Two categories of disease are interacting within specific populations—infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and an array of non-communicable diseases (NCDs). These conditions are clustering within social groups according to patterns of inequality deeply embedded in our societies. The aggregation of these diseases on a background of social and economic disparity exacerbates the adverse effects of each separate disease. COVID-19 is not a pandemic. It is a syndemic. The syndemic nature of the threat we face means that a more nuanced approach is needed if we are to protect the health of our communities.
The most important consequence of seeing COVID-19 as a syndemic is to underline its social origins. The vulnerability of older citizens; Black, Asian, and minority ethnic communities; and key workers who are commonly poorly paid with fewer welfare protections points to a truth so far barely acknowledged—namely, that no matter how effective a treatment or protective a vaccine, the pursuit of a purely biomedical solution to COVID-19 will fail. Unless governments devise policies and programmes to reverse profound disparities, our societies will never be truly COVID-19 secure.
[…] I would add one further advantage. Our societies need hope. The economic crisis that is advancing towards us will not be solved by a drug or a vaccine. Nothing less than national revival is needed. Approaching COVID-19 as a syndemic will invite a larger vision, one encompassing education, employment, housing, food, and environment. Viewing COVID-19 only as a pandemic excludes such a broader but necessary prospectus.
My paper is a part of the Technology & Infrastructure panel, and if you think mine sounds of any interest at all, then I’d ask that you go and give my co-panellists the same attention you would grant to me.
It was an unusual experience, producing a video for a conference paper—not really so different a process in terms of writing the piece and developing the slides, but recording and editing the script and compiling the video was an interesting new challenge. It feels a little amateur, but I suspect that’s a legacy of having been a sound engineer in a former life: all I can hear are the cheap production values, and the hurriedness of a project completed in the run-up to a relocation. BUT: it’ll be easier and faster next time, and hopefully I’ll have more time to plan and integrate the production into the drafting of the actual paper itself. I have a feeling that there’ll be a lot more of this sort of work in academia in the near- to medium-term future…
Scientists, public intellectuals, and journalists bemoan denialism, but have no solutions to offer apart from urging us to fight harder not to get sucked into an ocean of misinformation. This is because they refuse to engage with the roots of the problem, which cannot be addressed by doubling down on the denial that there are any legitimate sources of understanding apart from science. After scientism has hollowed out public discourse of any way to present and disagree about values and ways of living, where else is discontent with policies that claim to only ‘follow the science’ to be directed except at the science itself?
By fostering a political culture, in which placing responsibility for a political decision on ‘the science’ is a viable way of defending it, scientism has made challenging science the only way to challenge political decisions. But, in both cases, a debate that should be about politics is misdirected. Political decisions cannot merely follow science, because political decisions, as any decisions for that matter, are motivated by specific interpretations and values. They are not merely dictated by the facts. As Jana Bacevic recently wrote in an Op-Ed in The Guardian: “What policymakers choose to prioritise at these moments is a matter of political judgment. Is it the lives of the elderly and the ill? Is it the economy? Or is it political approval ratings?” If our ability to discuss and argue over values had not been degraded, we could demand that policy-makers defend their choice to prioritise certain values over others, rather than taking refuge in the claim that scientific facts determine what choices they make, as though they were hardly choices at all.
For better or worse, [the city] invites you to remake it, to consolidate it into a shape you can live in. You, too. Decide who you are, and the city will again assume a fixed form round you. Decide what it is, and your own identity will be revealed, like a position on a map fixed by triangulation. Cities, unlike villages and small towns, are plastic by nature. We mould them in our images: they, in turn, shape us by the resistance they offer when we try to impose our own personal form on them. In this sense, it seems to me that living in cities is an art, and we need the vocabulary of art, of style, to describe the peculiar relationship between man and material that exists in the continual creative play of urban living. The city as we imagine it, the soft city of illusion, myth, aspiration, nightmare, is as real, maybe more real, than the hard city one can locate on maps, in statistics, in monographs on urban sociology and demography and architecture.
Raban, J. ( 2017). Soft City. Pan Macmillan.