Introduction

Epidemics have their own particular biography. This Mortality special issue was commissioned as the secure acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was beginning to take hold in early 2020. The rapidly escalating infection rate provoked comparisons to the Spanish Flu pandemic of 1918 which caused 50 m deaths worldwide. Following months of extraordinary measures including lockdown and mass vaccination, ‘Covid’ has now been toppled from the headlines by the war in Ukraine. To date, the infection has caused more than six million deaths worldwide and although the disease continues to spread throughout the population, the likelihood of death has been tempered by vaccination regimes. Covid is almost – but not quite – becoming history.

Human responses to mortality are always subject to scrutiny during periods of crisis that inflate the death rate far above its normal course. Death in these circumstances is often a bad death. The mode of death itself is alien. At the medical front line, mass mortality enforces a priority to save life where possible. In hospitals, there is limited time for sensitivity and compassionate gestures to console the dying, who are isolated from the comfort of family presence. Perhaps worse, many people will die at home without medical intervention to alleviate suffering. Disease control regimes have also diluted the consolation that can be drawn from funerary ritual. During Covid, every culture has been reminded about the funeral practices it holds most dear and most essential to meeting the needs of the dying, the bereaved and society more generally.

The scope and range of the impact globally of the Covid pandemic on end-of-life experience, mourning practice, and rituals of disposal makes this collection a partial view on a landscape still unfolding. Erni and Striphas (2021) observed that ‘Covid was and remains so overwhelming because it is not one thing but many things simultaneously […:] a series of crises superimposed with such pressure as to leave one wondering where even to begin at all’ (p. 212). Where to begin? And where to end, given the pandemic is ongoing. For their part, Erni and Striphas begin with the place of their own quite different pandemic experiences. John Nguyet Striphas was working up the edited collection in a Hong Kong convulsed by democratic protest and its repression. Sensitive to the threats of infection, authorities instituted mask-wearing, social distancing and hand hygiene, measures adopted with alacrity and ease by a population long used to them. Nevertheless ‘that deep memory contains not only the formation of a public health consciousness, but also that of a public culture of protest […].the profound sense of a diminishing city marked by the intersection of a biological pathogen and a political disease’ (Erni & Striphas, 2021, pp. 217–218).

On the streets, the protesters masked themselves from the pathogen, certainly, but also from the prying eyes of a state that had perfected both maximal social interventions as infection control and sophisticated facial recognition software as a tool for policing dissidence.

Ted Striphas witnessed the differently awful consequences of an overlaying of pathogen and ‘political disease’. In the United States, public health measures aimed at stalling the progress of the pandemic were neither quickly instituted nor easily adopted. The first reflex was not individual protection (masking), but stricter bordering practices (tightened immigration control). After March 2020, disaster unspooled across the country thanks to a pathogen for which there was no immunity, but also because the States, separate and United, are poorly prepared for disaster and do not inculcate the social resilience that mitigates its harm. In that context, ‘[t]he shutdowns were a way of trying to get a handle on Covid […] but they were as much a moment to pause to figure out how to retrofit key aspects of life in the United States in such a way as to reflect priorities that should have been in place all along, but were ignored’ (Erni & Striphas, 2021, p. 220).

Those priorities were about the protection of the vulnerable, whether that meant free and universal public health, paid sick leave, better funding and oversight of aged care, or the overhaul of the prison system. It is such ‘priorities ignored’ as these that shape the impact of the pandemic. These priorities may differ from place to place or time to time in the sweep of the pandemic, or indeed may not be ignored at all but firmly guide pandemic response. Both priorities served and priorities ignored have shaped the fabric of everyday life and those threshold ‘fateful moments’ around illness, dying, mourning and disposal. Priorities served and priorities ignored have also shaped the end-of-life experiences for those who attend the dying, and the dead, whether in a professional capacity (emergency workers, medical carers, the laity, funeral and mortuary workers) or the personal (family, partners, friends).

This collection of papers focuses on the lived experience of the pandemic, and brings into focus the voices of people at its sharpest edge: medical staff on infection wards (Mercadal-Sánchez et al., 2022; Pilbeam & Snow, 2022); city and Church officials attempting to mitigate infection rates in 19^th century Cuba (Wade, 2022); bereaved people facing changes to allowable funerary practice (Long, 2022); marginal groups whose lives have become so much more dispensable in the context of emergency (Klaufus & Weegels, 2022); and photojournalists seeking to document events (Morcate & Pardo, 2022).

