Monday, November 9, 2020

Comics and the Pandemic

 

--PLEASE READ THE FOLLOWING NARRATIVES ON THIS PAGE 
--AND THIS PODCAST: HERE

ILLNESS NARRATIVES: in Healthcare

The first classification, Arthur Frank:  Professor Frank classifies stories into three common story types: restitution, chaos and quest. 
  • Restitution narrative: this is the story most favored by physicians and other medical professionals and poses the emphasis on restoring health. These narratives often have three moments: 
    • they start with physical misery and social default, 
    • continue with the remedy (what needs to be undertaken) and 
    • finish with the moment in which remedy is taken; 
    • moreover, the narrator describes how physical comfort and social duties are restored. 
      • These are often stories told about patients rather than by patients, also because they give little agency to the narrator: patients simply have to ‘take the medicine’ and get well. 
  • Chaos narrative, which is really a nonstory: there is little narrative drive or sequence, just a list of negative things that will never improve and by which the narrator is almost overwhelmed. 
    • The story signals a loss or lack of control, and medicine cannot do anything. 
  • Quest narrative: this is the teller’s story, where the teller is in control of things. Narrators tell how they met the illness ‘head on’ and sought to use it, to gain something from the experience; 
    • the story is a kind of journey, with a recognized departure, an initiation (the mental, physical and social suffering that people have experienced) and a return (the narrator is no longer ill but is still marked by the experience).
The second classification, Arthur Kleinmann: , The concept trilogy of ‘illness’, ‘disease’ and ‘sickness’ has been used to capture different aspects of ill health. 
  • Disease is defined as a condition that is diagnosed by a physician or other medical expert, and it is considered as alterations or dysfunction in biological and/or psychological process, a deviation from the recognized ‘normal’ state, an isolated malfunction of a body part; 
    • ideally, this would include a specific diagnosis according to standardized and systematic diagnostic codes. 
    • This also means that the clinical specific condition has a known biomedical cause and often known treatments and cures. 
  • On the other hand, illness is defined as the ill health the person identifies themselves with, often based on self-reported mental or physical symptoms. 
    • It refers to the lived experience, to how the ill person and the members of the family or wider social network perceive, live with and respond to symptoms and disability;
    • it is something being lived through the body and can have many types of meanings, in different contexts, to different people. 
  • Lastly, Kleinman introduces a third term, sickness. Sickness describes a disorder in a generic sense as applied to a population or group. It is related to a different phenomenon, namely, the social role a person with illness or sickness takes or is given in society, in different arenas of life, often used to measure social consequences for the person of ill health.
The third classification, Mike Bury: This type of classification foresees that analysis must consider three types of narrative forms: contingent, moral and core narratives. 
  • contingent narratives are concerned with those aspects of the patient’s story that deal with beliefs and knowledge about factors that influence the start of disorder. 
  • If this kind of narratives describes events, their proximate causes and their unfolding effects in relation to the performative of everyday life, moral narratives provide accounts of changes between the person, the illness and social identity and help to (re)establish the moral status of the individual or help maintain social distance, introducing an evaluative dimension into the links between the personal and the social. 
  • Core narratives reveal connections between the person’s experiences and deeper cultural levels of meaning linked to suffering and illness.

The fourth classification, John Launer: Stories can be divided into three types: progressive, regressive and stable one. 

  • Progressive narratives move towards the personally valued goals; 
  • regressive narratives move away from such valued goals; and 
  • stable narratives sustain the same position in relation to the valued goals throughout the narrative sequence. 
    • This last kind of narrative could be seen as less engaging than others, because it tends to relate a sequence of events without great drama—a form of storytelling that goes under the heading of the so-called contingent narratives. 
    • The use of a progressive, regressive and stable framework allows an analysis that safeguards against over-interpreting the range reserved of meanings conveyed by patients’ accounts. 
    • whatever narrative form may be identified in analysis, many accounts move from one to another, for example, from regressive to stable. 
    • Consistency in narrative accounts may be achieved or sought by patients, but it may not: much depends on the context in which narratives are constructed and presented and on the intentional acts which they help constitute. 
    • This classification is very useful to focus on the coping strategies acted by patients: if regressive or stable narrative may show no positive engagement and if narratives are progressive, this may represent an evolving positively situation.


