Perspectives on COVID-19 From Health Sociologists
The current COVID-19 crisis has generated a lot of sociological research to understand the dynamics of this new and horrendous threat. We will not know the results of much of this for several years. Sociological research takes time – time to write the proposal and get the funding - time to collect the data – time to do the analysis. Research takes longer when your team is trapped at home and you can go out only under limited circumstances.
In this case, it is actually good that the research goes on for a while. The COVID story keeps changing. Singapore had COVID beat. Then they discovered the migrant workers they had neglected. Then COVID was not beat. We have not yet seen the long-term comparative death rates on Sweden which did not shut down versus Denmark and Norway that did shut down. So we are still waiting for key processes to play out. What we are getting at this stage of the game are early results from the first studies, along with theoretical extrapolations from the more reliable findings in the sociology of medicine, science and public health. Those early results and theoretical projections are useful and worth sharing.
This essay is reportage of a Zoom Panel that was sponsored by the American Sociological Association in connection with that association’s virtual Annual Meetings. The panel was a heterogeneous mix of short presentations by six national leaders in various sub-branches of sociology that have been studying social responses to COVID-19. The early findings are provisional – but the early findings are stimulating as well. I report their arguments here. The Zoom audience consisted of other sociologists who were also knowledgeable and well informed in their own right. Where appropriate I include some of the sharper observations from the floor.
Expert 1: Bonnie Pescosolido, Indiana
People think of COVID-19 as being isolating. It has in fact been anything but. Usually, during social disasters, networks of people pull together to help each other. That is exactly what has been occurring during the current pandemic. People have increased their networks of cooperation with the onset of COVID-19. Nearly one in five people has reached outside traditional circles of contacts for when help is needed. Practically half of the people Pescosolido interviewed began to worry about the well-being of someone who was not in their traditional network. The new helpers and the new “people that one worries about” were generally family members with whom the respondent had been out of touch. In some cases, it was former acquaintances or friends. Either way, human connections were rebuilt. People communicated more with each other rather than less.
One other quickie lesson from Pescosolido. Don’t make enemies during the good times. People were less likely to help or worry about individuals who had created problems or hassles for them in the past. Be nice to everybody. You never know when you are going to need them.
Expert 2: Steven Epstein, Northwestern
The COVID-19 crisis has led to a parallel crisis in expertise. To be sure, 84% of the general population and 75% of Republicans still believe that doctors are the best authorities on questions of public health. But there is a rising skepticism on the authoritativeness of medical opinion. Nowadays, everyone thinks they are an epidemiologist.
This new skepticism has not been entirely negative. It has led to a largescale public engagement with scientific ideas; there has been an increase in sophistication in popular understanding of medicine as a whole.
But the good effects have been counterweighed by new forms of degraded thinking. People “grasp at straws” to justify partisan conclusions that were already decided based on personal identity. This did not happen in past epidemics. During the AIDS epidemic, there were people who questioned medical authority. But those ideas were individualized and dispersed. They did not disrespect medical authority as a whole. Nowadays, there is a common party line to what opposition to the medical mainstream looks like. Plus people jump to use every shred of contrarian material they can find, while earlier critics were more discerning.
A further danger will occur when vaccines actually get developed and get tested. Because COVID can be prevented by both masks and social distancing and vaccines, it will be difficult to disentangle these three effects unless studies are very large. Self-interested parties will use the new data to attack either masks or social distancing or vaccines or all three.
Expect debates about coronavirus to become even more acrimonious.
Expert 3: Claire Decoteau, Illinois Chicago Circle
Clare Decoteau argues that health disparities between whites, on one hand, and blacks and Hispanics, on the other, continue to be high. This is even the case in Chicago, where both city officials and the public health officials in Illinois state government are strongly committed to reducing racial differences in mortality. A key issue is the data collected at the federal level, which obscures differential racial experiences. Because data is not collected or not released, the causes for higher mortality among minorities are often hidden. One such item is ethnic differences in access to a health care facility with empty beds. Hospitals in minority neighborhoods are more likely to be at full coronavirus capacity. There are few ways to transfer minority patients to treatment centers in wealthier areas that happen to have extra beds.
I would note, and Decoteau would probably agree, that data collection protocols are not the only factor causing racial inequity in healthcare. The current federal government is not unfriendly to white privilege. For this administration, black lives don’t matter. It doesn’t matter if deaths are caused by police violence or disease.
Expert 4: Anthony Ryan Hatch, Wesleyan
Racism may lead to black people being more likely to die of COVID-19. However, being more likely to die of COVID-19 can also lead to greater levels of racism. Blacks are perpetually blamed for their own mortality outcomes even when they are not at fault. Higher death rates can be blamed on inadequate social distancing or use of masks. Having less access to medical care, having more crowded housing or having to work jobs that do not allow them to self-isolate may be acknowledged – without removing latent issues of “black blame”. Past epidemics such as the Spanish flu led to the increased stigmatization of blacks. They were viewed as infection risks. In hospitals, they were segregated into all-colored wards so as to not present a hazard to white people.
In this regard, Hatch does not see increased data on racial disparities in health outcomes as being particularly helpful since that material can be used against blacks just as much as it can be used to help.
There were some counterarguments that groups committed to racial equity in healthcare need ethnic disparity data to be able to carry their case. Few disputed the argument that the American healthcare system develops systematic ways to reproduce white privilege in both health and economic well-being regardless of minor changes in data collection or the details of health service delivery.
Expert 5: Joseph Harris, Boston University
American sociologists are paying a lot of attention to COVID-19, a pandemic that affects the wealthy United States. They virtually ignored many savage infectious diseases that have decimated populations in the Global South. This includes malaria, SARS, Ebola and water-borne diarrhea. The only Global South disease that got a reasonable level of attention was AIDS, because that affected the U.S. too.
This argument received a lot of blowback from the audience, notably from scholars who had been working on those other diseases themselves. After the fireworks died down, it was agreed that public health journals had supported and published work by American social scientists on the neglected diseases. Sociological journals generally had not. The condemnation of American researchers was rolled back. The condemnation of American social science journals stuck.
Expert 6: Stefan Timmermans, UCLA
Major mortality crises change the way societies die. Enbalming was a product of the Civil War. The Spanish Flu produced the doctrine of flattening the curve. It is too early to assess the long term effects of coronavirus. However, at least two trends seem to be in the making. The first is that death has become a more public phenomenon. Previously, deaths were treated as a private affair, of little importance outside the immediate circle of the friends and families of the deceased. Now, trends in death are discussed in the newspaper.
More importantly, coronavirus may lead to a sense of the greater disposability of large swathes of our population. The elderly are being written off as natural coronavirus risks. This is even more the case for elderly with pre-existing conditions such as diabetes or lung pathology. Patients with serious non-COVID related diseases such as advanced cancer are being denied treatment to save hospital beds for “more promising” cases. America is now a society where death has more immediacy. What this implies for the future remains to be seen.
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Altogether, the sociological study of coronavirus is alive and well – even if the nation and the world as a whole are fairly sick.
The findings will become more crystallized and more coherent as more data come in. Early analyses always have to be modified in the face of later studies done with better data, larger samples and more sophisticated analytical techniques.
However, the early findings coming out tell a stimulating story.
People are building ever more robust social networks. The attacks on medical authority become ever more widespread, organized and facile. Racial disparities increase – and they increase through a wide variety of mechanisms. The attention of the American people and American scholars continues to be disproportionately centered on the American experience. The American way of dying has led to greater public awareness of the end of life, and greater willingness to view some of the living as already-dead.
These are not particularly cheerful findings.
But then, hey – our nation’s sick.