This all could’ve gone differently. Bob Woodward revealed that Donald Trump knew in February that COVID was airborne, information both men declined to share with the rest of us until just now. Congress was also briefed. Their only response was to adjust their investment portfolios. The rich have been given a head start to prepare, to plan for millions of deaths, and to prevent their own. In the meantime, the rest of us must work—if work is even available.
I was laid off on the first day of the Texas lockdown. I’d been on FMLA for an illness related to a disability. As Marx said in Capital, Volume I:
“Suppose you were in want of an additional workman, and two were to apply, both equally well qualified in other respects, but one had lost a thumb or a forefinger, which would you engage?”
The same logic applies to who gets fired first. The cripple, of course.
Marx stays relevant because little has changed. I have tentatively accepted a lower-paying job starting in November, but unlike the last one, I won’t be able to work remotely. I must accept more dangerous work precisely because of disabilities (including asthma) that make me higher risk. This might kill me. That’s surreal. I can feel a close, parallel timeline, where the evidence that COVID was deadly and airborne prompted basic public health interventions that saved two hundred thousand lives, and perhaps millions to come. The membrane separating this world and a better one is paper thin.
I’m not the only disabled American who’s struggling. Currently, about one in four Americans have a disability, and they are far more likely to be poor; half of people in poverty have a disability. The pandemic won’t improve matters. Research from past pandemics shows that while everyone’s general health declines, people with disabilities struggle more with stress, with feelings of isolation, and with getting adequate medical attention—they feel deprioritized compared to able-bodied patients. They aren’t wrong.
For example, people with intellectual disabilities, who most frequently live in institutionalized or group settings, have higher infection and death rates than the general population. They’re four times more likely to catch it and twice as likely to die if they do catch it. New York State’s ventilator allocation policies even permit hospitals to remove people who have been on ventilators long-term from the machines (i.e., killed) if an able-bodied person is judged more likely to survive. As of June, 41% of Americans had delayed seeking medical care (including emergency care) as a result of COVID-related anxieties. Disabled people were one of the demographics most likely to delay treatment.
Of course, disabled people aren’t the only group avoiding going to the hospital. Refusing necessary medical treatment is at this point an American pastime. That is a universal phenomenon, regardless of race, sex, and disability status—regardless of everything except class. But describing it as “avoiding” is almost inaccurate—these are people making assessments of risks they didn’t choose and can’t mitigate. They might be risking death and disability by not getting treatment—but they’re also risking it by going to an E.R. or a doctor’s office and potentially exposing themselves to the virus. At least if they stay home, they’re not out a copay.
There’s emerging evidence that COVID is a vascular disease. Even mild cases have a high incidence of long-term disabling complications, including stroke, organ damage, and loss of limbs. Among everyone, treated or not, it’s becoming clear that there will also be a heavy psychiatric toll—an increase in mental illness overall, and in the severity of mental illnesses that are exacerbated by stress and isolation (so, all of them). Evidence already suggests that’s happening. A CDC survey suggests the incidence of suicidal ideation has nearly tripled, from 4% to 11%. This crisis isn’t just hitting disabled people especially hard. It is also creating disabled people. And remember: the crisis isn’t COVID, because COVID could have been contained. Our leaders had the information and the resources to stop it, and they chose this instead.
Almost all of this could have been avoided.
But never mind. Here we are, adapting to a new reality. Many of us must still work or go to school in person. For others, our work, school, and social lives (for people who are taking this seriously) have moved to online spaces. This migration has an incidental benefit for disabled people: accessibility. I was forced to drop out of college twice because of illness, both times for the stated reason that I needed to be physically in a chair. Attendance was not optional. I couldn’t get additional days off, or attend remotely, or get notes from the professor. Ass in seat only.
Later, in my career, remote work would have also reduced the number of sick days I needed. I could do the work, and the work could be done remotely, but I couldn’t necessarily drive a car that day. Again, physical presence was required. Remote work was a reward for people who didn’t need it. Well, the pandemic hit, and wouldn’t you know it, suddenly warming a seat just isn’t that important. Fancy that! I am far from the first disabled person to observe this. Online, disabled workers and former students have been muttering darkly about how remote work was completely “impossible” until a literal plague hit and all the able-bodied people needed it.
