with severe Long COVID may not have the physical capacity to undertake that sort of project. The party, the network, the union local or tenants’ association or neighbourhood committee that’s built a capacity to mobilize significant numbers of people in defence of its most vulnerable members: these kinds of political collectivity are important means of lifting up the demands of people who can’t bring their bodies to the demo.

There’s no direct substitute for masses of people in the streets, and those who can access those tactics should do so. But there’s also a pressing need to build new coalitions that foreground rather than sideline the swelling ranks of comrades who are sick and disabled and not in waged work, or barely so. For any left organization seeking to carve a just pathway out of the cost of living crisis, circumstances that have grown from the soil of the very much ongoing SARS-CoV-2 pandemic, there are few more urgent tasks today.

Daniel Sarah Karasik (they/them) is the managing editor of Midnight Sun and a member of the network Artists for Climate & Migrant Justice and Indigenous Sovereignty (ACMJIS). Their newest book is the poetry collection Plenitude.