Readings & Audiovisual

In parallel with the COVID-19 pandemic, an infodemic—an information epidemic—challenges human populations across the planet. Often framed as an enemy to be conquered, infodemics endanger public health because inaccurate or erroneous information spreads quickly on a large scale, triggers potentially harmful behaviours, and generates stress and anxiety. Much infodemics research privileges the investigation of online information creation and circulation, as well as measures to counter erroneous information. Less examined, however, are the offline effects of an infodemic. This chapter surveys how infodemic analysts have evaluated interactions between online information and offline practice. It examines studies focusing on the harmful content of the online informational ecosystem and containment efforts, and then explores social sciences contributions, which broadly identify factors contributing to public interpretation and offline practices. We conclude with a concrete example of an anthropological study exploring the interplay of online information and offline practice during the COVID-19 pandemic.

The COVID-19 pandemic has shown how syndemics and protracted crises increase the vulnerability of communities facing concurrent, cascading risks and complex secondary events that aggravate health risks and underlying burdens of infectious and non-communicable diseases. Epidemics start and end in communities, where citizens are often the first to observe changes in the environment and in animal health, and the first to be exposed to new or re-emerging pathogens. Local stakeholders have crucial roles in the prevention and control of disease transmission, and frequently develop systems of appropriate health and social care based on local knowledge. However, current approaches to disaster risk management often do not sufficiently recognise and engage community expertise.

The COVID-19 pandemic has the potential to affect the human microbiome in infected and uninfected individuals, having a substantial impact on human health over the long term.

In this article, we focus on how the proxemics of the pandemic affect people with chronic conditions, including the impact of changed norms of engagement for self-care and chronic disease management for individuals and households. Among older people, COVID-19 can both directly and indirectly increase their isolation, load onto existing health problems, and add to the risks of depression and anxiety. While there is excess mortality among older people from COVID-19, the concomitant accumulating social and physical effects of changes to everyday lives may equally contribute to untimely death. With the spread of coronavirus, there has been growing concern for the vulnerability of older people to serious diseases for both biological and social reasons. Emerging data suggest that COVID-19 deaths and other acute conditions are increasingly unrelated to the virus itself, but born out of its social consequences (Delmas, Bouisset, and Lairez 2020; Manderson and Wahlberg 2020). There is concern regarding increasing suicides and (often interconnected) problems of gender-based violence and alcohol misuse (Al-Ali 2020; Gratz et al. 2020; Ramalho 2020; Troutman-Jordan and Kazemi 2020). The aptly named ‘broken heart syndrome’– stress cardiomyopathy or Takotsubo cardiomyopathy – is also reported to have increased since the start of the pandemic, with the primary risk factor being age, along with anxiety and/or depression (Alharthy et al. 2020; Giustino et al. 2020; Jabri et al. 2020; Sattar et al. 2020). Well into the pandemic, we now need to consider its continuing direct and indirect effects on people’s lives.

Community responses to the SARS-CoV-2, or “coronavirus” outbreaks of 2020 reveal a great deal about society. In the absence of government mandates, debates over issues such as mask mandates and social distancing activated conflicting moral beliefs, dividing communities. Policy scholars argue that such controversies represent fundamental frame conflicts, which arise from incommensurable worldviews, such as contested notions of “liberty” versus “equity”. This article investigates frames people constructed to make sense of coronavirus and how this affected social behavior in 2020.

The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.

The coronavirus (COVID-19) arrived in the United Kingdom (UK) in February 2020, placing an unprecedented burden on the National Health Service (NHS). Literature from past epidemics and the COVID-19 pandemic underscores the importance of using a gender lens when considering policy, experiences, and impacts of the disease. Researchers are increasingly examining the experiences of healthcare workers (HCWs), yet there is a dearth of research considering how gender shapes HCWs’ personal experiences. As the majority of HCWs in the UK and worldwide are women, research that investigates gender and focuses on women’s experiences is urgently needed. We conducted an analysis of 41 qualitative interviews with HCWs in the British NHS during the first peak of the COVID-19 pandemic in the Spring of 2020. Our findings demonstrate that gender is significant when understanding the experiences of HCWs during COVID-19 as it illuminates ingrained inequalities and asymmetrical power relations, gendered organizational structures and norms, and individual gendered bodies that interact to shape experiences of healthcare workers. These findings point to important steps to improve gender equality, the wellbeing of healthcare workers, and the overall strength of the NHS.

