Even the devastating pandemic of HIV/AIDS today is received as a somewhat triumphal story of the transformation of an infectious deadly illness into a chronic, lifelong but manageable condition. It is often only in the work of scholars on HIV/AIDS outside of the west or examining marginalized communities that we see the hardships associated with this disease (Angotti 2010; Arnold, Rebchook, and Kegeles 2014; Brent 2016; Campbell 1999; Decoteau 2013).
Sociology has largely as a field ignored epidemics and pandemics as subjects or phenomena of study unto themselves save for a brilliant volume in Sociology of Health and Illness entitled Pandemics and Emerging Infectious Diseases: The Sociological Agenda (Dingwall, Hoffman, and Staniland 2013). This may be because the acute nature of their emergence often means that by the time one is able to actually conduct ethnographic or targeted research and cleared the funding, ethical and logistical hurdles to conduct such research, the epidemic may have expired. There are of course, as we are seeing, also significant physical risks involved.
There is also, I would argue an issue of perspective that clouds sociological analysis of infectious diseases. The most sustained inquiry into what I might call acute epidemics such as recent epidemics of Ebola Virus Disease in West Africa (Abramowitz et al. 2015; Richards 2016) and the Democratic Republic of Congo, zika virus, or yellow fever are usually taken up in the somewhat amorphous domain of Global Health research which focuses, by and large, upon the concerns and health problems occurring in the ‘developing world’. This leaves North America and Europe often outside of the realm of direct analysis or comparison except in cases examining migrant populations, and the international organizations (Chorev 2012), and geopolitical entities involved in health policy making (Lakoff 2017).While hugely important analyses, much of the thought produced within the domain of global health upon infectious disease, by its focus on the “developing world” perhaps would over-assume the differences in dynamics shaping epidemic responses and crises based on this distinction between west and rest. We see this both in the public sphere and in academia.
This has had a persistent effect on the way this pandemic has been discussed, theorized and ultimately affected the ways to which it has been responded. No doubt we have read many news articles comparing this pandemic to the 1918 Influenza pandemic. In both public press (Gross and Barry 2020; Harris 2020) as well as in medical fields (Ellul et al. 2020), close comparisons between the two largest respiratory borne pandemics of recent times are made. While there are significant similarities certainly in the scale of the pandemics and in the epidemiological dynamics of the two diseases, I would suggest that our knee-jerk comparison to 1918 reflects also a (false) perception that the last time an epidemic of this scale graced our shores was one hundred years ago.
Such a perspective elides more recent histories and voices who may likely provide more critical and important understanding to our current moment. As we consider the lessons we will learn from COVID-19 about sovereignty, state power, geopolitics, bureaucracy and other key objects of sociological analysis we should be aware of the silos that we have constructed for ourselves as theorists that silence the voices of those with particular experiences with epidemics. As we recognize the challenges of the health community as well as the general public to convince the federal government to respond more forcefully to an epidemic that has killed well over 100,000 people in the United States alone, we should recall that this is not itself a novel phenomenon when we consider the massive efforts of the citizen scientists, gay, lesbian, civil rights and HIV+ activists to fight for healthcare provision against discrimination and for federal support (Cohen 1999; Gonsalves 2020; Grmek 1990; Shilts 2007). When we consider the xenophobia surrounding COVID-19 we must place this within the larger context of long histories of Sinophobic and anti-Asian discourses around migration and disease threat that have a long history in America (Kraut 1995; Lee 2003; Mohr 2006; Risse 2012; White 2020; White and King 2020). Similarly when sociological theory must consider the ways in which structural racism has placed Black and Latinx Americans at greater risk of COVID-19 mortality we should position such understandings within the longer legacies of medical experimentation, exclusion and violences imposed upon marginalized groups in America (Nelson 2003, 2011; Roberts 2009; Rusert 2017; Sufrin 2018; Wailoo 2011).
While these are examples that may be excluded from a US-centered analysis of our current moment, the earlier mentioned bifurcation between epidemics in the West and epidemics of the Rest must also be troubled. Currently, the United States is the epicenter of the COVID-19 pandemic. Nurses, doctors and care providers across the country are still rationing personal protective equipment and loved ones are being taken to hospital while their families wonder whether they will ever see them alive again. People die socially distanced deaths in intensive care units, as loved ones say goodbye via video call. All the while far less support has been provided by the state than needed. Absent from most discussions I have seen are the comparisons between our moment today and the recent West African Ebola virus disease epidemic. From 2014 to 2016 the nations of Guinea, Sierra Leone and Liberia suffered the deadliest Ebola epidemic in history. For a period of two years social distancing, curfews and hand washing requirements were employed across the three countries. Doctors went without effective PPE, contact tracing was mobilized to count cases and find contacts, and central governments were struggled to support the populace. Patients were taken away to hospitals not knowing if they would see their families again. As research on the West African Ebola epidemic has shown, far from the cultural stereotypes of unsanitary behaviors spreading the disease, in light of these challenges and the failure of centrally coordinated responses, communities banded together to produce solutions to halt the spread of the epidemic (Richards 2016). While a huge international effort was also required, people banded together to control the disease.
As we confront our tasks as sociologists to consider our particular moment, theorize its causes and understand the effects of this pandemic, I would suggest that we turn to the voices that our field has historically marginalized and learn from those who have experienced epidemics and whose experience could teach us a great deal. Our previously comfortable belief that epidemics in the west play out differently from those in Africa or Asia our South America has been shattered, while the voices of those who have battled the worst pandemics of recent times around the world and in the United States go unheeded. As we write the sociology to explain this moment we would be loath to not make these experiences central to our analyses.
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