The fifth classification, factual language and symbolic language

  • Factual language: digits, facts, visits, number of healed people, contaminated people, of deaths. Mechanism of action by the COVID-19. Rules, countries, decisions made, who visited whom, who was the patient 0, people seen by patient 1, dates of the outbreak, age by mortality rate, gender by mortality rate, immune children, number of available beds by Region, days of isolations- 14 and/or longer, number of potential contaminated people by one asymptomatic carrier, number of masks available, number of ambulances in the streets, spread and fall of the stock market value, number of closed activities, number of online new services, number of days spent in home working, volumes of purrell sold, potential time to vaccines,  and so on….
  • Metaphoric language: try just to see on the screen shot the numbers of healed and deaths and contaminated as they are in the Frankfurt, Paris, New York London stock-exchange market by analogy
  • Sontag argues, obscures illness within dramatic narratives, meant to rouse and inspire…through vigilance and alarm. The problem with stories, of course, is that the action only unfolds through the choices and responses of characters – that is, us – which in turn evokes assumptions about moral values and responsibility…about blame.If the disease wins the battle – does that mean the physician didn’t fight hard enough? that the patient didn’t have enough will to victory? or that, perhaps, the patient might even have inadvertently sabotaged her own defences, through insufficient vigilance, or morally lax behavior? And if contagion spreads, infecting, corrupting…whose unclean habits are to blame? who is the source of the pollution? Sontag makes the connections: our metaphors of illness tell stories of passive weakness, of malicious vice, of threat and danger, which we then use against one another. Never mind this pathogen, that imbalance of brain chemistry, this insufficiency of antibodies, that excess of cellular activity: we have others to blame (and “they” are always “other), others who can be the target of our shame, helplessness, fear, hatred. It might be a natural, human, impulse to use stories to give shape and meaning to otherwise arbitrary, uncontrollable phenomena; the danger is that the metaphorical thinking that we use to build those stories for our individual comfort then takes on a life of its own. The metaphors are especially vulnerable to ideological use, not at the level of the individual body, but of the body politic – the metaphors of invasion, pollution, sickness are used to justify the marginalization and separation of whole populations: Jews in 1930s Germany; gay men in 1980s America; immigrants, refugees, “aliens” (and their children) who threaten us with the infection of difference
  • In addition, -the plague and plague spreaders. The cancer metaphor of the society has quietly faded away: now the new words are “infodemia”, “the viral decisions of politicians”.

  • Albert Camus the plague: 

    “Flagella, indeed, are a common thing, but flagella are hardly believed to be when they fall upon your head. In the world there have been, in equal numbers, plagues and wars; and yet plagues and wars catch men always unprepared. (…) Stupidity always insists, we would notice if we didn’t always think of ourselves. In this regard, our fellow citizens were like everyone else, they thought of themselves, the scourge is not commensurate with man, we are therefore told that the scourge is unreal, it is a bad dream that will pass.”

The sixth classification, Plutchik emotions: Plutchik proposed that eight ‘basic’ emotions are biologically primitive joy, fear, anger, disgust, sadness, (the same as Inside Out) plus trust, surprise and anticipation. 
  • Plutchik argued for the primacy of these emotions by showing each to be the trigger of behavior with high survival value, such as the way fear inspires the fight-or-flight response.
  • Plutchik’s psycho-evolutionary theory of basic emotions has these main postulates: 
    • 1. The concept of emotion is applicable to all evolutionary levels and applies to all animals, including humans. 
    • 2. Emotions have an evolutionary history and have evolved various forms of expression in different species. 
    • 3. There are a small number of basic, primary or prototype emotions. 
    • 4. All other emotions are mixed or derivative states; that is, they occur as combinations, mixtures or compounds of the primary emotions. 
    • 5. Each emotion can exist in varying degrees of intensity or levels of arousal. 




The moment that I was informed that we had become a COVID-19 department, I was devastated. This coronavirus is so frightening, and I knew that I could die from it. I am a person who needs to be in control, and I had lost control, I was so frightened. This entire new situation was scary—a situation of life or death. Moreover, I was in it. At the level of the team, we did not know what to expect, personally and collectively, as a department. I did not know what was expected from me as a social worker and what were the guidelines; everything was new. We created everything from the beginning, and I was scared.

