Find part 1 here.
The plus side, for me, to a decade or more of chronic sleep deprivation is that it’s really helped ramp up my writing productivity. The downside is some days I really sympathize with Lady Macbeth. That, and a growing body of literature documents a strong correlation between insomnia and dementia.
Living with the autoimmune dis-ease known as Hashimoto’s, my sleep deprivation cannot be entirely put down to the news. Who can sleep easy in times like these? But Hashimoto’s wreaks havoc on sleep, and according to a 2023 international collaborative study, insomnia also puts me at a substantially higher risk of developing Long Covid.
Insomnia is also a common feature of Long Covid. Even people without pre-pandemic insomnia are at higher risk for it after contracting Covid. In a systematic review of data from 29 studies including 13,935 Long COVID-19 patients, 38% struggled with insomnia.
Sleep is an essential pillar of health, and one that, even in the absence of Covid becomes increasingly endangered under the kind of tech-heavy, hyper-capitalist world that threatens to invade every aspect of our daily lives and our attention and infuses our bodies on a cellular level. How in the world are they getting any sleep in Gaza, so many people now living in tents and in makeshift shelter, mortar strikes and drones forever clicking like locusts over head? All of it, as Jasbir Puar has extensively documented, producing debility. A study in The Lancet puts the loss of life expectancy for Gazans between October 2023 and October 2024 at 30 years.
The question of causes aside, Covid and Hashimoto’s each come with substantially elevated risks for dementia, and I’m now into my second round of Covid, despite daily and near constant masking. The risk of disabling impacts grows with each bout of Covid you contract. That elevated risk for me is a key motivator to mask as well as a catalyst to retire early from my university teaching job. “Your money or your life,” as the saying goes.
I’m in a privileged place. I have projects mapped out and Covid poses a direct threat to all of those plans. And yet like other friends who mask, I’m struck by subtle and not so subtle expressions of discomfort, disapproval, and occasionally open hostility in the face of a rational choice I make to protect my brain, my body, my health.
I wouldn’t last a week in Gaza, because for more than a decade, any energy I have has come strictly out of a bottle of Levothyroxine. Not having access to Levo could be a disabling or death sentence for me in short order. And until a couple of years ago for me Hashimoto’s came with a hefty side order of serial migraines that, if not preemptively knocked out with a bottle of Imitrex, risked sending me to bed for days.
I can’t begin to wrap my head around the ways that elderly people in Gaza have been pushed into disability, denied access to life-sustaining medications from levothyroxine, to insulin, losartan and Prozac. Their deaths are rendered “excess,” no masks, no protection from contracting Covid again and again in a Brave New World that Musk, Thiel, Kushner, and the other fascist Tech Bros want to normalize, to globalize.
And you can forget Paxlovid if you get Covid in Gaza, as odds are you will. It’s business as usual while old people, toddlers – and journalists, like Heidi Levine –are terrorized and thousand-year-old olive trees are put to the torch in plain sight. The weekly newsletter Disability Debrief has a bibliography with a wealth of sources on “Disability in Palestine.”
The zine Mask Up We Need You, Palestinian Solidarity, Covid-19 and the Struggle for Liberation by Rimona Eskayo and Sheyam Ghieth make the case for masking as an act of solidarity with people in Gaza, who are unable to mask and are repeatedly contracting the virus, with cumulative effects. Invoking Steven W. Thrasher’s The Viral Underclass, The Human Toll When Inequality and Disease Collide, they argue that, “Like the genocide of Palestinians, the unmitigated spread of Covid-19 across our communities is a policy choice — not an inevitability…. Masking helps to remind everyone that the effects are ongoing and anything but equally distributed” (4).
Eskayo and Ghieth emphasize that “[T]he very strains of the virus that plague Palestinians today directly evolved and made their way to Gaza as a result of the global north’s policies of denial and normalization”(5). Eskayo and Amghieth call on activists to “REJECT THE NOTION THAT COVID SPREAD IS INEVITABLE” and instead see “PREVENTING COVID” as “PARAMOUNT TO THE PALESTINIAN CAUSE” (36).[1]
In the U.S. there’s no guarantee either of accessing life-saving, life-sustaining drugs for the millions of uninsured, and too often the insured are priced out by deductibles and copays. There’s a reason we can’t have nice things: Funds that could go to fostering health and healthcare in the U.S. are instead subsidizing the production of debility in U.S. prisons and detention centers, in Palestine, and throughout much of the Middle East. Is it any wonder that people who can least afford to pay for the downstream effects of Covid, including, potentially, assisted living or memory care, might choose instead to mask up? And don’t we want to support the practice to minimize the impacts on people with disabilities and the debilitation of yet more people? We can model best practices by requiring or strongly recommending masking at events that we organize and by talking about why.
