In her 2017 work "Pale Rider" ("La Grande Tueuse" in French), the science journalist Laura Spinney shows how the international context and functioning of society in 1918 decisively contributed to the outcome of what was called the "Spanish Flu": "Basically, what Spanish Flu teaches us is that another influenza pandemic is inevitable but its net result - whether it is 10 million victims or a 100 million victims - only depends upon the world in which it is produced". As the planet has confronted Covid-19 for many months, this lesson leads us to ask what this pandemic teaches us about the world in which we are living. The link between the development of an infection on one hand, and the organisation and state of society on the other, doesn't only concern the Spanish Flu outbreak of 1918-20. Marxism has already effectively discovered that, in general, the mode of production of any time conditions all social organisation and, by extension, everything regarding the individuals of that society.
From the plague of the Roman Empire to Covid-19
In the period of the decline of the Western Roman Empire, conditions of life and the expansionist policy of the Empire allowed the bacilli (a class of bacteria) of the plague to spread like wildfire, bringing about a hecatomb among the population: "... public baths became Petri dishes: sewage stagnated and decomposed under towns and villages; granaries of corn were a blessing for rats; the commercial routes that linked the Empire facilitated the propagation of epidemics from the Caspian Sea to Hadrian's Wall with an efficacy unknown until then".
The Black Death, which hit Fourteenth Century Europe, found its conditions for expansion both in the development of commerce with Asia, Russia and the Middle East and also in the development of war, particularly linked to the Islamification of the Asiatic regions.
These two pandemic episodes figured hugely in the decline of slave and medieval societies by wiping-out important parts of society and greatly disorganising it. It's not the sickness in itself which engenders the fall of a system of production but, above everything, the decadence of these systems which have favoured the expansion of infectious agents. The Justinian Plague and the Black Death contributed to, and doubtless strongly accelerated, the destructive forces already well under way.
Since the beginnings of capitalism, sicknesses have been a permanent fetter on the good functioning of production by hampering the labour power which is indispensable to the creation of value. It has also hobbled imperialist undertakings by weakening the soldiers mobilised on the battlefield.
When the Spanish Flu virus began to infect the human species, the world of capitalism needed, more than ever, a human workforce at the highest levels of capacity. However, this need was linked to the conditions that themselves were the soil of a pandemic which killed between 50 and 100 million human beings; between 2.5 and 5% of the world population. The world of the Spanish Flu was a world at war. Beginning four years earlier and on the point of winding up, the First World War had already fashioned a new world, that of capitalist decadence, endless economic crises and constantly growing imperialist tensions.
But the war wasn't finished. Troops remained massed on the front as at the rear, creating the conditions favourable to the contagion. The transportation of soldiers from America to Europe in particular was made by boat in deplorable conditions: the virus spread greatly here and of course, when they disembarked they carried the virus with them and contaminated the local populations. With the war finished, the demobilisation and the return home of the soldiers constituted a powerful vector of the development of the epidemic, and much more so as the troops had been weakened, malnourished and with the least medical care during four years of war. When one talks of the Spanish Flu one necessarily thinks of the war, but the latter was not the sole factor explaining the expansion of the sickness; far from it. The world of 1918 was a world where capitalism had already imposed its mode of production throughout; where its interests pushed it outwards and where it had put in place conditions of terrible exploitation. It was a world where workers were regrouped, heaped together close to factories in areas that were filthy and lacking proper food, with sanitary services largely non-existent. If workers became sick they were sent back home to their village where they ended up contaminating the majority of the inhabitants. It was a world of miners confined all day underground hacking rock in order to extract coal, gold or other minerals which often produced chemicals that destroyed their organs and weakened their immune systems; at night workers and their families slept in extremely cramped conditions. It was also the world of the war effort, where sickness didn't prevent the workers from going to work and thus contaminating fellow workers.