Emma, a social worker in the hospital’s Corona Department

 “In our country, we know what a war is, and in the healthcare system we know how to function in the hospital during times of war, but still, this is a new war, a war that we have never handled, an invisible enemy, and it is frightening all of us.” In similar vein, Doron said: “to be significant, to be at the front is important. Before it was the army that was at the front, now it is the turn of the healthcare system to be at the front.” Sara, nurse
“In the Internal Medicine Department, I have been working for the past 18 years with my team, physicians, nurses, secretary—we have a common language. I felt especially secure in those days. How I will be able to use, in an efficient way, a new situation and new staff? This is ridiculous.” Dikla a nurse
This will increase the feeling of insecurity…think that the entire situation is new and scary; so, what will I do without my friends who I have been working with for years?” In particular, the need to be protected during shifts was pronounced. As Sara told us: “In order to continue to come here, I need to feel that someone is taking care of me. I do not care who in charge of that in the hospital, but I need to feel safe; it is essential for me.” Tania, a social worker
“I cannot believe it… because of the workload… it is only because of the workload… I have to tell you that I haven’t eaten for whole days…I grab something. It is not that there isn’t any food, but we don’t have the time and the needs of the staff draw you and you can’t ignore them; you need to respond to each one. At other times its different, of course. Here you can’t say anything to them. It’s the mask; it creates wounds on their noses, so I brought them cream. This kind of mask or any other; so, I saw masks in the grocery store and I bought them pink surgical masks so they would feel joy. Every day I am bringing something to make them happy. All the time. Yes, the protective equipment is a problematic issue by itself… I understand since I am involved in that; it depends on the equipment that comes to Israel, but it is not always suitable… this equipment is insane.” -Julie, a nurse in the ICU

Julie’s “I Poem”
I cannot believe
I have to tell
I haven’t eaten
I grab something [to eat]
I brought them cream
I saw face masks
I bought them masks
I am taking out [something to make them happy]
I understand
I am involved

“I love my job, and I love the feeling of contributing. People around me, outside the hospital, talk about us [the HCWs]. I am in the frontline. It is pleasant and heartwarming.” -Michal, a nurse
Michal’s “I Poem”
I love [my job]
I love [the feeling of contributing]
I am [in the frontline]
“I believe this will continue …. I discovered the richness of family and personal life, which reinforced things that I knew about myself and my [hospital] family—we are sturdy and dedicated and we cope well. I am filled with appreciation for the Infection Management Department that created a safe environment.” --Dina, nurse

Dina’s “I Poem”
I believe
I discovered
I knew [about myself]
I am filled [with appreciation]


Themes: Trauma and Stress
A deceased is a deceased but the separation from the family is extremely difficult, the wrapping process is a different from what you normally do in the internal ward. In addition to the regular wrap we put them in a nylon wrap and that is horrifying. A really unpleasant sight. It is like you put your patients in a plastic bag and you close it with a zipper. And then you cover with another bag but from the opposite side. An unpleasant wrapping of a patient since it is supposed to be isolated.--Golda, nurse
Look, the coronavirus is something completely new. A whole new disease that we do not have a clue how to treat, how to behave with it … and the craziest thing [is] that no-one in the world has the knowledge how to treat this disease, no knowledge-based expertise, no medical literature. So, you are constantly calling your colleagues in the country and around the world. Then, you are planning how you will cope with your first coronavirus patient. And then you are planning your second patient and the third. The decisions [as the head of the ICU] are just on your shoulders. They said to me: you are crazy … you are crazy; what are you doing? But I had to listen to myself, my instincts, and I said I have to go with my feelings and intuition. The decision is all yours. And what is most crazy is that you do not know what will happen next. Now it [the patient’s condition] is fine and five minutes later the patient can die and there is no-one to consult with because no-one knows [anything] about COVID-19.--ICU Physician Marina

Themes: Security and Knowledge
At the beginning of the corona outbreak, there was a lack of food, protective gear, and clothes and shielding eyeglasses to protect ourselves. We had to shower between the shifts, and there was a shortage of showers in the hospital, and we had to fight for the basic needs to be protected, especially during the weekends. It was horrible. Everyone was terrified. There was a lack of food in the Corona Department. At the beginning, I did not have what to eat during the day. I felt broken and choked …. There were shifts that I did not eat for almost 12 h.--Orr, nurse
I did not have a life except the work at the hospital these past few weeks. I did not have a private life at all. I did not meet my family. I am tired all the time, I just want to sleep like a human being, to eat, to be away from the hospital and from the Corona that is all over; these 12-h shifts killed me. I am a single mother and I have a daughter. My daughter was all by herself at our house. It is unbearable; she was all by herself for all those days of the corona, and I was here taking care of other people.--Sara, nurse
There was constant anxiety and fear that we would infect others; we [at the Corona Department] felt like lepers … and then the isolation from my family since I was so afraid that I would infect them. I was isolated like a leper. My children could not go out to play with other children because I was terrified that I would infect my children and that they would infect their friends with coronavirus. At the beginning of the coronavirus, my daughter was so stressed out from this crazy situation.--Dorit, nurse
The Head of the Department is constantly updating us … I do not feel detached … I feel secure, knowing where I stand.” --Dan
“ … a lack of communication and information about what is happening at the hospital at the general level and not at the sector level bothers me. I am worried.” Avi, administrator
Uncertainty concerns me—assessments of the situation and updates by my immediate supervisor would help me.”  “I feel like I’m in the dark and don’t know what’s going on.”--Ruth

