How to Have Sociology in a Pandemic

Originally published in Section Culture: Newsletter of the ASA Culture Section. Spring 2020, Vol 32. Issue 1

Alexandre White1,
Johns Hopkins University

As a graduate student, my first dissertation project intended to examine through ethnographic methods the long-term effects of social distancing practices associated with the West African Ebola virus disease (EVD) epidemic of 2014-2015. I was curious what, after many months of curfews, quarantines, and distancing measures, social life would be like. I thought this a novel moment to consider such a rare and potentially devastating social phenomenon. Today, the experiences of social distancing and public health mandated social isolation are becoming ever more universal to human existence. Similarly, I expect that many of us will become, in some form, sociologists of pandemics for some time to come. 

The role of the social sciences and humanities in a pandemic more broadly is a question that has been of deep discussion at universities around the country. Last week the Center for Medical Humanities and Social Medicine at Johns Hopkins University2 held an online workshop on this theme bringing together, anthropologists, sociologists, historians, science and technology scholars, and clinicians. Understanding the phenomenon of pandemics must be recognized to be an interdisciplinary concern from which we can draw from many intellectual communities. At a time when quick responses are needed and the  dynamics of the pandemic shifts in hyper-speed, pandemic moments are ones that are preternaturally resistant to contemplative sociological thought. Pandemics seem to require swift data and decision-making to manage, but they also need robust sociological intervention so that perhaps we won’t reproduce the mistakes of today in the future. 

Beyond chronic and lingering pandemics such as that of HIV/AIDS, acute epidemics and pandemics have rarely produced sustained sociological inquiry. This is even the case in medical sociology in large part. A 2013 volume entitled Pandemics and Emerging Infectious Disease: The Sociological Agenda and edited by Robert Dingwall, Lily M. Hoffman, and Karen Staniland produced an enduring account of how a sociological research agenda can be tailored to questions of acute epidemic events. They suggested that a reason for the lack of research on acute epidemics may be the perception that such moments are largely the domain of public health and medical sciences (Dingwall, Hoffman, and Staniland 2013). However, in so many ways they are much more complex. Pandemics are not only biomedical but also made manifest through the social and political lenses that produce  the experiences and practices of those living through them. An epidemic, to quote Allison Bashford is of course biological but also ‘a bureaucratic and political effect’ (2004:4). While I would highly recommend the provocations provided by the authors of this volume, I want to echo that, both prior to COVID-19 and now, epidemics are of urgent concern for our sociological imagination. 

At this moment we as sociologists are attempting to understand, theorize, and contextualize this alien moment to encapsulate this global phenomenon within our sociological frameworks. In this short article I want to suggest a few ways that  sociological imaginations can confront this moment. I also want to consider how they might call upon us to think otherwise about traditional scholarship and to produce new questions for critical investigation. I do not intend to be exhaustive but rather to highlight some frames through which sociology can confront the practice of sociology in a pandemic moment. In this very brief space I wish to outline two broad approaches to thinking about pandemics as sociological phenomena that will be essential to frame the COVID-19 pandemic in sociological terms. The first would be to explore questions of sociology ‘in’ epidemics. What lessons can we learn from epidemic episodes that teach us more about the wider social world? The second is to explore epidemic diseases and COVID-19 more specifically as  sociological phenomena themselves. This I would call sociology ‘of’ epidemics. I draw these framings from the work of David Mechanic on the role of sociology in health affairs (1990). 

Sociology in Epidemics

Maynard Swanson, in his work on plague and racist sanitation practices in 1901 Cape Town reflected, echoed Louis Chevalier that “Epidemics do not create abnormal situations but rather sharpen existing behavior which betray deeply rooted and continuing social imbalances” (Swanson 1977:389). My experience studying histories of international epidemic responses can attest to this perspective. Very recent work has been examining these very questions. Naomi Klein’s recent analysis of  the COVID-19 pandemic in the context of disaster capitalism suggests that pandemics come to be framed and responded to in the context of free market ideology. Similarly, the current responses to COVID-19 have exposed how latent inequalities – especially within US society – expose how access to care, resources, and even who gets sick and who doesn’t fissure along racial and socio-economic lines. Epidemics have historically produced aggressive responses against those already marginalized by society, such as those of lower class status, the impoverished, or the socially oppressed for reasons of race, gender, sexual preference, or other categorizations (Decoteau 2013; Paye-Layleh 2014; Swanson 1977; White 2017). How pandemics expose, reproduce, and highlight crises of inequality and economic systems allows sociologists to examine how what may otherwise be discrete phenomena affecting particular populations play out in real time on a much larger scale. The crises of capitalism, financialization and inequality, and biopolitics produced by COVID-19 as discussed by Klein (2020), Zizek (2020), Agamben  (2020) highlight spaces to reconsider how social structures, regulations, and governmentality all shift in such moments. Thus, pandemics can be a useful heuristic for understanding social dynamics when all institutions and relations are warped almost to breaking point. 

