The Percussive Effects of Pandemics and Disaster

ABSTRACT

In this special issue, we note the percussive – immediate, disruptive and urgent – effects of the coronavirus pandemic, while anticipating its longer term repercussions. As social institutions, global and local economies,  political relations, and everyday social lives are being remade, we highlight the implications of this microbial infection and its virulence. In doing so, we illustrate how medical anthropology both illuminates the present and warns of COVID-19’s unequal unfolding.

KEYWORDS:

• COVID-19
• rapid response
• urgency
• international governance
• coronavirus pandemic
• public anthropology

This introduction to this special issue on COVID-19 and other crises is being written on May 13, 2020. The date is relevant because under lockdown, while days merge into each other, the velocity of the pandemic and the mercurial shifts this has caused in economic, political, and social life are everywhere, day by day, very different. The speed and relative democracy of communication makes this all the more extraordinary. We watch changing graphs of statistics of cases, deaths, and tests conducted, as figures jump exponentially; we comment on the veracity of reportage and its dominance over other global events, and on the politics of the suppression of information and digressions from this. All things, right now, have threads to and from COVID-19.

This was not so in January, as the news of coronavirus infection in Wuhan filtered through; it was partly true, but the politics were different, as countries began to lockdown in March. The editorial and most op-eds in this issue were published in late March, when half a million cases and fewer than 25,000 deaths had been reported and logged for global media and our own consumption. Seven weeks later, as I write, there are 4.5 million cases and 300,000 deaths; the statistics largely underestimate both morbidity and mortality. And as this happens, anthropologists draw on multiple dimensions of the discipline to make sense of a pandemic in process.

As this issue goes to press, the 73rd World Health Assembly (WHA) – the supreme decision-making body for WHO – will meet, on May 18–19, 2020, its shortest meeting ever and its first virtual meeting. The WHA will now consider only the COVID-19 pandemic response and will postpone all other agenda items for later discussion. That is the power of this particular microbe. It has shut down economies worldwide, everywhere disrupting life and searing existing inequalities. It has, in the process, mocked the organization internationally charged with monitoring, interpreting, and harnessing its spread, and forced it to shelve its unique aim to consider social well-being and “not merely the absence of disease or infirmity.” The first WHA spent much of its time attending to this agenda, reiterating the importance of the social, economic, environmental, and other factors shaping inequalities and informing the distribution of disease. The WHA this year returns to the primary goal of earlier international health organizations “to fight disease and epidemics.”¹

In the context of COVID-19, Medical Anthropology acted quickly to ensure that anthropology was not a voice late to the table. The editorial and the four op-eds were written and published online when Wuhan had been in lockdown for 2 months, but as most countries were only beginning to accept the need to follow suit. These short publications offer a mix of early reactions: reflections on daily life in Italy, when the extent of the pandemic was likely unimaginable (Roberta Raffaetà); percussive politics of state and Islam in Turkey (Oğuz Alyanak); conspiracy theories gone viral in Pakistan, as occurred earlier in relation to measles vaccination (Inayak Ali); and consideration of how the money market might seize on the opportunities that disasters offer (Susan Erikson). As reflected in the editorial, Susan Levine and I were trying to make sense of the pandemic unfolding in our own cities, as its percussive effects began to infuse panic in South Africa and Australia.

As these opinion pieces went to press, so the article by Ato Kwamena Onoma on xenophobia in Dakar, Senegal, in response to Ebola, and the article by Christopher Dole on scaling psychiatric interventions following a massive earthquake in Turkey, were being prepared for publication. Onoma’s ethnography of how migrants during epidemics are subject to scapegoating, and Dole’s questions of care in times of and after crises, spoke directly to the present, and they anticipated the evolving percussive effects and repercussions of COVID-19. Robbie Davis-Floyd, Kim Gutschow, and David Schwartz had, at the same time, been conducting what they termed rapid-response research, using list-serves in the US and beyond to identify changes to birthing associated with COVID-19. Interpreted against decades of research on birth place and choice, they were concerned with how the pandemic was unsettling the work of midwives and birth supporters, forcing pregnant and parturient women to review their intentions to give birth safely in a hospital or a home setting.² Ayo Wahlberg’s and my evolving research on chronic conditions, our earlier ethnographic work, and notes from the field illustrated a different kind of percussion. The absolutely dominant discourse and flow of resources to attend to escalating cases of coronavirus and fear of its spread threatened to overwhelm the needs of other people with other health and care needs. In this context, we joined forces to write of our concern on policy and health practice in a time of urgency.³

In writing, in this introduction, of the percussive effects – the noise – of the virus, I aim to capture much of the urgency of the pandemic and its social, political and economic effects; this is in contrast to the repercussions reflected particularly in Christopher Dole’s article, although the xenophobia which Onoma describes is also, as noted above, both percussive and repercussive.

This special issue is a product of its time, an intense and perverse moment when institutions, political relations, global and local economies, sociality, and the banality of handwashing and physical distancing come together. It is a time when we, as medical anthropologists, draw on all we know about the social life of illness to make sense of microbial infection and its virulence.

Additional information

Notes on contributors

Lenore Manderson

Lenore Manderson is editor of Medical Anthropology, and Distinguished Professor of Public Health and Medical Anthropology in the School of Public Health, University of the Witwatersrand, Johannesburg.

Notes

1. Etter, M. 1948. Address by the Head of the Department of the Interior of the Swiss Confederation. In Official Records of the World Health Organization No.13. First World Health Assembly. Geneva June 24 to July 27, 1948. P.24. Palais de Nations, Geneva, Switzerland: WHO.

2. To ensure timely publication, this article was subjected to expedited review.

3. This article was also reviewed expeditiously and one of the few occasions when I have published in the journal as an author since 2010.