-Living, not surviving

A group of women from different working backgrounds offers several proposals for a “phase 2” of the Covid-19 emergency that also addresses social needs, and not only productive ones. We need a politics that goes beyond the management of emergencies, and tries to imagine a possible world.

By Tristana Dini, Ilaria Durigon, Barbara Buoso and Sara Gandini.

As women, we want to speak up. We are faced with a stall situation in which we are not getting answers from a political system that has shown itself to be incapable of acting quickly, at first in containing the health issue that is affecting our country and then in planning the strategies for the coming months.

Politics reduced to acting in an emergency is not politics. When it is reduced to policing the behaviour of single individuals, politics abdicates its primary function, which is making sure not only that everybody can survive, but also that they can live dignified lives, centred around their relations with others. The State is not made up of single individuals, and a community can only be built on social relations. We have turned a health issue in a war against an invisible enemy, spreading fear and panic among the population, and also feeding their mistrust, which threatens the foundation itself of democracy: trust in others.

We have something to say, and also specific proposals to offer, when it comes to the management of the Covid-19 emergency and of the so-called “phase 2”, the re-opening and re-building of our society, because as women we know that politics is made of relations and that differences matter, both in terms of needs and of desires.

This text is born out of a desire to begin an exchange that has at its core our vulnerability and also our freedom. It’s time to double down on “care”, understood as a thoughtful protecting of our lives which also takes into account the fabric of our relations. We need to go back to the trust that existed between the inhabitants of this country, and use it to make up for the time we have lost until now, learning how to co-exist with the virus, and with others.

What do we propose?

1. To begin at once, without wasting any more time, to rethink our health system. We need to increase long-term hiring of medical personnel, of nurses and caregivers, who must be prepared for future pandemics. We need to invest more on enlarging intensive and sub-intensive care units.

2. We need to stop centralising care in hospitals, and try to treat at home as much as possible those who suffer from less serious issues, and therefore do not have an urgent need for intensive care. Territorial services must be strengthened and we must invest in personnel and new, technologically advanced home-care structures, in order to meet both current and future needs, and to be able to implement health policies that are adequate to the needs of the population. We must return to the territorial dimensions of health-care systems (a far cry from the displays of power of local “governors”). As explained in a letter signed by more than one hundred thousand doctors, early treatment on the ground can contain and defeat the pandemic.

3. Investing in scientific research is paramount, in order to have a reliable test to detect infections, to understand which factors make this disease so aggressive in some people and not in others, to estimate how long immunity can last for, and to find effective treatments and affordable vaccinations. We must also urgently invest in testing, keeping in mind that it is not the solution to all of our problems, since in the early stages an infected subject can be contagious and still not be detected by a test. We need international and transparent cooperation, in order to counter private interests, which are guided only by the quest for profit and power.

4. Differences are important: women, children, teenagers, and the elderly staying in their houses or in care homes are not exposed to the same risks and do not have the same needs. We need to invest in a plan of sanitary and scientific education through the mainstream media, aimed at the entire population, taking into account differences and based on information rather than on fear.

5. We know who the people are that are most likely to develop serious pathologies, and they are the ones to be protected first. All people at risk (first of all, men above the age of 65 and below but suffering from other pathologies) must be given information and guidelines, mainly from their family doctors, on the risks they face, on the correct ways to use personal protection equipment and on the most dangerous situations (in which social distancing is not possible). It must be clear to everyone that protecting someone does not mean imprisoning them, while staying at home is a possibility that – when chosen freely – must be supported with at-home services (supplying of food and pharmaceuticals).

6. For all those who have to stay at home because they have been infected, free delivery of medicines, food supplies and medical assistance must be guaranteed. For example, supermarkets should reserve them access to home delivery, as opposed to what is happening in many cities, where they struggle to place orders because of too much demand.

7. We need to resume diagnosing and treating other pathologies (strokes seems to have halved, cancer patients had their treatments and tests discontinued or postponed…).

8. We must work to allow the greatest degree of community involvement, in order to be able to organise in a responsible manner the time we spend outside of our homes, for example making sure that everyone can access – in turns – public spaces, and especially children and teenagers, who have been particularly affected by this situation. Information and awareness-spreading can also go through self-organised community groups. It is of the utmost importance to give people the chance to die in their home, with their families, and not alone in a hospital. Obviously, palliative care at home should also be supported.

9. We must urgently talk about how to re-open the schools in September. The right of children to go to school with their friends is one we cannot give up on. We need schools with less students per class. This would improve both the sanitary conditions and the students’ learning processes, and it would also create more teaching jobs: we must invest in our public services, from schools to hospitals. We must hire teachers to make classes smaller, hire educators to guarantee services before and after school, invest in structures next to the sea, in the countryside or in the mountains to allow children to spend part of the summer away from the cities and together with other children. We must work to find solutions for the “teachers at risk”, that is, those who are over the age of 65 or suffer from other pathologies.

10. We must take into account regional differences, and plan a gradual, differentiated re-opening of certain productive sectors and commercial activities, in order to save the country from an unprecedented economic crisis, since this crisis will have heavy consequences on the country’s public health.

11. We must take into account the different levels of risks of the different professions. The working conditions of doctors and caregivers, of those who work in factories and in all other productive activities must be re-examined on the basis of protocols that protect the health of the workers (we must ensure distances and personal protection equipment). Instead of policing people who go jogging or take walks, the police forces should be checking that factories and commercial activities work in compliance with safety measures.

12. We must work on public transport, especially in large cities. We need more public transport in order to avoid overcrowding and to limit pollution.

We would like to conclude by calling for a discussion that can bring forward, and much beyond the coming months, an ambitious process of re-thinking that involves scientists, philosophers, sociologists and all those who want their voice to be heard, and that can return politics to its true, higher dimension: a type of politics that is not content with governing and administering, and that is capable of imagining a possible world in which ideals are not empty words, to be brushed aside when the first emergency arises.

Tristana Dini teaches in a hospital school in Napoli, Ilaria Durigon works as a bookseller in Padova, Barbara Buoso is a managing director in Padova, and Sara Gandini is an epidemiologist and bio-statistician in Milan.

Originally published in Italian on Jacobin Italia, on the 21st of April, 2020.

Translated by János Chialá