Trans healthcare, already woefully inadequate prior to the COVID-19 outbreak, has been stretched to breaking point. The Pandemic has left trans people across Britain without access to essential medical care. We need a socialist system based on bodily sovereignty and informed consent.
If you will forgive us the "indulgence", we wish first to insist upon the humanity of those our society has abandoned, stamped on and spat at. Since the outbreak of COVID-19 in the western imperialist nations, to do so is dangerous. Society has turned sour and voices that were once at least laced with pity have turned harsh. Many utter "only the vulnerable will die" and, perhaps, they do not realise what this excuses. For in the care homes the British abandon their elderly, in the prisons built to contain the beauty of autistic minds and in the homes of those who struggle, each day, with illness and mortality, an atrocity is in motion. These people, long abandoned and neglected by capitalist society, now find that their prisons are tombs. British imperialism is in the early dawn of a eugenics programme.
The "do not attempt resuscitation" (DNAR) notice is an anchor of this programme's implementation. For those unfamiliar with the device, it essentially describes the waiving of a patient's right to life, obligating the medical establishment to leave them to die where they would require resuscitation. It is generally signed by a doctor in consultation with a patient or their family, reserved for difficult circumstances where one would be extending a painful death. Since the outbreak began in Britain, it has been transformed into a death warrant. On 1 April, The Guardian revealed that residents of care homes in Hove, East Sussex and south Wales, among others, had DNARs placed upon them en masse. The next day, it surfaced that GPs around the country had been writing to vulnerable patients, suggesting that they fill out DNAR forms so that coronavirus care can be prioritized for those who are younger or healthier. These two examples have now given way to a flood with, for example, a GP surgery in Somerset recommending that autistic adults in care homes should have DNARs placed upon them or a GP in Scarborough suggesting that a DNAR be applied to an 11 year old boy with cancer.
Whilst the examples given above stem from the practice of individual sadists employed in doctor's surgeries and care home management positions, it is clear that they are acting nationally as part of a broad effort. In reality, this effort is being led and organised by the British state. The 2020 Coronavirus Act, which received Royal Assent on 25 March, both granted indemnity (essentially legal immunity) to health service activity and removed the obligation of local authorities to provide care for disabled people unless it breaches their human rights. The National Institute for Health and Care Excellence (NICE) – which provides legal guidelines for care and health providers – published guidelines on coronavirus and vulnerable people which tells medical professionals to assess a patient's viability for critical care by judging their frailty on an index. This index scores people for "frailty" from one to nine. An algorithm also provided by NICE suggests that anyone with a frailty of five – "moderately frail" – or above should be considered as potentially unworthy of critical care. The criteria for a five rating is that a patient needs help with more complex tasks like financial management, transport, heavy housework or managing medication. Whilst supplementary guidance from the Royal College of Physicians explains that this particular index is not appropriate for young people or those with long-term disabilities, autism or learning difficulties, it encourages an 'individual assessment'. No reasoning is provided as to why the process of triage – that is, the process by which the order of care for patients is assessed – has been so transformed into an instrument by which to judge the worth of a patient's life, nor will it ever be. To say such things openly, even in a Britain capable of such insensitivity as to say that "only the vulnerable will die", is political suicide. So, let us put words upon that which government's lips falter to explain. With the Coronavirus Act and NICE's guidance, Britain has created the medical, financial and legal framework of a cull. The government has, in bureaucratic terms, commanded murder. This is made clear beyond any doubt by the initial advice produced for the discharge of recovering coronavirus patients: infectious or not, whether there are ward beds available or not, they are to be sent to care homes. Whilst care homes won the right to stop this intake of COVID-19 on 15 April, it is clear that the damage may already have been done.
The impact is very clear beyond merely the observation of DNAR notices. Accounts from within homes repeatedly highlight the helplessness of the circumstances created, with GPs providing less and less support, no budget or reliable supply for the necessary PPE equipment required for staff and infected residents repeatedly refused hospital treatment. Whilst the government's coronavirus death tolls account only for those who die in hospital, a fragment of the horror beneath this silence has begun to emerge. On 14 April, two of Britain's largest care home providers revealed that they had seen a combined total of 521 residents in their care die in recent weeks and that their facilities are ridden with the virus, one stating that two thirds of their facilities are experiencing outbreaks, and the other, half. These two providers, which account for 3% of Britain's care home stock, sharply contradict what little glimpse has been offered by the Office for National Statistics, their combined total nearly double the 237 deaths in care homes it recorded for the two weeks up to 3 April. The true scale of this barbarism is perhaps impossible to conjure.
"With the Coronavirus Act and NICE's guidance, Britain has created the medical, financial and legal framework of a cull. The government has, in bureaucratic terms, commanded murder."