In the wake of the U.S. war on Iran, Resident Trump said the quiet part out loud about prioritizing war – and corporate war profiteers like Kushner – over and above health, healthcare and day care, which he dubbed “individual things,” as in “It’s not possible for us to take care of day care, Medicaid, Medicare, all these individual things….We have to take care of one thing: military protection,” just two days short of the 59th anniversary of Rev. MLK’s April 4, 1967 Riverside Church speech. “The greatest purveyor of violence on earth” was how Rev MLK described the U.S. in the April 4, 1967 speech that got him killed a year to the date later in Memphis.
Holding down multiple jobs to keep a family housed and afloat isn’t conducive to sleep in the best of circumstances. It isn’t conductive to well-being, or to family harmony. Public housing provided a guarantee to rest, mental and biological reproduction. It also gave us a threshold from which to negotiate with the boss. Whatever happened at work, you still had your housing, you still had the promise of sleep, and the promise of some retreat from public health threats.
Public housing was defunded under Carter and Reagan in the late 70s and 80s, and that funding has never been restored. Housing isn’t a guarantee of getting good sleep, but it is a prerequisite for it, especially in cities. We collude in corporations stripping surplus workers of the necessary conditions needed to maintain life, and then criminalize them for a condition that, when chronic, cuts life expectancy by decades, even in the absence of Covid.
In a Canadian study covering “7 cities, the risk of death among homeless women was greater than that among women in the general population by a factor of 4.6 to 31.2.” And protracted sleep deprivation is no doubt one of the reasons for epidemic levels of traumatic brain injuries (TBIs) among unhoused people.
One summer as undergrads, my younger sister and I had a brief and very privileged experience of being houseless on the campus of Georgetown University, and the experience stuck with me. The sense of total isolation and overwhelming stigma, of dodging security guards, sleeping amid drop cloths and freshly painted vacant dorms on the campus where our recently deceased father had worked and taught for more than a decade.
I was recently diagnosed with sleep apnea, and, thanks to a C-Pap machine, only recently found out what a good night’s sleep might actually feel like. I have to wonder how long did I needlessly suffer before I finally did a sleep study, and what toll has a couple of decades of insomnia had on my life expectancy and on my brain?
There’s a persuasive case to be made that at least some ADHD “symptoms” might be an effect of sleep apnea, of sleep deprivation. Stroke, hypertension, coronary disease and early death are all preventable byproducts of sleep apnea, which, like Covid, exacerbate the already debilitating effects of capitalism. Knowing that and knowing what their impacts have been on my own health, I choose to mask in the hope that I might have another functional decade or two ahead of me.
People were tortured at Abu Ghraib and Guantanamo in myriad ways, most, if not all, of which involved sleep deprivation. Its capacity to incapacitate is well known. There needs to be a universal human right to rest, to sleep. Restoring funding to public housing would go a long way toward making that possible.
Some well-founded anti-capitalist critiques of ADHD diagnoses as a byproduct of an industrial-carceral-education system aside, the constellation of behaviors that ADHD describes, a goodly number of which I grapple with daily, including chronic insomnia, is correlated with a life span reduced by more than six years for women and more than 8 for men. I’ve personally never understood gender as binary, so I figure that means I’m set to lose about seven. I’ve made peace with that fact and accepted that I would likely have spent the bulk of those seven years searching for the car keys anyway. But knowing the odds of a long life are not in my favor and having already been diagnosed in my thirties with melanoma (which happily had not metastasized but for which I had multiple surgeries), taking precautions against Covid seems one way to even out the odds, Face masks have the added bonus of providing sunscreen when I forget to bring it.
Dig into the literature on Hashimoto’s and you’ll find that, while genetics clearly plays a role, so also does environment, with stress, radiation, heavy metal and chemical exposure all potentially contributing causes. I can conclusively say that in childhood I was exposed to all of the above. Adverse Childhood Experiences (ACES) can have lifelong health impacts, and even growing up as privileged, lily-white kids, with some very mockable gingers in the mix, my siblings and I definitely racked up a few.
As children we had the occasion to watch the timed-release effects of fascism take their toll on my father’s body decades after his childhood flight from the Nazis. If you had eyes to see, you could watch war take his body apart piece by piece, beginning with his teeth and heart, from malnutrition and pneumonia. His sudden death while I was accompanying him on a bioethics lecture tour of Europe a month from graduating from my all-girl Catholic high school left me with a lifelong legacy of panic attacks.
For me, that experience begs all kinds of questions about the lifelong health effects our tax dollars, pensions, and portfolios, are inflicting on children in Gaza – assuming they manage to live into adulthood. Suffering sustained sleep deprivation alongside malnutrition, famine, and pandemic conditions, is a set up for disease in both the short and long term, the transformation of the open-air prison that is Gaza into a death camp.
Our tax-funded bombs, missiles, drones and quadcopters aside, the environmental health toll of daily breathing in the rubble of Gaza will no doubt shorten people’s lives across the board. Tax resistance, and boycott, divestment, and sanctions are all essential to shutting down the grotesque vision of “Trump Gaza Shining Bright” that Jared Kushner has been trying to sell his demented in-law. We need to find new and creative ways – and tax incentives – to bring those funds home, to invest in housing, healthcare, education, and the arts.