Sociology of Epidemics

But what  novel questions do pandemic moments themselves produce?  As much as this is an empirical question it is also a call to decenter our analyses and bases of comparison from Eurocentric or US cases to geographies that have experienced similar events more recently. While the 1918 H1N1 Influenza pandemic may be seen as the archetypal comparison to the COVID-19 pandemic, geographical biases might preclude us from seeing more recent epidemics such as the West African Ebola epidemic of 2014-2015 or even the very recent ebola epidemic in the Democratic Republic of Congo (where similar social distancing measures were employed at national and regional levels) as prime cases for important comparison and conversation. Much anthropological work has explored how epidemic moments as well as broader health crises produce new rationalities of medical practice, politics, and citizenship. Given the scarcity of COVID-19 tests in the United States and the difficulties of access, we might ask: How are those potentially sick with the disease having to perform new modes of patient-hood in order to receive care? What sort of performative practices translate their experience into effective healthcare seeking procedure? These questions would be informed by the work of Vinh-Kim Nguyen on HIV/AIDS care in West Africa (2010), Adriana Petryna’s analysis of negotiating social support and welfare claims after Chernobyl (2004) and Claire Decoteau’s examination of bio-citizenship in Post-Apartheid South Africa (Decoteau 2013). Paul Richards (2016) explores how community responses and peoples’ science confronted the failures of international responses to EVD in West Africa in the absence of clear case counts and a lack of personal protective equipment for health workers.  My own work explores the histories of the phenomenon of epidemics, how they produce populations for control and care, and how epidemic threat is perceived as a function of geopolitical concern (White 2020). All of these comparisons should give us pause. They should make us think about how the current crises of data and forecasting, the discourses on ‘flattening the curve,’ and the health and policy responses currently deployed have distinct valences to epidemics of the past around the world. 

This is in no way meant to be a complete accounting of the lines of sociological inquiry that emerges from pandemic events. It is an attempt to sketch some paths towards sustained sociological inquiry of pandemics. As phenomena they require a plethora of sociological tools, theories, and perspectives to understand. Like all phenomena they are shaped by the histories, contexts, and geographies of their emergence. 

Footnotes

  1. For this title and for much of my analysis here I am grateful to Paula Treichler’s 1999 work “How to Have Theory in an Epidemic: Cultural Chronicles of AIDS”.
  2. I am grateful to Jeremy Greene, Elizabeth O’Brien, Carolyn Sufrin, Svea Closser, Graham Mooney, and Marian Robbins for organizing this thought provoking event.

References

Agamben, Giorgio. 2020. “Giorgio Agamben, ‘The State of Exception Provoked by an Unmotivated Emergency.’” Positions Politics. Retrieved March 30, 2020 (http://positionswebsite.org/giorgio-agamben-the-state-of-exception-provoked-by-an-unmotivated-emergency/).

Bashford, Alison. 2004. Imperial Hygiene: A Critical History of Colonialism, Nationalism and Public Health. Houndsmills [England] ; New York: Palgrave Macmillan.

Decoteau, Claire Laurier. 2013. Ancestors and Antiretrovirals: The Biopolitics of HIV/AIDS in Post-Apartheid South Africa. Univ. of Chicago Press.

Dingwall, Robert, Lily M. Hoffman, and Karen Staniland, eds. 2013. Pandemics and Emerging Infectious Diseases: The Sociological Agenda. Chichester, West Sussex: John Wiley & Sons Inc.

Klein, Naomi. 2020. “Coronavirus Capitalism — and How to Beat It.” The Intercept. Retrieved March 30, 2020 (https://theintercept.com/2020/03/16/coronavirus-capitalism/).

Mechanic, D. 1990. “The Role of Sociology in Health Affairs.” Health Affairs 9(1):85–97.

Nguyen, Vinh-Kim. 2010. The Republic of Therapy: Triage and Sovereignty in West Africa’s Time of AIDS. 1 edition. Durham, NC: Duke University Press Books.

Paye-Layleh, Jonathan. 2014. “Ebola Outbreak: Quarantine Camps in West Africa at Breaking-Point.” The Independent. Retrieved September 14, 2015 (http://www.independent.co.uk/life-style/health-and-families/health-news/ebola-outbreak-quarantine-camps-in-western-liberia-at-breakingpoint-9814796.html).

Petryna, Adriana. 2004. “Biological Citizenship: The Science and Politics of Chernobyl-Exposed Populations.” Osiris 19:250–65.

Richards, Paul. 2016. Ebola: How a People’s Science Helped End an Epidemic. London: Zed Books.

Swanson, Maynard W. 1977. “The Sanitation Syndrome: Bubonic Plague and Urban Native Policy in the Cape Colony, 1900-1909.” Journal of African History 387–410.

White, Alexandre I. R. 2017. “Global Risks, Divergent Pandemics: Contrasting Responses to Bubonic Plague and Smallpox in 1901 Cape Town.” Social Science History 1–24.

White, Alexandre I. R. 2020. “Historical Linkages: Epidemic Threat, Economic Risk, and Xenophobia.” The Lancet 0(0).

Žižek, Slavoj. 2020. “PANDEMIC!: Covid-19 Shakes the World by Slavoj Žižek.” OR Books. Retrieved March 30, 2020 (https://www.orbooks.com/catalog/pandemic/).