Skip to content Skip to footer

Chicago Responds to COVID-19: Public Health Infrastructure from Below

Article published:
Black and white photo of people marching at a protest

A thriving public health infrastructure is as necessary as air, food and clothing argue Paul Siegel and Dr. Howard Ehrman.

People’s COVID-19 Response a newly formed Chicago-based coalition, fights for the reconstruction of public health, and the public sector generally, on democratic and community-based foundations. The project argues that this approach is absolutely necessary if the woeful failure of the current U.S. response to the COVID-19 pandemic is to be abated.

This new effort is anchored by public health and other service workers, teachers, rank-and-file union members and community activists. It complements other vitally needed, primarily legislative work by coalitions like Right to Recovery, albeit with less support of well-established progressive unions, other organizations, and elected officials. With weekly national and Chicago zoom conferences providing reliable information, People’s COVID-19 Response creates a forum for a broad-based conversation about how people in communities and workplaces in Chicago and around the country are coping. These meetings have produced an initial set of concrete demands which are expected to develop further as more people enter the conversation.

The coalition aims to contribute to a groundswell of action for its the evolving program. While Chicago-based, People’s Response views the COVID-19 crisis as requiring nationwide and global communication, strategy development and practical cooperation.

The gutting of public health

Over the last 30 years Chicago’s public health infrastructure has been gutted. Cost cutting and the outsourcing of public health responsibilities to nonprofits has produced a Balkanized, fragmented system, which made an effective immediate response to COVID-19 impossible.

Your inbox needs more left. Sign up for our newsletter.

Four decades ago, the administration of Harold Washington (1983-1987) took seriously the development of a robust public health infrastructure. Since then the gains made were undercut by Chicago Democratic Mayors Richard M. Daley & Rahm Emmanuel. They cut city public health workers from 2000 in 1985 to 500 today and closed many public health clinics. (This is a nationwide phenomenon, with 100,000 public health workers lost in the last 40 years.) They also closed more public schools than any other city in the U.S. and cut back on public transit serving African American and Latinix neighborhoods while charging higher fares.

Such policies pushed 300,000 African Americans out of the city and produced a grim calculus of racial disparity. Today, African Americans make up 29% of Chicago’s population but account for over 50% of known Coronavirus infections and a staggering 70% of the ever-increasing deaths.

Over the last three months mayors and governors from both political parties, while in some cases trying to “step up,” have in varying degrees aggravated the bottomless incompetence of the Trump Administration’s white nationalist response. They have failed to issue the comprehensive legal orders that would save lives and allowed social distancing and barriers to be haphazardly and ineffectively determined and enforced by individual businesses, hospitals, and public agencies. These officials failed to  use their authority to set and implement a coherent program in a unified public health department in their states or cities.

Reconstruct the public sector

In the present moment, for all the vast amounts of widely disseminated information, some of it excellent, some of it flawed, we rarely hear the words “public health infrastructure.”  Even on the left, there has been insufficient awareness of this need. There is far more awareness of single payer Medicare for all, while greatly needed, will not in itself providing the vital foundation of public health institutions.

A thriving public health infrastructure is as necessary as air, food and clothing. To be effective in Chicago such a system and must be firmly rooted in a large cadre of well-paid health workers from the city’s Black and Brown and poor communities.

Let us imagine that as of December 2019, Chicago and other urban centers had constructed such systems; that they were ready with thousands of public health workers, functioning in partnership with armies of community and workplace volunteers, to combat any public health emergency. That these workers already had experience in strengthening environmental land occupational health protections. Such a partnership would certainly have won the trust and support of our communities.

Imagine that the corps of public health workers and volunteers had by December 2019 organized effectively to accumulate the resources that would be needed to deal with a pandemic, which epidemiologists have long told us was inevitable. Imagine that Chicago had a nurse in every single public school every day of the school year.

Had that kind of system been in place the minute a virus showed up in Chicago, a well-equipped, well-protected, masked, gloved, and suited up public health corps would have gone into action. Door to door testing, contact tracing and education on symptoms, modes of transmission and social distancing would all have started immediately. People testing positive and/or showing symptoms would have been referred to treatment right way.

Cuba has such a system (and People’s Response conferences have informed many people about their model). Can’t be done here? It can and must be if we are to collectively and individually survive.

Too expensive?

In the U.S., austerity, privatization, cutbacks, and tax relief for the super wealthy have been accompanied by trillions of dollars of death-feeding military hardware and mass incarceration. On local levels, the care and feeding of destabilizing, displacing, environmentally destructive gentrification by real estate and financial interests using Tax Increment Financing development (TIFs) and other vehicles has helped to bankrupt the public sector.

Corporate Head Taxes and Financial Transaction Taxes that would raise public revenue have been blocked or, where they existed, repealed. In Chicago, $1.2 billion are tied up in mostly gentrification driven TIFs. These funds can and must be appropriated and channeled into the kind of vibrant, community based and democratic public sector that is necessary for the survival of human civilization.

People’s COVID-19 response demands

The People’s Response demands as developed so far cover the most urgent matters: direct relief for furloughed and laid-off workers; moratoriums on rent increases, evictions, mortgage payments, fees and student loans; free laptops for all Chicago Public School students, immediately offering lodging to all houseless in 1887 currently vacant public housing units; decarceration, and more.