Theme: Need for Belonging
We were all a big family helping each other. I felt so close to all my peers; working together in such a tough time was different from what I had known in the last 26 years that I have been working in the hospital. As a team, we have become closer to each other, and I have discovered additional angels in my team …. In our department there is a sense of “togetherness” and comradery. Professionally, there will be changes; there are thoughts about modifying procedures in light of the current pandemic …. Relating to each other, currently feeling that we are a united and cohesive group.---Vicki, administrator
This period is a mixture of emotions. The reality is that everything is so new and unfamiliar. Nevertheless, the staff are so devoted to each other and struggling to do their best to help each other and changing shifts due to the lack of nurses. Sometimes they asked about treatment and I did not have an adequate answer. How I will say it? This is the period that we are re-inventing the protocols and rules of treatment. I am telling them that I am so sorry but there are no guidelines yet.--Pam, ICU nurse

A good word, a compliment, and a positive attitude made me feel valued and…reassured.” “A kind word makes my day …. It is essential for me to get feedback on my work and to know that I am doing my job well.”--Lori, nurse

The presence of management in all departments and during all shifts made the staff aware that there was someone with them.” She added: “Personal appreciation by the management increases motivation and reduces concern….I would like to see more direct communication with management… in my team, I feel appreciated. I don’t feel I’m getting feedback from management.” --Alma

Management worked well during the crisisI want to thank the management for the adaptions that were made by mobilization of staff and change of policies and for taking the time to listen; and in my opinion, the hospital and management are doing well.--Dan, assistant nurse


Theme: Meaningfulness

Patients with coronavirus helped me to feel valued and meaningful, [especially] the conversations with the patients and the phone conversations with their families out there in their homes, so worried about their loved ones. I was there for the patients and their families, and it allowed me to feel meaningful and to want to continue treating patients.”--Carol, nurse


Wednesday, October 28, 2020

Illness Narrative #3: essential Workers


DUE NOVEMBER 19th

For this illness narrative you will be interviewing essential/frontline workers. These are people which deal directly with the impact of COVID-19 in our communities. Though essential workers are found in many sectors, the richest stories can be found from those who work in the healthcare sector (for example)

  • doctors
  • nurses
  • therapists (variety)
  • home healthcare 
  • nursing home workers
  • chaplains
  • funeral homes
  • hospital workers
  • morgues
  • police and firemen
  • EMT
To complete this narrative you will interview 3 essential workers and present their stories considering the physical and psychological impact that their work has had on them since March, 2020. In doing so, you should elicit "stories" that they have which illustrate their experience. Some useful questions:
  • What kind of work do you do?
  • can you describe a typical day now?
  • "what has changed"?
  • what was the most trying incident?
  • What surprises you the most?
  • How has this affected you and your family?
  • etc.?
Narratives should contain these stories with minimal introduction (your voice). Please look to the examples on the blog post. The interviewers voice is absent for the greatest impact. If you can see the person, make sure you record their demeanor (body language, appearance, etc.) without drawing conclusions (simply be descriptive) This plays well in a narrative, and adds to its evocative impact.

Minimum of 5 pages in length.

Narratives From the Front Lines: First Responders

chaplain illness narrative HERE

doctor ER HERE

Front Line Workers in Italy HERE












Tuesday, October 27, 2020

Illness Narratives and Political Systems-international



GUATEMALA

  • Miasmatism, claimed that diseases were transmitted by poisonous vapors stemming from putrid organic matter, originating from contaminated environments.
    • These competing views are sometimes framed in terms of the binary contagionism/anti-contagionism when one looks at the longer history of theories of disease transmission
    • Contagion held that disease is spread by direct contact with the body of an affected person, advising measures aimed at repelling the causes of the disease, emphasizing quarantines, segregation and sanitary cordons. 
    • Infection held that disease is spread through the air or other distant means like objects, dust and water, leading to measures aimed at removing causes of insalubrity. 
  • The nature of COVID-19 seems so abstract and hard to do something about that people needing to take practical measures will find ways of deciding, by recurring to notions of disease transmission drawn from their experience and which resemble those of nineteenth century contagionism and infectionism. 

But why sanitary cordons? 