Pandemics are disruptive forces that wrench funerary practices from what might be regarded as their ‘traditional’ moorings. Emergency protocols based entirely on sanitary principles reframe the social experiences of mortality. The body of the loved one becomes a dehumanised contagion threat and attendant rituals at the deathbed and in subsequent days are curtailed. Funerals are also viewed with the suspicion, in carrying the potential to become – in modern phraseology – ‘superspreader’ events. Similar broad funeral narratives are evident in each pandemic incident, but exploring the nuance of difference can lead to some surprising conclusions. The first paper in this collection reviews events around the recurrent incidence of cholera in Havana over the course of the nineteenth century. Cuba was part of the Spanish Empire, and during the eighteenth century, Charles III had introduced legislation to curb the practice of burial in churches, deemed to be insanitary as a consequence of congregational exposure to fatal miasmas from decaying bodies. Wade discusses the way in which the municipal, medical and church authorities co-operated in the establishment of new and more sanitary burial grounds. However, an attempt to simplify and sanitise funerals by transporting bodies directly to the cemetery created an opportunity for the development of new and more lavish funerary processions. In actuality, the epidemic hastened the development of a commercial funeral industry in the city and exacerbated modes of societal inequality in funerary practice.

In the current pandemic, ‘sudden, seismic acceleration of bordering’ practices under Covid (Mountz, 2020) have increased the vulnerability both of those without ‘place’ (asylum seekers, the homeless) and those forcefully emplaced (the incarcerated). Klaufus and Weegels explore the complex vulnerabilities of the incarcerated during the first year of Covid crisis in Colombia, Nicaragua and Argentina. Latin America has one of the largest prisoner populations in the world and some of the largest prisons. There, as in many countries, the precarity of prisoners pre-exists the pandemic, but that precariousness was increased by policies for infection control and disposal of the infected dead. Using interviews with prisoners, their families and with administrators and workers in the public cemeteries tasked with disposal, Klaufus and Weegels explore the necropolitics of marginalisation for the incarcerated: a trajectory from social death in prison, to the depersonalisation of the dead prisoner body, and its physical and social dispossession as a mournable object. That trajectory of disposability affects prisoners and their families, who struggled to secure a record, place, and cause of death and to ensure a dignified disposal. Hasty interments and processes for infection control that sealed and masked cadaver and casket also worked to evoke painful political memories of earlier disappearances. The pathway from ‘prison to pit’ fits within a classed geography of disposal and memorialisation as the prisoner dead were consigned to the margins of those large public cemeteries that were already the preserve of the poor, the indigent and of the unclaimed dead. In this way, Klaufus and Weegels unpack the impacts of pandemic crisis response on an already disposable population (the incarcerated) in the context of broader ‘structures and practices that gird the treatment and disposal’ of the marginalised dead.

While Klaufus and Weegels deal with the ‘processual’ marginalisation of the incarcerated, Morcate and Pardo address a very different kind of marginalisation: the absence of a photographic record of Covid from major Spanish newspapers in the early months of pandemic. Using interview data with a range of photojournalists, and visual analysis of the corpus of Covid print media imagery, Morcate and Pardo argue that that absence of imagery, or the partiality of news photo-journalism for symbolic and representative imagery (‘veiled and indirect’), retarded the forming of a public imaginary of the mortal costs of Covid.

Photojournalists were discouraged from capturing images of mortal illness, of the Covid dead, scenes of bodily disposal and scenes of mourning in a number of ways. They were constrained by editorial policies respectful of public sensibilities and by their own delicate ‘balancing act’ between ‘bearing witness’ and compounding compassion fatigue. The capacity of photojournalists to bear witness was also constrained by the pandemic emergency in all its forms. Access to hospital emergency rooms, to Covid wards, to the ‘ride-along’ with emergency services were all difficult to secure, while breaching the inner sanctums of Covid domestic dying was all but impossible. Morcate and Pardo argue that the resulting lack of images of the reality of Covid dying, death and disposal shaped the narrative of the developing pandemic – crucially excepting a view on the pandemic from Covid sufferers themselves and undermining public preparedness for the crisis unfolding around them.

