Readings & Audiovisual

I think the gut reaction of many Hong Kong was that "oh no, it is SARS again", probably because the memory from when the disease plagued Hong Kong 17 years ago is quite vivid and painful for many of us. But the side effect of that is that people reacted quickly to see the virus from Wuhan by saying you should wear a mask in public whilst government officials were seen on TV not wearing a mask. Other knowledge such as cleaning a home with bleach solution, maintaining good hand hygiene are also from 17 years ago and people are putting this knowledge to good use. Anot

The outbreak of the new coronavirus in Wuhan and the spread of the epidemic across China have led to the adoption of community containment measures, such as quarantine and the lock-down of cities numbering millions of people. To understand what is happening in China, we need to place epidemic control measures in their proper historical context.

This document provides WHO checklists for risk communication and community engagement (RCCE) readiness and initial response for novel coronaviruses (nCoV) recently identified in Wuhan, China (2019-nCoV). The objective of this document is to provide actionable guidance for countries to implement effective RCCE strategies which will help protect the public’s health in the early response to nCoV. This document includes recommended RCCE goals and actions for countries preparing for nCoV cases and for countries that have confirmed -nCoV cases.

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 report is the third instalment of the ‘Social Science in Epidemics’ series, commissioned by the USAID Office of U.S. Foreign Direct Assistance (OFDA). In this series, past outbreaks are reviewed in order to identify social science ‘entry points’ for emergency interventions and preparedness activities. The aim is to determine tangible ways to address the social, political and economic dynamics of epidemics and to ensure that interventions build on the social and cultural resources of the communities they aim to support. This report explores lessons about the social dimensions of past and recent influenza epidemics and the emergence of SARS-CoV.

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.

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]

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 article traces the early evolution of the H1N1 pandemic as it played out in China′s Pearl River Delta in the spring and summer of 2009, as local public health professionals there tried to contain the virus when their American counterparts did not do so. My informants′ difficulties in escaping their perceived status as a source, rather than a victim, of dangerous viruses; their use of disease control tactics that were portrayed abroad as excessive, unscientific, and unsophisticated; and their fatalism about reforming their local system of governance; all frustrated their ambitions. At the same time, the gulf between their reactions to H1N1 and the reactions across the Pacific suggests the need for a more serious global debate about what local places in all parts of the globe should and should not be prepared to do in the name of pandemic preparedness. [SARS; H1N1; pandemic; China; preparedness]

This article explores the disease-associated stigma attached to the SARS victims in the post-SARS era of Hong Kong. I argue that the SARS-associated stigma did not decrease over time. Based on the ethnographic data obtained from 16 months of participant observation in a SARS victims' self-help group and semistructured interviews, I argue that the SARS-associated stigma was maintained, revived, and reconstructed by the biomedical encounters, government institutions, and public perception. I also provide new insight on how the SARS-associated stigma could create problems for public health development in Hong Kong. As communicable diseases will be a continuing threat for the human society, understanding how the disease-associated stigma affects the outcomes of epidemic control measures will be crucial in developing a more responsive public health policy as well as medical follow-up and social support service to the diseased social groups of future epidemic outbreaks.

The appearance and spread of severe acute respiratory syndrome (SARS) on a global level raised vital legal and ethical issues. National and international responses to SARS have profound implications for 3 important ethical values: privacy, liberty, and the duty to protect the public's health. This article examines, through legal and ethical lenses, various methods that countries used in reaction to the SARS outbreak: surveillance and contact tracing, isolation and quarantine, and travel restrictions. These responses, at least in some combination, succeeded in bringing the outbreak to an end. The article articulates a set of legal and ethical recommendations for responding to infectious disease threats, seeking to reconcile the tension between the public's health and individual rights to privacy, liberty, and freedom of movement. The ethical values that inform the recommendations include the precautionary principle, the least restrictive/intrusive alternative, justice, and transparency. Development of a set of legal and ethical recommendations becomes even more essential when, as was true with SARS and will undoubtedly be the case with future epidemics, scientific uncertainty is pervasive and urgent public health action is required.