  • Here is where narratives with militaristic overtones blend in with notions of disease transmission to inform control measures. 
    • Between mid-March and mid-May the Guatemalan government’s narrative about COVID-19 was one of defending the country from an external threat, that the country was at war and the virus was the enemy to defeat. 
      • people returning from Europe or the United States became the source of the virus that had to be kept away, but as it became evident that the virus was circulating in the country, community leaders adopted the same logic to protect their communities with the implementation of their own version of a sanitary cordon, and adding more people to the list of suspects.
  • global health’s emphasis on biosecurity have led to our current obsession with sanitary measures, losing sight of 150 years of advances in epidemiology and public health that had shown us that the object of epidemiology is people’s health, and its objective is to contribute to its improvement.  

HOMELESS in California
  • As growing fears of coronavirus contagion became more prevalent, it fell to officialdom to focus on demographics deemed particularly “at-risk” to assuage public concerns. Sensibly, the project aims to secure 15,000 hotel rooms for “homeless candidates” deemed particularly vulnerable to the virus.
    • sufferers become objects, death and illness become statistics, lives become measurable and so the categorization of lives is (re)established. 
    • That is to say, the logic of Project Roomkey distinguishes the (hapless) lives to be saved from those who are able to save, setting in place the respective values of said lives.
      • The most at-risk individuals include those already suffering from health problems which disproportionately affect those experiencing homelessness
      • the present emergency-focus has meant authorities have avoided discussion of long-term solutions to homelessness. 
      • By temporarily “sweeping away” urban street dwellers from public areas into confinement, public concerns have been prioritized over efforts to effectively remedy homelessness.  
      • slogans such as “Stay at home” and, “Keep your distance” are behavioral luxuries that poorer communities and those experiencing homelessness can seldom afford
  • The economics of homelessness
    • Homelessness has served a necessary capitalist function beginning with the ‘wandering men’ – a mobile source of labour in the industrial city
    • “Skid row” – with its Single Room Occupancy units (SROs) and cheap lodging – reflected US economic trends, shrinking in times of abundance and expanding in times of economic hardship
    • Two Factors Changed this
      • deindustrialisation. 
        • This marked the end of associating Skid row inhabitants with their reserve labour --Instead, the mostly single, white male occupants became only known for their failure to observe social norms or their duty to fulfill social, political, or community roles. 
        • their dwelling place directly implicated their personhood; their character, status, and value. Skid row and ghetto inhabitants were judged by where they lived, not who they were; the social imaginary of the “homeless” as a person, not an experience.
      • deinstitutionalisation 
        • over the course of the 1970’s. Those suffering from acute mental illness were forced from state-funded facilities without sufficient housing or medical provisions, tripling the homeless population throughout many US cities.
        • Negative effects from policies accelerated under Reagan’s administration during the 1980’s, when minimal welfare benefits under the New Deal and Great Society initiatives were abolished in favor of capital-first mandates. 
          • Public housing and SROs were sold and destroyed to make way for more profitable real-estate construction, forcing thousands onto the street. 
          • Class distinction increased and the poor who could no longer access low-cost housing options became increasingly marginalized to the point of invisibility. 
          • Government and public attitudes towards the resulting increase in Californian homelessness remained confined to this discourse of homelessness by “personal choice” and was addressed through punitive measures 
      • criminalisation of the poor 
        • is the product of the same discourse that implies poverty as matter of choice and continues to ignore evidence to the contrary
        • It ignores structural failures throughout the mental and physical healthcare services and the effects of stigma and social classification which this unchecked discourse recreates. 
        • Research quantifiably points to public medical failures leading to homelessness --Inability to work due to injury or illness and the expiration of personal resources to cope (e.g, limited insurance or family support) often ends in some form of homelessness. 
          • Physical conditions like tuberculosis, HIV/AIDS, hepatitis, hypertension, vascular disease, seizures, and most other infectious and chronic conditions affect transient residents over their domiciled counterparts by factors ranging from two to twenty
          • the lack of having basic storage for medicines means diabetes, asthma, and high blood pressure patients suffer the effects of these illnesses more acutely. 
          • individuals experiencing homelessness have a higher frequency of post-traumatic disorders, but homelessness itself is produces symptoms of psychological trauma 
      • homeless individuals have and do exercise agency by giving life to various communal spaces within the urban landscape; places which are synonymous with relationship, compassion and care. 
  • Project Roomkey’s Fallibilities
    • 15,000 is only a scratch on the 150,000 surface of people experiencing homelessness in California. 
    •  only one-fifth of the hotel rooms secured for the project have been filled as of July 19, 2020
    • disaster capitalism?--the project is set to benefit hoteliers more than those from the homeless communities it ostensibly assists. 
      • COVID-19 has brought a sudden halt to travel and in lieu of tourism, state funds directed to Project Roomkey support these businesses in a time of economic decline 
      • This is ALSO evident on the Los Angeles Homeless Services Authority (LAHSA)
        • It covers the conditions for the temporary lodging scheme on issues concerning hoteliers specifically: the strict guidelines for eligibility, the extent of time the project would run for (three month term from when the hotel decided to open their doors, not when the pandemic subsided nor when it was safe for the new tenant to leave) and the assurance of twenty-four hour, on-site security, and of police readiness-to-respond.
    • The contrast in motives behind fiscally driven “relief efforts” with the motives of service-provider agencies produces two very different and distinct outcomes. 
      • The former deems the temporary hotel occupant as a commodity – a rather objectifying approach. 
      • non-government organizations and non-profit volunteers are more effective in providing care for those in need. 
        • They identify problems with state-aid dependency under the disaster capitalism paradigm explaining: “Chronic disaster syndrome… [should] be used to refer not just to the individual diseases associated with the stress of disruption that manifest in individual bodies but also to the social conditions that produce distress, tied in nonspecific ways to larger political and economic arrangements that generate belief in, but ultimately prevent, recovery from disasters.” 
        • Denied essential political life, individuals experiencing homelessness are stripped to bare life; to be separated, regulated, and erased as officialdom sees fit. 
        • The relocation of those more vulnerable individuals to places for isolation has also generated stigma and negative attitudes (not in my backyard)
      • $150 million, could make a significant contribution towards long-term housing solutions or the establishment of medical healthcare facilities to provide preventative care for poorer populations.