Healthcare workers have emerged as a vulnerable population group during COVID-19, and securing supply chains of personal protective equipment (PPE) has been identified as a critical issue to protect healthcare workers and to prevent health system overwhelm. While securing PPE is a complex logistical challenge facing many countries, it is vital to recognise the social and health systems issues that structure the differential degrees of risk faced by various subgroups of healthcare workers. As an illustrative case study, the author identifies two key social factors that are likely to face the degrees of risk faced by midwives in the Special Region of Yogyakarta, Indonesia, if and when COVID-19 takes hold in Indonesia. Healthcare workers in both high and low resource-settings globally are likely to face particular risks and vulnerabilities that are shaped by localized social and health systems factors. Qualitative social and health systems research can and should be utilized proactively in order to protect healthcare workers, to inform more equitable program design, and to create a foundation for health equity within the future of global health that emerges from the pandemic.

A study started in Uganda before the coronavirus began its global travels may be the only reliable, real-time information the world has on how a community thought about and responded to the pandemic. It showed the need to assess vulnerability before a disaster, and show empathy based on understanding.

Une enquête faite à Dakar (Sénégal) apporte des éléments de réponse à cette question. Elle a été menée auprès d’acteurs de l’économie informelle de février à mai 2020 dans la zone de Ngor-Almadies, commune d’arrondissement de Dakar de plus de 20 000 habitants et qui compte de nombreux immigrés ouest africains vivant de l’informel.

This paper investigates the genealogy of social science research into antimicrobial resistance (AMR) by piecing together the bibliometric characteristics of this branch of research. Drawing on the Web of Science as the primary database, the analysis shows that while academic interest in AMR has increased substantially over the last few years, social science research continues to constitute a negligible share of total academic contributions. More in-depth network analysis of citations and bibliometric couplings suggests how the impact of social science research on the scientific discourse on AMR is both peripheral and spread thin. We conclude that this limited social science engagement is puzzling considering the clear academic and practical demand and the many existing interdisciplinary outlets. [Antimicrobial resistance, Health policy, Social science, Bibliometrics, Network analysis]

Community engagement is commonly regarded as a crucial entry point for gaining access and securing trust during humanitarian emergencies. In this article, we present three case studies of community engagement encounters during the West African Ebola outbreak. They represent strategies commonly implemented by the humanitarian response to the epidemic: communication through comités de veille villageois in Guinea, engagement with NGO-affiliated community leadership structures in Liberia and indirect mediation to chiefs in Sierra Leone. These case studies are based on ethnographic fieldwork carried out before, during and after the outbreak by five anthropologists involved in the response to Ebola in diverse capacities. Our goal is to represent and conceptualise the Ebola response as a dynamic interaction between a response apparatus, local populations and intermediaries, with uncertain outcomes that were negotiated over time and in response to changing conditions. Our findings show that community engagement tactics that are based on fixed notions of legitimacy are unable to respond to the fluidity of community response environments during emergencies. [Ebola; community engagement; ethnography; legitimacy]

This study investigated the cognitive-affective-behavioral sequence of public activism by examining the role of citizens’ perception of government dialogic communication during a national pandemic crisis. Through a case study of the 2015 Middle-East respiratory syndrome (MERS) outbreak in South Korea, the results of a survey of 400 South Korean citizens showed that distrust in government and a high level of situational uncertainty were significantly mitigated by citizens’ perceptions of government efforts for dialogic communication during the crisis. Conversely, when the perception of dialogic government communication was low, high distrust in government increased cynicism, anger, and anxiety among citizens; high situational uncertainty led to higher levels of anger and anxiety, but not cynicism. Consequently, the findings showed that anger, anxiety, and cynicism significantly motivated citizens’ intentions to take actions against the government. Direct and positive effects of anger, anxiety, and cynicism on activism participation were not found and were mediated by the citizens’ activism intentions.