You might think some of this would be a source of an incredibly twisted optimism—maybe all these deaths in our community will make systemic ableism more than a punchline on the left. Maybe liberals will remember we exist and mention us once in a while! Wouldn’t that be a treat? Of course we don’t rejoice in anyone’s pain, but, thanks to the ravages of COVID, disabled people will soon represent a larger share of the electorate. Perhaps we could finally get some legislation passed. There’d also be no reason to roll back work and school accessibility gains if so many more people are disabled… right? Some disability groups are already trying to draw attention to how essential these accommodations are to employing disabled professionals, and how much better our lives would be if we kept them around after the crisis passed.
I fear that’s not how any of this works. All of it rests on a very individualistic, liberal conception of power. If we have more numbers, why, we’ll be a voting bloc! But we’re already a quarter of the population. We could swing entire elections, but most years, we don’t make either party’s platform. We just aren’t a priority. Aside from last decade’s Affordable Care Act (and a few other laws passed around that time), which made it mandatory to cover preexisting conditions, our last major policy win was in the ‘90s: the Americans with Disabilities Act, which mandates protections for disabled workers and has provisions to ensure disabled people have access to public spaces. Disabled organizers had to crawl up the steps of Congress to shame the legislature into passing it.
We’re also, if I had to guess, pretty unlikely to hold onto the gains in accessibility conferred by the increasing ubiquity of remote work. Workplaces were already capable of allowing this much of the workforce to work remotely, as evidenced by the fact that so many jobs switched over instantly. That means the infrastructure was in place. Disabled workers aren’t unaware of this; we aren’t bad at advocating for what we need. We’ve been asking for years, and we’ve been told “no.” The status quo, as it existed, was optional, and it was changed easily.
An Artificial Crisis
All of this is optional, even the aspects that don’t seem to be on their face. I’ve been using the word “disability” without defining it, but it feels pretty inert, doesn’t it? Nothing optional about it. Someone can see, or not. They can walk or not. They can work or not. Simple. Obviously, “disabled” doesn’t just mean someone who is unable to work because of a physical impairment. Plenty of people with disabilities do work. But I think it’s pretty clear from how it’s discussed generally, from its place in the culture, and from the correlation between disability, poverty, and unemployment—disability has something to do with labor.
There are multiple models of disability, but the one I favor is the social model. The social model says that the distinction between a person and their environment is artificial—a person is disabled in an environment, not just inherently disabled. I want to emphasize that this model does not deny that disabled people have impairments—a man who is paraplegic has impaired movement. That’s not “society,” that is a physical limitation. But what makes him disabled is not that his movement is impaired, it’s that he is impaired and we design cars and sidewalks and buildings with the assumption that everyone who uses them has the full use of both their legs. Because of those assumptions, work may be difficult or impossible because he needs transportation to get there, and he needs to be able to navigate the hallways when he does. If he doesn’t have access to transportation or his building isn’t ADA compliant, he’s disabled. He can’t work.
Going one step further, he is disabled because we have decided he must work, or must be taken care of by someone who can. Otherwise, he can’t have food or housing. If he can’t work (again, because we have made choices that prevent him from working, and because we predicate survival on the ability to work) that same man has to rely on programs with strict poverty requirements so he doesn’t starve. For example, Social Security Insurance has a strict asset limit of $2,000 per person and $3,000 per married couple—in some cities, barely enough to cover rent and food for the month. Food stamps and Medicaid have similar requirements. I’m friends with more than one couple who simply can’t afford to get married because the assets represented by the able-bodied partner’s car would push the disabled partner off of Social Security and Medicaid.
Those programs aren’t easy to get into, either. If benefits are lost, it can take years to get them reinstated—and again, there’s no reason a disability application must be a years-long process. Disability causes none of this. Impairment is a fact of life, and all of us who live long enough eventually experience it. But disability doesn’t need to exist. We could end it. That is what disability liberation means—not an end to impairment, but an end to oppression.