      • Acceptance into the project also demands hotel residents abide by strict rules and curfew regulations, crediting the revanchist notion that “unknowables” should remain invisible and away from the public eye. The denial of agency and separation from one’s familiar local community is a high price to pay for the brief comforts of a stock standard interior of a hotel room. 

      • does nothing to protect future sufferers of homelessness from the next pandemic – as history should inform us this will not be the last international pandemic.

Risk Perception and Political Division
  • The increasing political divide in the U.S., and its reflection in where and how individuals consume news and, correspondingly, interpret facts 
    • different news sources may present different interpretations of factual data, instilling different perceptions of risk in their viewers—who may in turn respond differently to information provision or suggested social distancing choices. 
    • individuals have an increased tendency to view the world through a “partisan perceptual screen,” whereby their assessment of economic conditions and policies depend on whether their party of preference is currently in power 
  • Measuring Risk: Two streams of data
    • Google health search
      • The higher the search share in a particular location and time period, the higher the perceived risk among that population. 
      • search share for unemployment-related terms (benefits, insurance, etc.), capturing individual’s perceptions of the economic risk of the pandemic. 
    • Cell Phone and Travel
      • change in average daily distance traveled from the pre-pandemic period. 
        • distance traveled in the county relative to the average for the same day of the week from the beginning of the year up to March 8th (the “pre-COVID period”). 
        • the percent change in visits to non-essential retail and services from the average for the same day of the week during the preCOVID-19 period. 
          • Essential locations include venues such as food stores, pet store and pharmacies. 
          • Non-essential retail and services include, but are not limited to, restaurants and bars, clothing stores, consumer electronics stores, cinemas and theaters, spas and hair salons, office supply store, gyms, car dealerships, hotels, hobby shops and so forth. 
          • both measures follow expected patterns, decreasing sharply as the case load in the U.S. increases
  • Risk perceptions and political partisanship
    • We document a muted response to preliminary cases in high Trump VS areas—even as state governments imposed a variety of school and business closures and stay-at-home recommendations—with a catch-up in attention only after prominent Republican figures were quarantined following the announcement of COVID-19 exposure at the annual CPAC meeting. 
    • As countries across the world struggle to flatten the curve of the pandemic and lessen the possibility of significant deaths and prolonged economic contraction, understanding how individuals and households react to information treatments and voluntary compliance measures becomes of ever more importance to the ultimate resolution of the current crisis.
    • Our findings suggest that risk perceptions and—consequently—behavioral choices, may be shaped through the lens of politics, rendering certain types of interventions that rely on uniform interpretation of the risk associated with the outbreak less effective.  
 