This article investigates camel raising as a possible cause of transmission of the Middle East Respiratory Syndrome coronavirus (MERS-CoV) on the Arabian Peninsula. Drawing on collective research among camel workers in Qatar, it shows the difficulties of asking questions about camel raising in the context of a potential zoonosis, given the secretive nature of herding practices and the values attached to camels in Arab societies. It suggests that the concentration of camels in farms and central markets after the ban of camel grazing as well as the revival of the tradition of drinking camel milk have increased the risks of the transmission of MERS-CoV from camels to humans. The recent valorisation of camels, in the context of the transformation of Qatar from a pastoral economy to a global trade centre, may appear to be an obstacle in the surveillance of MERS-CoV, since camel owners are prone to denying that their animals are infected, but it can be converted into an asset if public health becomes a key element of national pride alongside camel raising.

The purpose of this article is to provide an understanding of how different countries formulate and regulate antibiotic use in animals raised for human consumption. A comparative case study was undertaken, analysing historical documents from the 1950s to the 1990s from the UK, the first country to produce a scientific report on the public health risks of agricultural antibiotic use; and Sweden, the first country to produce legislation on the growth promotor use of antibiotics in food animals. Sheila Jasanoff's concepts of ‘co‐production’ and ‘political cultures’ have been used to explore how both countries used different styles of scientific reasoning and justification of the risks of agricultural antibiotic use. It will be argued that national dynamics between policy, science and public knowledges co‐produced different risk classifications and patterns of agricultural antibiotic use between both countries. UK's political culture used ‘expert committees’ to remove the issue from public debate and to inform agricultural antibiotic policies. In contrast, the Swedish ‘consensus‐oriented’ political culture made concerns related to agricultural antibiotic use into a cooperative debate that included multiple discourses. Understanding how national policies, science and public knowledges interact with the risks related to agricultural antibiotic use can provide valuable insights in understanding and addressing countries agricultural use of antibiotics.

Durant l’épidémie d’Ebola de 2014-2016, les anthropologues se sont engagés dans la riposte de trois manières : en tant qu’experts d’Ebola, médiateurs culturels entre populations et soignants, et chercheurs. L’article propose une esquisse de bilan de leurs approches et contributions, et discute les enjeux de cet engagement sur la base d’une revue de la littérature, d’études de cas et de débats lors de colloques. Les résultats de recherches en anthropologie présentés dans l’article concernent quatre thèmes : les contextes épidémiologiques de la transmission ; l’interprétation culturelle de la maladie et les réponses sociales ; la construction sociale de l’expérience des acteurs ; l’analyse critique des interventions de santé publique. Outre des contributions éclairantes en particulier sur les contextes sociopolitiques et leurs interfaces avec les mesures de santé publique globales, les anthropologues ont expérimenté des formes de communication de leurs résultats accessibles pour les acteurs de santé publique. Cependant, ces formes d’engagement hétérogènes soulèvent quelques questions, notamment lorsqu’elles reflètent des interprétations de l’anthropologie par ceux qui la sollicitent ou qui s’en revendiquent lui déniant toute portée critique ou réflexive, ou lorsqu’elles la confondent avec une intervention sociale. Néanmoins, les acquis de la recherche anthropologique sont importants, et pourraient l’être davantage si les réseaux transnationaux mis en place par les chercheurs pour analyser les dimensions sociopolitiques, économiques et bio-culturelles des épidémies émergentes pouvaient être pérennisés pour « préparer » la riposte à de futures crises sanitaires. [Afrique de l’Ouest; Ebola; Anthropologie; Épidémie; Sciences sociales]