The penultimate papers in this special issue relate to the complex impacts of the pandemic crisis on the healthcare professionals and healthcare workers at the frontline of care. The practices of ‘palliative accompaniment’ that Mercadal-Sánchez, Ferrer-Romero & Fradejas-García identify and the coping strategies of nursing staff in the UK that Pilbeam & Snow unpack show end-of-life caring practices and protocols radically undermined, and professional identities turned upon their head by the press of the Covid dead and dying in healthcare settings.

Mercadal-Sánchez, Ferrer-Romero & Fradejas-García use interviews, focus group and participant observation to explore the everyday experience of hospital and aged care workers in the early stages of the pandemic in Spain. These accounts suggest that the pressures of overburdened hospitals and hastily employed infection control measures upended professional processes of care of the dying. Overworked professionals, including an emergency workforce of barely trained nurse assistants, were stranded with the medical, social, and emotional support of the dying. Prior to the pandemic, caring had been a collaborative effort between professionals and family and friends, but Covid infection control practices largely locked out the face-to-face support of intimates. In the face of these challenges, new rituals of work arose, as when the staff in one Spanish Covid ward reoriented the beds of the dying so that, faced to the window, the sufferers might more easily slip from the world.

Mercadal-Sánchez, Ferrer-Romero & Fradejas-García, and the following article by Pilbeam & Snow explore a kind of ‘make-do’ of individual and collective meaning-making where the routines and practices of clinical care are at breaking point. Pilbeam & Snow focus on the situation of UK nurses redeployed from non-critical care wards to overburdened ICUs, and the ways in which these workers struggled to reconcile the exigencies of work on Covid wards with the tenets of their training about standards of care for the critically ill, the dying and their families. These workers had to find mechanisms for coping, and make meaning from the new conditions of work, and the new shape of relationships with patients and family.

Pilbeam & Snow’s work maps sense-making ‘in crisis’ and the various coping strategies employed by their nursing staff interviewees. These strategies aimed at forestalling moral injury, at problem-solving ‘on the fly’, and at making the best of increasingly contingent decision-making about care. Such strategies are proactive attempts to reconcile professional and clinical practice under extraordinary crisis with the precepts of training and with formed professional identities. The accounts are eloquent testimony to the pressures that nursing staff in the UK and elsewhere navigated on a day-to-day basis for the weeks and months of Covid during its most savage phase.

At the height of the pandemic, Covid deaths were understood to be ‘bad’ deaths by professionals and families. These deaths called for the consolation of a funeral service as a means of reparation, but the management of infection risk limited numbers allowable at funerals and forbade attendants to intermingle and provide comfort to one another. The epidemic provoked a global iteration of what is meaningful in funeral practice as communities realised the impact of a prohibition on the ability to perform the expected ritual. The iteration of loss in this regard has been particularly marked among communities where funerary ritual extends beyond framing and attending a service at a cemetery or crematorium. In many cultures, ‘the funeral’ is an event that draws together the extended family network and the community in a series of gatherings before and after the formal deposition of the body. Long’s paper contends that scholarship on the impact of funeral restrictions has tended to take one of two approaches. First, a ‘deprivation model’ focusses on the nature of funeral restrictions and possible impacts in terms of complicated or disenfranchised grief. Second, an ‘adaptation model’ emphasises resilience where meaning is forged through innovation and adaptability. Long uses primary qualitative data to explore the experience of Samoan funeral practices of families living in Aotearoa New Zealand. Samoan practices include an assembling of the wider family and important community members, and reciprocal gift-giving. Long’s respondents felt that Covid had relieved them from the often extravagant burden of fa’alevelave. The epidemic was an opportunity to explore how Samoan culture might adopt new practices, and echoes Wade’s findings with regard to longer-term impacts of epidemic on funeral change.

This collection of papers was chosen as a consequence of their remarkable nearness to pandemic experience. The authors here have captured voices, decisions, and behaviours enacted during a period of acute stress. The ‘priorities served and priorities ignored’ for a short time recoloured and redrew the landscape of mortality with more vivid and damaging expressions of exclusion and funerary rituals that were greyer and de-natured. As yet, time has not afforded sufficient perspective to judge how far and in what ways this landscape has altered, although Wade’s contribution to this issue is itself an example of the potential speed and scope of change under the pressure of pandemic. Funerary ritual will adopt new variances and become re-vibrant. However, it is likely that marginal groups will again fall further from view and the unequal toll of deaths will be largely forgotten.

Disclosure statement

No potential conflict of interest was reported by the author(s).