Monday, October 19, 2020

Pandemics and Protests: The Politics of Illness Narratives

Read This Article HERE Sanitary Cordons and COVI-19 in Guatemala

Read This Article HERE Homelessness in California during COVID-19

Read This Article HERE Risk Perception and Political Discourse



Saturday, October 17, 2020

Naomi Klein: Disaster Capitalism and COVID-19

 The coronavirus is officially a global pandemic that has so far infected 10 times more people than SARS did. Schools, university systems, museums, and theaters across the U.S. are shutting down, and soon, entire cities may be too. Experts warn that some people who suspect they may be sick with the virus, also known as COVID-19, are going about their daily routines, either because their jobs do not provide paid time off because of systemic failures in our privatized health care system



  • These are the perfect conditions for governments and the global elite to implement political agendas that would otherwise be met with great opposition if we weren’t all so disoriented. This chain of events isn’t unique to the crisis sparked by the coronavirus; it’s the blueprint politicians and governments have been following for decades known as the “shock doctrine,” a term coined by activist and author Naomi Klein in a 2007 book of the same name.
  • History is a chronicle of “shocks”—the shocks of wars, natural disasters, and economic crises—and their aftermath. This aftermath is characterized by disaster capitalism,” calculated, free-market “solutions” to crises that exploit and exacerbate existing inequalities.
  • Klein says we’re already seeing disaster capitalism play out on the national stage: In response to the coronavirus, Trump has proposed a $700 billion stimulus package that would include cuts to payroll taxes (which would devastate Social Security) and provide assistance to industries that will lose business as a result of the pandemic.
  • “They’re not doing this because they think it’s the most effective way to alleviate suffering during a pandemic—they have these ideas lying around that they now see an opportunity to implement,” 
Let’s start with the basics. What is disaster capitalism? What is its relationship to the “shock doctrine”?
  • disaster capitalism is really straightforward: It describes the way private industries spring up to directly profit from large-scale crises. 
    • Disaster profiteering and war profiteering isn’t a new concept, but it really deepened under the Bush administration after 9/11, when the administration declared this sort of never-ending security crisis, and simultaneously privatized it and outsourced it—this included the domestic, privatized security state, as well as the [privatized] invasion and occupation of Iraq and Afghanistan.
  • The “shock doctrine” is the political strategy of using large-scale crises to push through policies that systematically deepen inequality, enrich elites, and undercut everyone else. In moments of crisis, people tend to focus on the daily emergencies of surviving that crisis, whatever it is, and tend to put too much trust in those in power. We take our eyes off the ball a little bit in moments of crisis.

Where does that political strategy come from? How do you trace its history in American politics?
  • The shock-doctrine strategy was as a response to the original New Deal under FDR. [Economist] Milton Friedman believes everything went wrong in America under the New Deal: As a response to the Great Depression and the Dust Bowl, a much more activist government emerged in the country, which made it its mission to directly solve the economic crisis of the day by creating government employment and offering direct relief.
  • If you’re a hard-core free-market economist, you understand that when markets fail it lends itself to progressive change much more organically than it does the kind of deregulatory policies that favor large corporations. So the shock doctrine was developed as a way to prevent crises from giving way to organic moments where progressive policies emerge. 
    • Political and economic elites understand that moments of crisis is their chance to push through their wish list of unpopular policies that further polarize wealth in this country and around the world.

Right now we have multiple crises happening: a pandemic, a lack of infrastructure to manage it, and the crashing stock market. Can you outline how each of these components fit into the schema you outline in The Shock Doctrine ?
  • The shock really is the virus itself. And it has been managed in a way that is maximizing confusion and minimizing protection. I don’t think that’s a conspiracy, that’s just the way the U.S. government and Trump have utterly mismanaged this crisis. 
    • Trump has so far treated this not as a public health crisis but as a crisis of perception, and a potential problem for his reelection.
  • It’s the worst-case scenario, especially combined with the fact that the U.S. doesn’t have a national health care program and its protections for workers are abysmal. This combination of forces has delivered a maximum shock. 
    • It’s going to be exploited to bail out industries that are at the heart of most extreme crises that we face, like the climate crisis: the airline industry, the gas and oil industry, the cruise industry—they want to prop all of this up.

HOW HAVE WE SEEN THIS PLAY OUT BEFORE?
  • This happened after Hurricane Katrina. Washington think tanks like the Heritage Foundation met and came up with a wish list of “pro-free market” solutions to Katrina. 
  • We can be sure that exactly the same kinds of meetings will happen now— in fact, the person who chaired the Katrina group was Mike Pence. 
    • In 2008, you saw this play out in the original [bank] bail out, where countries wrote these blank checks to banks, which eventually added up to many trillions of dollars. 
    • But the real cost of that came in the form of economic austerity [later cuts to social services]. So it’s not just about what’s going on right now, but how they’re going to pay for it down the road when the bill for all of this comes due.