More generally, the world of Spanish Flu was also a world where knowledge of the origins of sicknesses and the vectors of contagion were largely unknown. The theory of germs, which put forward the concept of infectious agents external to the organism suffering the sickness, had hardly been born. If some microbes had begun to be observed, the existence of a virus was only posed as a hypothesis by some exceptional scientists: twenty times smaller than a bacterium, a virus wasn't observable by the optical microscopes of the time. Medicine then was still undeveloped and inaccessible to the great majority of the population. Traditional remedies and all types of beliefs largely dominated the fight against the unknown malady which was often terrifying and overwhelming.
The breadth of the human disaster brought on by the Spanish Flu pandemic should have made it the last great health catastrophe of humanity. The lessons that could be drawn from it, the subsequent research on infections, the unequalled development of technology since the beginnings of capitalism, could lead one to think that humanity would be able to win the battle against disease.
Health policies of the state are at the service of capitalist exploitation
The ruling class has understood the dangers that health issues represent for its system. Within this understanding there is no human or progressive dimension but only a will to do what it can so that the workforce is affected as little as possible, so that it remains as productive and profitable as possible. This concern of the bourgeoisie already appeared in capitalism's ascendency after the cholera pandemic in Europe in the years 1803 and 1840. The development of capitalism was accompanied by an intensification of international exchanges and, at the same time, the comprehension that pathogens didn't stop at capitalist frontiers. The bourgeoisie thus began to put in place a multilateral health policy with the first international conventions from 1850, and above all the creation of the International Office of Public Hygiene (IOPH) in 1907. At the time the aim of the bourgeoisie was crystal clear: these measures were essentially centred on the safeguarding of the industrial countries along with the protection of their indispensable commerce and economic growth. The IOPH was composed of only 13 members. After the war, the League of Nations created a committee of hygiene whose vocation was already more international (its actions concerned around 70% of the planet) with its programme openly aiming to ensure that all the cogs of the capitalist machine functioned optimally with the promotion of health policies. After the Second World War a more systematic approach to health appeared with the creation of the World Health Organisation (WHO) and, above all, with a programme for the amelioration of health standards aiming not only at member states but the whole world population. Provided with the necessary means the WHO organised and financed its operations around many illnesses with a strong accent placed on prevention and research.
Here again, one shouldn't look for a sudden outbreak of humanitarianism from the dominant class. But in the world of the Cold War, health measures were seen as a means of ensuring, right from the end of the 1939-45 war, the possibility of getting the most productive and numerous workforce up and running, particularly during the period of reconstruction and subsequently to conserve a presence in and a domination over the developing countries and their populations: prevention was seen as a less costly solution than looking after people in hospital.
At the same time research and medicines were being developed, allowing a better understanding of infectious agents, how they functioned and the means to combat them, particularly with antibiotics which produced a cure for a growing number of illnesses of bacteriological origin, along with the development of vaccines. This to such a point that in the 1970's, the bourgeoisie had begun to think that the battle was won and that numerous infectious illnesses belonged to a distant past: the development of vaccination and notably that of children, the access to a better health system led to infant sicknesses like measles and mumps becoming rare; smallpox was virtually eradicated, as was poliomyelitis over most of the globe. Capital could perhaps now rely on a work-force that was invulnerable, readily available and fully exploitable.
AIDS, SARS, Ebola... indications of a retreat in capitalist mastery of the laws of nature
The anarchic development of capitalism in its decadent phase beginning at the opening of the Twentieth Century generated a strong demographic transition, an accrued destruction of the environment (notably de-forestation), an intensification of displaced persons, an uncontrolled urbanisation, political instabilities and climatic changes which are also factors favouring the emergence and diffusion of infectious sicknesses. Thus at the end of the 1970's there appeared a new virus among the human species whose pandemic origins are still with us today: AIDS. The hopes of the bourgeoisie were extinguished as soon as they were lit, because, at the same time, the capitalist system entered into the ultimate phase of its existence, that of its decomposition. It is not in the remit of this article to develop on the origins and consequences of the decomposition of capitalism but we can note that the most striking manifestations of this decomposition very rapidly affected health issues: each for themselves, short-term vision and a progressive loss of control by the bourgeoisie over its system, and all this in the context of a still-more profound economic crisis that is becoming more and more difficult for the ruling class to fight against.