The demands also focus on the public health infrastructure priority:

  • Immediate reopening of the six mental health clinics that were closed, full staffing of all 12 clinics;
  • A full-time registered nurse in every Chicago Public School as soon they re-open;
  • Prompt distribution of all Personal Protective Equipment (PPE), medication, and equipment to hospitals and health clinics equitably, based on Black and Brown communities being at highest risk;
  • Place Department of Health personnel in every open business and public facility to enforce clear and strict orders for PPE, physical barriers, and social distancing to protect workers and customers;
  • And crucially, the City must hire 1,000 Chicago Department of Health (CDPH) public health workers, recruiting from and employing them in Chicago community areas with the greatest health and economic inequality. These workers would carry out door-to-door testing, screening, tracing, education, and referral for ongoing treatment as soon as proper PPE is available.
  • Train, certify, supervise, and deputize the thousands of retired health worker volunteers and health science students to become health department workers to be deployed in the hardest hit communities.

Looking to our history

Our own grassroots history reveals the roots from which the organizing of reconstruction must flow. In the late 1960s, mostly young people in the Black Panther Party (BPP), the Young Lords Organization, the Young Patriots and others in Chicago and elsewhere, who constituted the original Rainbow Coalition, worked day and night recruiting medical personnel, getting resources and starting Peoples’ Free Health Clinics that carried out mass screening, education and prevention programs.  Braving armed repression, they so embarrassed the powers-that-be before the whole world that the City soon established new Board of Health clinics in communities in need. The movement that elected Harold Washington was building upon this until the mayors that followed gutted the system.

The late 1960s free clinics movement and other BPP-inspired programs for “survival pending revolution,” inspired George Jackson to define the potential for a “Central City Commune” which would demonstrate the kind of world we want to live in. The “Commune” would organize to take the power and resources from those profiting from them and move from those survival programs to fundamental and revolutionary change.

Community based health organizing continued in the 1970’s and after. One Chicago example: The Chicago Area Black Lung Association began with the concentration of coalfield migrants in the Uptown community and spread throughout the region. Disabled miners and surviving spouses went door to door extensively. They found the disabled miners in Uptown, got federal black lung claims filed and won, brought coal field migrants out of their invisibility, brought Cook County Hospital doctors to the homes of disabled miners to document their plight and get them medical follow-up.  They then spearheaded a movement of the whole community for health care, fighting the political machine to win a comprehensive health center with a special black lung facility.

When the Uptown clinic was closed by cuts, the black lung facility continued at Cook County Hospital. It became a model center for diagnosis and treatment and an invaluable resource for the struggle in the coalfields, as well as for displaced migrants.

The movement in Uptown took on many health struggles, notably including a vast door-to-door campaign that won major victories regarding lead-based paint in the aging buildings in Uptown.

Knowledge of this kind of peoples’ history will help in taking on the great challenges we face.

Current reality and potential

Organizing from community bases for peoples’ power continues in the present day and has come more and more to the forefront as the crisis of society develops, especially among young people of color.

These actions must and will move to higher levels. The development of local People’s Movement Assemblies, introduced into the U.S. in 2007 at the first U.S. Social Forum, is a concept whose time has come. Base building — face-to-face, door-to-door, block-by-block, school-by-school – which has begun in many localities will become more and more primary as an organizing strategy. Health workers, people at risk and suffering from the virus, and all the many thousands of “ordinary” people called to do extraordinary things for their communities and co-workers have the potential power, if organized, to make a reconstructed public sector a reality.

The heartbreaking montage of exhausted and underequipped health and social service workers, facing death daily so that their fellow human beings will not die uncared for and alone upon Trump’s narcissistic babble, eats at our souls. Responding to federal and local failures, coalitions and networks have sprung up in abundance. Large numbers of people have acted as individuals, as small ad hoc committees, and through existing community organizations and unions to protect themselves, their families, their neighbors, and their co-workers. People’s Response members also provide mutual aid, while working collectively to take on the local, state, and federal government for not doing what they should.

Turn disaster capitalism on its head

COVID-19 is only the latest (and certainly not the last) manifestation of the underlying crisis of this society. Can the history of “disaster capitalism,” becoming more frequent and pervasive with neoliberal policies, be turned on its head? Can progressive forces unite and make the pandemic a turning point? Can we rebuild and reconstruct a public sector including public health, education, transit and housing, on democratic, community and workplace-based foundations?

Can this help to build a new Rainbow Coalition to pursue short and long term demands toward fundamental change? Can such a reconstruction replace racist city-“whitening” real estate speculation and gentrification with a serve-all-people public sector?

With all the hope and love for the potential of humanity in our hearts we believe that now is the moment to move in that way.

You can contact the People’s COVID-19 Response by sending an email to  [email protected]. National Meetings are every Sunday @ 7:30 pm Central Time; Chicago Meetings are Noon CT every Saturday. Articles are welcome on organizing, victories, multimedia, art, music, information, education, from anywhere in the world to post on our new website.

Did you enjoy this article?

We're in the middle of our annual fund drive, and this year we're building our own internal infrastructure for subscriptions, meaning more of every dollar pledged goes to fulfilling our mission. Subscribe today to support our work and be a part of Convergence's next evolution.


About the Author