Middle East Respiratory Syndrome (MERS) is a severe viral respiratory illness that is caused by a new strain from the beta group of coronavirus (CoV). At both the global and national level (Saudi Arabia), men are at a greater risk of contracting the virus (68%) in comparison to women. This disparity presents an interesting question: What accounts for these observed sex differences in MERS infection rates? Using an analytic lens that considers the unique dynamics of socially constructed and specific gender roles, this review challenges the common assumption that biological differences in vulnerability (genetic disposition) are the primary drivers for the disparate male infection rates. Specifically, the author uses a gender-based analysis (GBA) to explore gender-based risk factors within Saudi Arabia that may contribute to this disparity. The findings of this review suggest that particular gendered risk factors including religious (Hajj) and cultural practices (shisha smoking), and social roles pertaining to livestock management (dromedary camels) may create different exposures to MERS-CoV. Ultimately, this research illustrates a significant gap in the current knowledge and understanding of how gender dynamics affect infectious diseases, especially concerning the issue of containment of and protection from MERS. [MERS, MERS-CoV, Middle-East Respiratory Syndrome, Gender-based Analysis]

In attempting to provide protection to individuals and communities, childhood immunization has benefits that far outweigh disease risks. However, some parents decide not to immunize their children with some or all vaccines for reasons including lack of trust in governments, health professionals, and vaccine manufacturers. This article employs a theoretical analysis of trust and distrust to explore how twenty-seven parents with a history of vaccine rejection in two Australian cities view the expert systems central to vaccination policy and practice. Our data show how perceptions of the profit motive generate distrust in the expert systems pertaining to vaccination. Our participants perceived that pharmaceutical companies had a pernicious influence over the systems driving vaccination: research, health professionals, and government. Accordingly, they saw vaccine recommendations in conflict with the interests of their child and “the system” underscored by malign intent, even if individual representatives of this system were not equally tainted. This perspective was common to parents who declined all vaccines and those who accepted some. We regard the differences between these parents—and indeed the differences between vaccine decliners and those whose Western medical epistemology informs reflexive trust—as arising from the internalization of countering views, which facilitates nuance.

The emergence of Severe Acute Respiratory Syndrome (SARS) in China’s Guangdong Province in the winter of 2002 was an exemplary spillover event: it marked the passage of a lethal pathogen from nonhuman to human animals and was widely heralded as the first “plague” of the twenty-first century. The SARS coronavirus seemed to burst out of nowhere and demonstrated pandemic potential from February 2003 when it diffused globally via Hong Kong. After SARS was officially declared contained by the World Health Organization (WHO) on 5 July 2003, there were a few isolated cases but none since 2004

This comparative study explores incertitude about hepatitis B (HBV) and its implications for childhood vaccination in Bangui, Central African Republic, and the Cascades region, Burkina Faso. Anthropological approaches to vaccination, which counter stereotypes of “ignorant” publics needing education to accept vaccination, excavate alternative ways of knowing about illness and vaccination. We build on these approaches, evaluating different kinds of incertitude (ambiguity, uncertainty, ignorance) about infancy, HBV, health protection, and vaccination. Using interviews and participant observation, we find that Bangui and Cascades publics framed their incertitude differently through stories of infancy, illness, and protection. We locate different forms of incertitude within their historical contexts to illuminate why vaccination practices differ in the Cascades region and Bangui. A more nuanced approach to incomplete knowledge, situated in political, economic, and social histories of the state and vaccination, can contribute to more appropriate global health strategies to improve HBV prevention.

Parents’ decision to use vaccination services is complex and multi-factorial. Of particular interest are “vaccine-hesitant” parents who are in the middle of the continuum between vaccine acceptance and refusal. The objective of this qualitative longitudinal study was to better understand why mothers choose to vaccinate—or not—their newborns. Fifty-six pregnant mothers living in different areas of Quebec (Canada) were interviewed. These interviews gathered information on mothers’ views about health and vaccination. Almost half of the mothers were categorized as vaccine-hesitant. A second interview was conducted with these mothers 3 to 11 months after birth to look at their actual decision and behavior concerning vaccination. Our results show the heterogeneity of factors influencing vaccine decision making. Although the majority of vaccine-hesitant mothers finally chose to follow the recommended vaccine schedule for their child, they were still ambivalent and they continued to question their decision