Today the Covid-19 pandemic is an exemplary manifestation of capitalist decomposition. It is the result of the growing incapacity of the ruling class to manage a question that it itself raised in principle with the creation of the WHO in 1947: to get populations to the highest levels of health possible. One hundred years after the Spanish Flu, scientific knowledge about diseases, their origins, their infectious agents and viruses have developed to an absolutely incomparable level. Today, the genetic code allows the identification of viruses, the following of their mutations and the development of more efficient vaccines. Medicine has made immense progress and has imposed itself more and more over traditions and religion. It has also taken a very important preventative dimension.
However, it’s the impotence of states and panic in front of the unknown which has dominated proceedings faced with the Covid-19 pandemic. Whereas a century ago humanity reached out to progressively master the laws of nature, we now find ourselves in a situation where this is less and less the case.
Covid-19 is in fact far from a bolt appearing out of a clear blue sky: We've had HIV of course, which pointed to new pandemics still to come. But since there have also been SARS, MERS (Middle-East Respiratory Syndrome), Swine Flu, Zika, Ebola, Chikungunya (like Zika spread by mosquitoes), BSE, etc. Some maladies which have disappeared or almost disappeared, such as tuberculosis, measles, rubella, scurvy, syphilis or scabies are, along with poliomyelitis, making a comeback. All these warnings should have led to research and preventative actions; this was not at all the case. Not through negligence or miscalculation, but because with decomposition capitalism is necessarily more and more a prisoner of a short-term vision which leads it to progressively lose its mastery over its tools of regulation which, up to now, have allowed it to limit the damage caused by its frenzied competition in which all the actors of the capitalist world are engaged.
In the 1980's, the first criticisms appeared from member states of the WHO based upon its overly expensive prevention strategy, particularly when there was no direct benefit to their own national capitals. Vaccinations began to lessen. Medicine became more difficult to access as a result of cuts in public health systems. And this backward step gave way to parallel, "alternative medicines" feeding off the irrational climate favoured by decomposition. Thus, a hundred years on from the time when they didn't even know that the sickness was down to a virus, the "remedies" recommended against today’s virus (SARS Cov2) are the same as those deployed against the Spanish Flu (rest, nourishment, hydration).
Science globally lost its credibility and with it, credits and subsidies. Research on viruses, infections and the means to fight them had almost ground to a halt everywhere due to a lack of funding. Not that it's so costly, but in relation to its immediate profitability, the cost is necessarily judged to be too high. The WHO abandoned its operations around tuberculosis and was summoned by the United States, under the threat of halting its financial contribution (the WHO's most important, 25% of it), and told to focus on illnesses that the US regarded as a priority.
The needs of science, which still tends to work in the long term, are not compatible with the constraints imposed on a system in crisis, driven by the pressing need for a direct profitability from all investments. For example, when the Zika virus was recognised world-wide as a pathogenic agent causing a fall in the birth rate, there followed almost no research, neither any vaccine in an advanced stage of development. Two-and-a-half years later, clinical trials were postponed. The absence of a profitable market between two epidemics did not leads states or pharmaceutical enterprises to invest in this type of research.
Cutting-back the policy of prevention reflects a society without a future
Today the WHO is almost reduced to silence and research on illnesses is in the hands of the World Bank which demands a profit-based approach (via the implementation of its DALY indicator which is based on a cost ratio/benefit in number of years of life lost).