The social model of disability invites us to see all of these are choices—not choices on our part, of course, but the result of policies imposed on us by a Congress consisting of and beholden to the capitalist class. This is wholly compatible with Marx, who wrote extensively about capitalist exploitation’s toll on workers’ bodies. Per Bengtsson:
“New technology also demanded faster movements, as when Marx used a factory inspection report that stated that ‘fingers must be quicker and defter in their movements to take up the broken thread, for, if placed with hesitation or carelessness, they are sacrificed’, which underlines how man’s value was based on how well the body could adapt to the system it was supposed to serve.”
COVID-19 is, of course, not a new technology. It is simply yet another artificial crisis, yet another unnecessarily hazardous working condition imposed upon us by our government and the capitalist class it serves.
It goes almost without saying Republicans take a perverse glee in the brutality of capitalism, seeing it as people “getting what they deserve.” Democrats take pleasure in feeling superior to that sadism and stop there, without bothering to do any actual good. I’ve had conversations with Democrats where they (rightly) point out the party defends against cuts to Medicare, Medicaid, and Social Security. But Democrats also oppose Medicare for All (or any other single-payer system) and an end to the means testing that forces disabled people into poverty. Imposing means-testing limitations on previously generous programs is a hallmark of modern Democratic centrism, in fact. What is required is not the benevolent maintenance of the disabled underclass, but liberation. The Democrats are in no way offering that liberation. In fact, they stridently oppose it.
Far be it from me to critique liberals without noting the left could stand to improve. The majority of the time I hear ableism talked about, it’s as a laugh line in a podcast. No joke necessary; just say “ableism” and everyone brays like an ass. Where it is discussed seriously, I think there is a temptation among Marxists to dismiss disabled people as lumpenproletariat (the segment of the proletariat lacking class consciousness; too disempowered to revolt), and to exclude them from their conceptions of the working class. I would reply that the social model of disability comes from disabled thinkers, is widely discussed, and is fundamentally class conscious. The Capitol Crawl, while it did rely on the benevolence of elected officials, is an absolutely masterful instance of direct action. As Marxists, we could stand to learn from disability activism and thought.
Second, many disabled people do work, not just in conventional jobs, but within institutions, like prisons and group homes. Prisoners are three to four times more likely to have a disability than the general population—and are paid either vastly reduced wages or nothing at all. Many developmentally disabled people who live in other institutional settings do piecework—stuffing envelopes for pennies a day, things of that nature. This is legal because disabled people are exempt from the minimum wage.
But even disabled people who don’t work, who are on programs like Medicaid and housing assistance, are still exploited by capital. Landlords profit off their housing, and insurance companies and hospitals still profit from their care. That is exploitation. The poverty that makes those programs necessary is, again, imposed on them. We could, instead, remove that requirement and let disabled people use those programs to escape poverty and live a good life. Or we could simply guarantee healthcare, housing, and food for every person, regardless of ability.
We are facing a future with millions dead, and where a huge proportion of the survivors are newly disabled. We can’t afford to limit our political imagination to hoping that employers will let disabled accountants use Zoom a little more often after the COVID crisis is over. Capital has already developed sophisticated systems for exploiting disabled people, and having more of us around won’t really force any change. If anything, it will further weaken worker power by mandating abject poverty for an even larger proportion of the populace.
Why would capitalists prevent that? It benefits them. I’m not suggesting a conspiracy, or even any malice. Nobody is stroking a cat and twisting a mustache and plotting to cripple us all. A series of dispassionate decisions have been made as part of a process bereft of humanity—a series of spreadsheets were inspected, and the most profitable choices were made. The sum of all those choices has led to the United States dooming large swaths of its population to death and disability for a marginal increase in quarterly profits. All of this was optional. It could have been different. And we can know that and despair, or we can remember that someone benefits from these choices. Those someones could have chosen differently for us, but they didn’t. And if that’s true, why keep them around? That’s optional, too. ♦
M.K. Anderson is a writer with several short fiction credits. She has worked as a direct care provider and a coordinator of care for individuals with dual diagnosis developmental disabilities and mental illness in an ICF/ID institution. Later, she worked as a financial analyst overseeing the administration of Medicaid insurance contracts. She can be found at mk-anderson.com.