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Covid-19 in Italy: should sociology matter? Giampietro Gobo

Covid-19 in Italy: should sociology matter?

Issue 46: Pandemic (Im)Possibilities vol. 2 Sat 1 May 2021 0

Giampietro Gobo and Enrico Campo, University of Milan, Italy.

The worldwide spread of the novel Coronavirus is a major public health issue. However, it poses problems that extend beyond the simple and exclusive fields of virology and epidemiology, so that it is necessary to mobilize knowledge that also relates to other disciplinary fields. From this perspective, the way in which the Covid-19 health emergency has been dealt with in Italy, but probably also in other European countries, demonstrates the extent to which the role of sociologists of various specializations (health, science, environment, organization, economics, media, etc.) is important in the management of a problem as complex and articulated as a pandemic.

In spite of this, from the outset of the spread of Covid-19, the epidemic has been presented as an exclusively virological and epidemiological issue, and the adoption of a mono-disciplinary rather than an interdisciplinary approach was the preferred approach. In the first (and more important) months, experts and members of both the national technical-scientific committee (supporting the Government) and of regional bodies (supporting the governors of regions), were recruited almost exclusively among physicians. In any case, they were certainly not recruited among the ranks of psychologists, economists, sociologists, or anthropologists. Despite this, the spread of Covid-19 is not merely a viral or clinical issue, but rather poses problems that go far beyond the strictly medical field (which clearly remains central). The choice of following a mono-disciplinary and virological approach has most likely led to a reductionist perspective, and therefore to the implementation of policies which have significantly underestimated the economic, relational, organisational, and psychological aspects of the epidemic; without taking advantage of previous experiences and studies (such as those relating to policies for combating AIDS), which have demonstrated that collective wellbeing and health are not solely the responsibility of doctors, but on the contrary, are the concern of everyone [1].

In adopting measures related to the novel Coronavirus, the contribution of other experts and non-medical scientists would most likely have avoided several errors that have, in some cases, increased the spread of the virus. For example, a media expert (had he or she been consulted) would probably have called for caution on the part of some virologists who, at the beginning of the epidemic in mid-February, cited inauspicious analogies with the Spanish flu (which killed between 50 and 100 million people worldwide between 1918 and 1920, but in very different environmental and health situations – the world had just come out of war, there were no antibiotics or antivirals, etc.).

These narratives, taken up and amplified by the media – which have long since become entrepreneurs of the “culture of fear” [2] [3], and which support that peculiar form of entertainment with apocalyptic themes that Foster [4] calls apocotainment – fuelled catastrophic scenarios and triggered panic. Many people, even those with mild symptoms, panicked, poured into hospital emergency rooms (which have always been the most infectious of environments), which in turn became ideal places for the virus to spread. Additionally, it is likely that the initial assault on supermarkets further accelerated contact and spread of the virus. A media scholar would also most likely have advised handling communication (by the government) of restrictive measures for the whole national territory differently: a reckless information leak (that preceded the adoption of restrictive measures across the national territory) led to a corresponding flight of workers and students with families in the South from the Northern metropolises, who suddenly brought a virus to their regions of origin which would probably have arrived much more slowly and perhaps even in a milder form (as it is often the case that over time viruses become less dangerous), after the peak of serious illnesses was exceeded in the North.

The most evident and deleterious consequence of this reductionist and monodisciplinary logic has been the adoption of a standardized and uniform approach to the emergency, rather than a more contextual approach (which is proper to sociology). In fact, the same measures have progressively been taken for all situations across the entire national territory, although the situation has been quite different from region to region. In this way, the diversity of the impact of the virus has been levelled out. In other words, by avoiding thinking about targeted measures limited to the most vulnerable population groups, urban conditions, demographic structures, relational models, etc., a one-size-fits-all approach has been created.