Thus, when a specialist in the coronavirus, Bruno Canard, evokes "a long-term work which should have been started in 2003 with the arrival of the first SARS" and when a fellow virologist, Johan Neyts, states his regrets that "for 150 million euros, we could have had in ten years a broad-spectrum antiviral against coronavirus that could have been given to the Chinese in January. This done, we wouldn't be where we are today", they put themselves against the actual dynamic of capitalism.
We are seeing the demonstration of what Marx had already written in 1859 in the Contribution to the critique of the political economy: "At a certain stage of development, the material productive forces of society come into conflict with the existing relations of production (...) From forms of development of the productive forces these relations turn into their fetters".
Whereas humanity possesses the scientific and technological means to combat diseases as never before, the maintenance of capitalist society constitutes a fetter on the realisation of these means.
Thus in 2020, humanity, which is capable of understanding living organisms in all their forms and knows how to describe their functioning, finds itself forced to take up the "remedies" of the past where obscurantism still reigned. The bourgeoisie close their borders in order to protect themselves from the virus, just as they did in the Eighteenth Century when a wall was built in order to isolate Provence from the plague. Sick or suspected cases are isolated, ports are closed to foreign boats, as at the time of the Black Death. Populations are confined, public places closed, meeting-up and activities forbidden, curfews are decreed, just as in the big towns of the United States at the time of the Spanish Flu.
Nothing effective has been devised since and the return to these violent, archaic and outmoded methods shows the impotence of the dominant class faced with the pandemic. Competition, the basis of capitalism, doesn't disappear faced with the gravity of the situation: each national capital must outdo the other or die. So, at the time when deaths were accumulating and hospitals faced not being able to take a single patient more, all states still tried to confine everyone, some later than the others. Some weeks later, there was a rush to lift lock-downs and put back in place the economic machine for the conquest of competing markets. These actions showed nothing but contempt for human health and were taken despite the warnings of the scientific community of the still-lively and mutating SARS-Cov2 virus. The ruling class is incapable of going beyond the dog-eat-dog principle which reigns over all levels of society. It simply cannot achieve, just as with the question of global warming for example, the elaboration of a common strategy in the fight against the virus.
The Justinian Plague precipitated the fall of the Roman Empire and its system of slavery; the Black Death precipitated the end of the feudal system. These pandemics were products of these decadent systems in which "the material forces of society (come) into contradiction with the existing relations of production" and were, at the same time, accelerating factors in their fall. The Covid-19 pandemic is also the fruit of a decadent and decomposing world order; it will also be an accelerator of its demise.
Should we be happy to see the fall of capitalism accelerated by the pandemic? Could communism advance as capitalism did on the wreckage of feudalism? Comparisons with pandemics of the past end there. In the world of slavery and the feudal world, the bases of an organisation adapted to the level of development reached by the productive forces were already present within the old society. The methods of production in place, having already reached their limits, left a space for a new dominant class already capable of bearing new, more adequate relations of production. At the end of the Middle Ages, capitalism had thus already taken up an important part in social production.
Capitalism is the last class society in history. Having put under its control the quasi-totality of human production, it could leave no place to another organisation before its disappearance and no other class society could replace it. The revolutionary class, the proletariat must first of all destroy the present system before posing the basis of a new era. If a series of pandemics, or other catastrophes, precipitate the fall of capitalism without the proletariat being able to react and impose its own force, then the whole of humanity will be dragged down with its demise.
The stakes of the period really lie in the capacity of the working class to resist capitalist disorganisation and inefficiency and from there to progressively understand the reasons for it and take up its historic responsibility. That's how the quote above from Marx ends:
"At a certain stage of its development, the productive material forces of society come into contradiction with the existing relations of production (...) From forms of development that they were, these relationships become fetters. Thus opens up an epoch of social revolution."
GD (October, 2020)
 cf. “A new Twenty-first century science for effective epidemics response”, Nature, Anniversary Collection no. 150, vol. 575, November 2019, p. 131.
 Ibid, page 130
 Ibid. page 134
 "Covid-19 on the track of future treatments", Le Monde (October 6, 2020)