Speaking of nuclear lunatics, it’s tough to say whether literal nuclear fallout from atomic testing might have blown our way from time to time growing up. I do know that as kids, we loved visiting a shoe store that allowed five-year-olds unsupervised access to what was known as a “shoe-fitting fluoroscope,” an x-ray machine that allowed us to study the bones in our feet at some leisure whilst our mother put salve to her sorrow shopping for shoes.
Even for privileged white kids like us, who never worked a day in pesticide-soaked fields, there was no shortage of pathways to environmental injuries in childhood that ramp up our vulnerability to Covid and other diseases. Lulled by the assurances provided by DDT ads with the singing cow – “DDT is good for me” – my mother made a practice for several months, at least, of sprinkling DDT around the edges of our beds when we were children to keep bugs at bay as we slept.
I guess we could take heart that a lot of people who really bought into RFK’s whole MAHA schtick are pretty pissed off right now at Trump for ramping up the production of glyphosate (the active ingredient in Roundup) under the auspices of national security and handing its producer Bayer total impunity. But doesn’t it just make you feel nostalgic for the good old days? Back to the Future and all that.
In the sixties and early seventies, middle class kids were routinely gifted at the holidays with chemical byproducts of a military-industrial complex born out of World War II and supercharged during the Cold War. We were routinely entrusted to work with searing, vaporous, hot plastic and metal forms to make things called “creepy crawlers,” “rings and things” and “fun flowers.” It wasn’t until 1973, following passage of the Consumer Product Safety Act, Mattel pulled its “thingmakers” from the market.
The classic 1976 SNL skit featuring Dan Ackroyd and Candice Bergen lampooned the hazards common to children’s toys in the period, and toy companies bucking attempts to enforce regulatory compliance. As toy company CEO Irwin Mainway, Akroyd is (lightly) grilled by Bergen on the fictionalized show called “Consumer Probe,” with Ackroyd/Mainway shamelessly defending products that included such classics as “Bag O’ Glass,” “Bag O’Sulphuric Acid,” and “Teddy Chainsaw Bear.”
All those potential sites of childhood stress, radiation, and chemical injury aside, it seems to me no coincidence that the symptoms of Hashimoto’s first started to hit me in around 2008 during a protracted battle over institutional racism at Washington State University Vancouver. That’s when my health took a heavy hit, and I have no doubt that workplace stress was a major contributing factor. And it’s taken a far greater toll on the health of faculty of color in the crosshairs. The working conditions in academia have only grown more toxic since, given the defunding and corporatization of higher education and the rollback of DEI, gender studies, and anti-racist curriculum that’s been decades in the making, the moral cowardice of liberal administrators on full display.
The industrial waste from runaway consumerism disparately impacts communities of color. At least two decades of research into the social determinants of health and into racial health disparities has illuminated the role that lifelong stress from racism in myriad forms plays in shaping health outcomes across the board. No wonder, then, that Elon Musk, his motley crew of Doge Douches, and RFK have been only too eager to defund research in health disparities, given the longstanding data on the daily toll that racism exacts on the health of people of color across the U.S.
In Washington, D.C., those disparities on average shave nearly two decades off the lives of African American men. Nationwide, Black Americans have suffered the highest mortality rates from Covid, with employment and housing discrimination, racist policing, and high rates of incarceration all serving as contributing factors. But similar patterns of discrimination and lack of access to insurance and healthcare also disproportionately impact Latinx, Native American, and queer and trans people.
More broadly, the material conditions of working people in the U.S., including real wages, benefits and access to healthcare, have steadily declined. And if, in that elusive quote about measuring a society by how it treats its weakest, holds water, then the U.S. is pretty deep into the “spiritual death” that MLK warned of nearly 60 years ago in his April 4, 1967 Riverside Church Speech.
The Brown University Cost of War Project estimates, conservatively, that since 911, the U.S. has spent more than 8 trillion dollars on war, which amounts to “$70,000 per taxpayer and $100,000+ per household — borrowed money that will cost even more in interest over the coming decades.” Factor in the “future veteran care and interest,” and the Cost of War Project puts the (financial) cost of U.S. wars since 9-11 at closer to $14 trillion.
If you’re wondering how far a trillion dollars could go toward universal healthcare in the U.S., you might find the answer a little bit confusing, given that, according to the Yale School of Public Health, “A single-payer universal health care system could cover every American, save more than 100,000 lives a year, and still cost $1 trillion less than the system it would replace.”
But if we want to be clear about the domestic costs of militarism, the urgent need for single-payer universal healthcare, and the need to rebuild, revitalize and redouble our commitment to public health in the U.S., masks are a critical, a necessary tool. They serve not only as a defense against Covid transmission, but also as a daily act of solidarity and a reminder that Covid is still with us, and it continues to kill and disable people in the U.S., Palestine, and around the world.
Many thanks to Linda Cargill, Frann Michel, and Mikel Clayhold for their feedback on drafts. Any errors are my own.
1. Capitalization is original. ↑