While primarily targeted toward the disabled and the elderly this campaign is, of course, not limited here. The British state has also wielded the virus against those it has chained, whether in migrant or general prison. On 2 April, a leaked letter from G4S, which has contracts to run British immigration prisons, revealed that migrants at risk of dying from COVID-19 would be placed in solitary confinement for up to three months to keep them “safe”. Despite a Home Office pledge to release these people, they remain so entombed. More than this, the Home Office have reapplied the government's strategy of funnelling the virus into care homes. For example, on 2 April a migrant with COVID-19 was placed in Brook House immigration prison. With the virus unleashed, the patient himself was placed in solitary confinement facilities – left to die. This virulent form of racialised eugenics finds a parallel in Britain's handling of its general prison population. At time of writing, over half of prisons in Britain have outbreaks of the virus and prisoners with common influenza are forced to share cells with those infected with COVID-19. Scant reporting flows from these dungeons of death.
That eugenics is being practiced today should not come as a surprise. Indeed, those who presently hold Britain's helm have long made plain their affiliation with the theory. The Prime Minister, Boris Johnson, has had known links to the fascist media strategist, Steven Bannon, for a considerable period and holds the crown as Britain's least scrutinised open racist. In 2013, speaking to a meeting of bankers, he said that “it is surely relevant to a conversation about equality that as many as 16 percent of our species have an IQ below 85 while about 2 percent have an IQ above 130” and that IQ is an indicator of “spiritual worth”. His chief advisor, Dominic Cummings, is more naked still. His approach to education – a fetish of Cummings' view of the world – is fundamentally based upon the argument, in his words, that “a child's performance has more to do with genetic makeup than the standard of his or her education”. After putting out a blog post to recruit “weirdos” to make up his Number 10 team, Cummings' first hire was Andrew Sabisky, an open advocate of eugenics and white supremacy. Though he resigned from post when this hit the media, both Cummings and Johnson have refused to condemn these positions. The rot does not stop here – for example, the Home Secretary Priti Patel is an advocate of the death penalty – but it is worth lingering upon Cummings, who has been somewhat unabashed regarding the government's approach to the virus. At the start of the outbreak he said that “if [it] means some pensioners die, too bad”. Eugenics is an ideological principle of those who today govern British imperialism.
The particular nature of the eugenics campaign is enabled by the particular conditions those who it targets are kept in. The care home and the prison both render their inhabitants as captive, thus dependent, upon the state or the private institute. The disabled and elderly are forced to economically rely upon the state due to the various manners by which capitalism constructs the world toward increasing productivity and standardisation; the migrants and prisoners placed in Britain's squalid jails are rendered reliant upon the state by the very fact of their incarceration. As such, in the context of the virus, the British state has found itself in a position where it is able to wield an invisible weapon (the virus), by bureaucratically weaponising these systems of oppressive dependency and the NHS. At present, what is driving this process is that which has driven, for example, the mass death of disabled people on benefits – that is, capitalism's need to force down wages by the elimination of any means to live one's life other than waged labour – but brought to a new scale. The nature of this transformation can be expressed simply: the care home, which Britain has long constructed as death's lobby, has been turned into the slaughterhouse.
The extension of this process, which presently centres upon those who capitalism has already assaulted most vehemently, is but a stone's throw away. Whilst by no means fated, it is clear that the capitalist system will require far greater barbarity still as its crisis unfolds. On 14 April, the Office for Budgetary Responsibility predicted that Britain's GDP would contract by 35% between April and June. By comparison, the flood of violence and privation unleashed by the 2008 crash represented a loss of 5% of Britain's GDP. More than this, the economic, legal and technical infrastructure for an expansion of this campaign is already being constructed. The paralysis brought to the world economy by the coronavirus has seen a rapid expansion of relationships of state dependency and prompted several companies to invest in automating their operations. The Coronavirus Act, which allows the arrest of anyone deemed a risk to public health, is set to remain in place for at least two years, even if the virus disappears. Palantir, who provide predictive policing software to the US' Immigration and Customs Enforcement agents, is working with a number of other companies to collate medical data for the NHS. It aims to be able to distinguish who lives in any household in Britain by “type”. Whenever the virus ends, it is clear that eugenics and fascism are planning to stay.
Red Fightback calls upon all revolutionary and progressive organisations and individuals to resist this. We call upon care home workers to protect those they can to the best of their ability and to expose the realities of what is today in motion, for mutual aid groups to mobilise now to provide protective equipment to these staff, and for all left groups to mount an immediate propaganda campaign to consolidate a meaningful resistance. Complacency before such atrocity is complicity. And so we warn you: in the years to come, you may be asked a question. You would do well to prepare.
First, they came for the elderly, the disabled, the migrants and the chained. What did you do?