On the other hand, Covid-19 mortality rates are linked to multiple socio-demographic-environmental factors: the demographic structure of the population, as well as housing structure, urban fabric, family composition, all the way up to air pollution, etc. [5]. Clearly, in order to understand complex processes, such as the high mortality rates in Lombardy, it makes no sense to look for a single causal factor when multiple factors always seem to intervene. Clearly some factors have a greater incidence and weight than others as well. Among these, the organizational principles of the regional healthcare system have certainly had a large impact on the spread of the disease. In Lombardy, infected persons were hospitalized by choice much more frequently than in Veneto. The Veneto region therefore relied more heavily upon the healthcare facilities spread across the territory, and on more detailed mapping of infected persons, whereas Lombardy preferred to adopt a centralized strategy, which further exacerbated the fragility of its hospitals [6].

The negative effects of standardisation can also be observed in its practical requirements. The case of masks, imposed as mandatory in some Italian regions, is in this sense exemplary. The World Health Organization argued for their use by the sick to avoid spreading the virus and as indispensable tools for health care workers; but called for caution with respect to generalized use, stressing a lack of scientific evidence that masks are able to help a healthy person avoid infection. The WHO therefore called for caution with regard to their indiscriminate and standardised use, not least of all because of the (dangerous) sense of security that mask use might induce in people wearing them. The WHO's argument is contextual: it specifies under what conditions they are useful or unnecessary or even harmful. Clearly this is much more difficult to communicate to a wider audience, especially when this function is delegated to the mass media. However, it is a scientific, articulated, and systemic discourse that takes the complexity of the processes in place into account.

Unfortunately, the scientific approach to complexity is not as easily communicated to a wide audience as standardised measures are. Moreover, reductionist policies, which are not based on systemic criteria, do not take the non-virological and health consequences (in the short and medium term) of actions into account. For example, the environmental pollution caused by using masks produced with materials that are not recyclable or difficult to dispose of, could have a strong ecological impact (in China, 200 million masks are already produced every day, and there are reports of used masks being found on the beaches of Hong Kong and Soko Island). Similarly, the risks of mortality linked to the consequences of a sedentary lifestyle (such as an increase in obesity and heart disease), the likely increase in mental illness, as well as psychiatric damage caused by loneliness and isolation anxiety [7], stress and insomnia, as well as the impossibility of continuing therapies that require a certain constancy, not to mention the risks associated with forced cohabitation in family situations marked by violence, particularly gender-based violence [8], are all examples here.

The recent establishment of a task force for a “second phase” (i.e. the gradual return to social and productive life), mainly composed of experts “in economic and social matters” (with the presence of a sociologist of work) who are to engage dialogue with the already existing scientific technical committee, might represent an important tool for contrasting the reductionist and standardized approach adopted thus far. This is what many of us expect.

References

[1] Epstein, Steven. 1996. Impure Science: AIDS, Activism, and the Politics of Knowledge. Berkeley: University of California Press.
[2] Furedi, Frank (1997). Culture of Fear. Risk Taking and the Morality of Low Expectation. London: Continuum, 1997.
[3] Glassner, Barry (1999). The Culture of Fear: Why Americans Are Afraid of the Wrong Things. New York: Basic Books.
[4] Foster, Gwendolyn Audrey. 2014. Hoarders, Doomsday Preppers, and the Culture of Apocalypse. New York, New York: Palgrave Macmillan.
[5] Burnett, Richard, et al. 2018. “Global Estimates of Mortality Associated with Long-Term Exposure to Outdoor Fine Particulate Matter.” Proceedings of the National Academy of Sciences 115 (38): 9592–97.
[6] Nacoti, Mirco, et al. 2020. “At the Epicenter of the Covid-19 Pandemic and Humanitarian Crises in Italy: Changing Perspectives on Preparation and Mitigation.” NEJM Catalyst Innovations in Care Delivery 1 (2).
[7] Brooks, Samantha et al. 2020. “The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of the Evidence.” The Lancet 395 (10227): 912–20.
[8] Erbaş, Merve. 2020. “‘StayAtHome’ vs. the Protection of Women against Domestic Violence in the Outbreak of COVID- 19.” European Law & Gender. April 7, 2020.

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