Is there anything people can do to mitigate the harm of disaster capitalism we’re already seeing in the response to the coronavirus? Are we in a better or worse position than we were during Hurricane Katrina or the last global recession?
  • When we’re tested by crisis we either regress and fall apart, or we grow up, and find reserves of strengths and compassion we didn’t know we were capable of. This will be one of those tests. 
    • unlike in 2008—we have such an actual political alternative that is proposing a different kind of response to the crisis that gets at the root causes behind our vulnerability, and a larger political movement that supports it.
  • This is what all of the work around the Green New Deal has been about: preparing for a moment like this. We just can’t lose our courage; we have to fight harder than ever before for universal health care, universal child care, paid sick leave—it’s all intimately connected.

If our governments and the global elite are going to exploit this crisis for their own ends, what can people do to take care of each other?
  • ”'I’ll take care of me and my own, we can get the best insurance there is, and if you don't have good insurance it's probably your fault, that's not my problem”: 
    • This is what this sort of winners-take-all economy does to our brains. What a moment of crisis like this unveils is our porousness to one another. 
    • We’re seeing in real time that we are so much more interconnected to one another than our quite brutal economic system would have us believe.
  • We might think we’ll be safe if we have good health care, but if the person making our food, or delivering our food, or packing our boxes doesn’t have health care and can’t afford to get tested—let alone stay home from work because they don’t have paid sick leave—we won’t be safe. 
    • If we don’t take care of each other, none of us is cared for. We are enmeshed.
  • Different ways of organizing society light up different parts of ourselves. If you’re in a system you know isn’t taking care of people and isn’t distributing resources in an equitable way, then the hoarding part of you is going to be lit up. 
    • So be aware of that and think about how, instead of hoarding and thinking about how you can take care of yourself and your family, you can pivot to sharing with your neighbors and checking in on the people who are most vulnerable.
LESSONS FROM KATRINA (in New Orleans)

The Politics of Pandemics

 We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas . . . Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it." --Arundhati Roy, “The Pandemic is a Portal”:



How Does COVID 19 Reveal Political Realities?

  • Narratives from the 1918 Influenza Pandemic
    • Little data collected-disadvantage
    • Rates of Morbidity for Blacks lower and mortality higher
      • May have caught first wave in Spring and Summer and been immune to deadlier second wave in Winter
      • Structural violence and crowded living conditions led to greater susceptibility to first wave
    • Racist Discourses-1918 (and today?)
      • Negroes are biologically immune (not human like us-if they dont get it)
      • Negroes are inferior (if they die)
      • Negroes are virus vectors but dont get the illness
      • Black medical schools and institutions founded in the 1880s were regulated through policies in 1910
      • Black nurses could not join the war effort in WWI
      • During the pandemic they treated white patients, not black
    • Counter Narratives- Black Voices
      • Created their own medical responses within their communities
      • created their own counter-narratives which directed Blacks to take precautions and debunked racist narratives
  • Exacerbating factors
    • great migration and ghettoizing in crowded northern cities
    • Jim Crow Laws

COVID-19 Comparison

  • affecting Black, Hispanic and Native American populations in similar ways due to structural violence
  • As a result of continued redlining, minority residential environments bear substantial barriers to health optimization, such as reduced green space access, disproportionate tobacco and alcohol marketing, low perceived neighborhood safety, and food deserts MAPS
  • Similar racist narratives being put forth
    • poor hygiene
    • greater immunity (physical superiority/mental inferiority)
    • vectors for disease (people or communities of color)
  • narratives of personal responsibility as a key driver of health outcomes 
    • These accounts place the burden of differential outcomes on minorities rather than acknowledging the lasting legacy of structural racism. 
    • They also detach minority health from that of the majority rather than viewing it as part of the nation's collective mission.
  • Challenges
    • long-term COVID-19 sequelae (pathological conditions resulting from a disease)
    • pre-existing conditions in minority communities
    • exacerbation of underlying chronic conditions, 
    • mistrust in the health care system
    • misinformation in poor communities
  • Responses
    •  1) examine the historical arc contextualizing current disparities in vulnerable communities; 
    • 2) recognize the inherent strengths in these communities, empowering them to participate in research and generate solutions alongside those who traditionally hold power; 
    • 3) acknowledge the contributions of frontline workers in communities of color; 
    • 4) prepare for future public health emergencies by enhancing minority civic participation; and 
    • 5) use a restorative justice framework to acknowledge and make amends for the structures contributing to disadvantages in these communities 

QANON, Distrust of Biomedicine and Vaccine Conspiracies

  Distrust of vaccines may be almost as contagious as measles , More than 100 people have been infected with measles this year. Over 50 of t...