Our Culture of Coerced Infection

“You Do You”—unless you are trying to protect yourself from Covid

It’s a weekday evening and I am removing my N95 mask to have my temperature taken by the ER triage nurse at a local hospital. I know they can put the thermometer in my armpit—so that I don’t have to unmask—but instead I hold it under my tongue as she insists, because I am in far too much pain to advocate for myself in this moment. Also, I can barely speak; half my face is puffed up from a dangerously expanding abscess inside my mouth. It has nearly reached my right eye; I look either like I’ve been punched in the face or haven’t slept in a year—both would be an apt description of how I am feeling at that moment.

Over the next several hours, a handful of healthcare workers (HCWs) examine my face. Almost none of them are masked. A few nurses in the ER are masked, but are wearing surgical masks (rather than far more protective respirator masks)—and haphazardly at that. And so, even though the annual fall Covid wave is well under-way and, due to my autoimmune disease, I am at particularly high risk to contract Long Covid—an illness that has debilitated millions—I don’t ask that those in charge of my care (especially since I cannot be examined or treated while masking) to wear a mask. I know an unmasked ER doctor or nurse has clearly convinced themselves masking is pointless and I feel I can’t afford conflict or tension when I am approaching a life-threating situation (on the verge of developing a sepsis infection). In my worst pain, at my most vulnerable, I must play the role of the good (that is, compliant) patient lest I risk worse quality treatment.

Rewind to a little over a year ago. I suppose you could say I walked away, but really was forced out of my job/main source of income because the employers would not allow me to continue to teach university courses (as a contract instructor) online—despite medical documentation as I wrote about last year for The Globe and Mail. Part of the reason I stopped applying to teach courses (unless they were online: and few in my discipline are) was not just risk of infection but because I was not going to work in an environment of unmitigated disease spread as a contract employee without benefits, including medical leave. The exploitation for me stopped at my health and safety.

In other words, I found myself, that night in the ER, in a terribly (and terrible) ironic situation: years of vigilantly protecting my health and my loved ones and my community—including economic sacrifice—only to have no choice but to expose myself for hours to possible infection (spoiler: miraculously neither me nor my partner appear to have contracted Covid). I had no choice but to take this risk, other than, quite possibly, die. There was no individual risk calculation here nor was it a situation that the “you do you” individualistic and dangerous message of public health care, these last few years, could be applied. Rather it was a situation of coerced infection.

I imagine I could, to some, sound ungrateful for the care I received that probably saved my life. And that this care was largely paid for through Canada’s universal/single payer healthcare system (Canada’s recent government dental insurance plan—for low income residents—has partial and limited coverage). I feel grateful to an extent, and in another possible world—one where we were able, say, through a sterilizing vaccine, to actually end the pandemic (though the pandemic opened my eyes to how all viruses, airborne, as well as droplet carried, should have always been mitigated far better in hospitals) or a world where public health had not abandoned the most medical vulnerable to a debilitating forever pandemic—that gratitude would not be undermined by the grave injustice of the situation that Sick and disabled people like myself (in particular) face when seeking necessary medical care.

I know it’s unfashionable to blame individuals as a leftist, and actually this is not so much a case of pointing the finger at any individual HCW but a culture of dissonance, denialism, arrogance, and control in medicine. There appears to me to be a certain entitlement—to not consider the medically vulnerable—amongst those on the front lines of the worst days of the pandemic. And this, I believe, is because of the mass death and disease they witnessed then. And I have sympathy for how traumatizing that must have been. But being traumatized also leads one to either address that trauma or repress it. The vast majority of HCWs are clearly doing the latter. To repress their trauma involves not just acting as though Covid ostensibly did not exist (e.g. not masking) but to dismiss a masking patient as a hypochondriac or otherwise “mentally ill” (as though there is zero material basis, even among particularly medical vulnerable patients, for covid precautions). For otherwise, HCWs, are, at best, behaving with negligence and would have to reckon with that. This culture of repression leads to medical settings, given how disempowered patients are to protect themselves, being the place where coerced infection is perhaps most rampant.

Another site of powerful coerced infection is the workplace: certain labor conditions where masking is (illegally) disallowed or the culture of the workplace is such that it is unofficially disallowed. Yet another site of coerced infection is The Family—where pressure to act in accordance with the family norms is often internalized^[1] (including being “back to normal”/in denial of Covid’s harms).

And one faces in this culture explicit and implicit social pressure, among peers, friends, and colleagues, to act “normal”—as though the pandemic is over/Covid is ostensibly harmless—with the cost of refusal (foremost by masking—what former Biden-admin CDC director Rochelle Walensky called “the scarlet letter of the pandemic”) being isolation and alienation. This too is a kind of coercion though we might call it “soft-coercion.”

To put this all another way, coerced infection—the complete lack of mitigation and the normalization of mass and repeated infection of a debilitating virus—is ubiquitous throughout society. The culture and policy—or maybe better said political project—of coerced infection is crucial to the maintenance of late stage Capitalism. Once the Omicron virus in late 2021 demonstrated the significant limits of the vaccine-only strategy, our corporate-political class—which public health takes its cues from—shifted to a strategy of minimization of Covid towards erasure of the pandemic. To control an airborne virus as contagious as Covid would require seismic policies similar in scale to The New Deal (e.g. upgraded air filtration in virtually every building). Unlike the New Deal there is no left to fight for such changes because of eugenic-tendencies I have discussed in other posts and for reasons I worry I will spend the rest of my life trying and failing to understand.

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^[1] I do not have the space to take a deep dive on such family dynamics, but recommend R.D. Laing’s Massey Hall lectures on “The Politics of the Family” as offering insight into how the family unit coheres and operates, in part, through denial and gaslighting.