To End a Pandemic,

Create a Disease

May 2022

by Jessica Wright

Image: Silver Janus Figure, post-16th c. Peru (Colonial?), Metropolitan Museum of New York, 26.33.7

When Odysseus returns Chryseis, Agamemnon’s war-captive, to her father in Iliad 1, the plague that Apollo has unleashed upon the Greeks at Troy comes to an end. We know this because Chryseis’s father, a priest of Apollo, raises his arms to the god and prays that the sickness, which he earlier invoked upon the Greeks, might be averted. “So he spoke in prayer,” declares Homer, “and Phoibos Apollo heard him” (Iliad 1.457). Then Odysseus and the Greeks, led by the priest, deliver a sacrifice of roasted meats and sung paeans to the god all day long. Through verbal cues, ritual actions, feasting, and music, the poet marks an end to the plague.

Who gets to decide when a pandemic is over? This is a question that has begun to press upon us as governments around the world lift COVID-19 restrictions. Perhaps unsurprisingly, we are as divided about this question as we have been about the virus since it began. Can scientists tell us when the pandemic is finished? Or politicians? How we assign authority to declare the end of the pandemic depends very much on what kind of question we think this is—epidemiological, economic, ethical, historical, logistical—the list could go on. Mass disease events are both biological and social phenomena, and as such, as Dora Vargha and Jeremy Green have argued in relation to COVID-19, there are necessarily competing perspectives on how best to define them and to identify their conclusions.

Disciplinary frames and technologies produce distinct ways of seeing. Even within a biomedical frame, a virologist might come up with a different answer than an epidemiologist, and an oncologist might have a very different answer than a paramedic. Future historians will come up with yet different answers, and not only because they will have more information about the spread and mutation of the virus between now and then, but also because they will be working with different conceptual frames.

Image: Terracotta Amphora, Berlin Painter, ca. 490 BCE, Metropolitan Museum of New York, 56.171.38

It is also the case, of course, that the virus affects us all differently. The “end” of the pandemic must therefore mean something different also, depending on where we live, the condition of our bodies, our access to healthcare and sick leave, our age, our financial responsibilities, the demands of our working lives and our families, our levels of exposure, our responsiveness to vaccines, our hopes for the future, what we are grieving about the past. For some, the end of the pandemic came when they were no longer required by law to remain apart from their loved ones. For others, it came with the vaccine. For yet others, it never truly started. For others, especially among the clinically vulnerable, it will never entirely end.

According to research psychologists based in London, some of us are also suffering from Covid Anxiety Syndrome. This hypothetical disorder, recognizable through symptoms such as the avoidance of public transport and in-person gatherings, is characterized by its inventors as a kind of PTSD that generates acute anxiety and prolonging the use of maladaptive coping strategies (such as social isolation) after the crisis has passed.

The Covid Anxiety Syndrome Scale—C19ASS for short—has been tested for validity on US research participants (who do not, unlike the researchers who designed the study, have access to a national health service or statutory sick pay). The study indicated that the kinds of individuals most liable to develop Covid Anxiety Syndrome are those who are clinically vulnerable, those who are at financial risk, and those who are neurotic.

There are a range of critiques that might be applied to the C19ASS study—not least the fact that it relies for its population sample on MTurk (an Amazon web service that brokers access to crowd-sourced workers who are paid, on average, $2 per hour), a research practice that is both ethically and scientifically controversial. More relevant here, however, is that the fundamental premise of Covid Anxiety Syndrome as a disease category is that the conclusion of the crisis is straightforward to determine or possible to generalize.

As the study itself picks up in its identification of clinical and financial vulnerable as risk factors for the syndrome, the end of the pandemic is not going to be uniform. It will always depend on who you ask, what disciplinary lens or tools they bring to the question, and how their own body and economic circumstances affect their relationship to the disease. By turning non-normative avoidance of the virus—degrees of worry that fall outside the bell curve—into an anxiety syndrome, we presume as normative low-risk bodies with access to healthcare. A disease category that is dependent upon a determination that the crisis is past—or that it can be unilaterally declared so—fails to account for the plurality of ways we might or might not reach an end of COVID-19, both as individuals and as a collective.

The removal of mitigations—or, depending on how you look at it, the easing of restrictions—has allowed for a return to communal eating practices, in-person religious gatherings, live performances, and music festivals. In some respects, perhaps the world of the Iliad is not so very different from our own. Above all, however, these public signals that we’ve crossed from intolerable to tolerable levels of collective risk reveal that there are no clean conclusions to mass disease events. What research psychologists have framed as Covid Anxiety Syndrome might better be understood as a consequence of this ambiguity, which leaves the end of the pandemic frayed and various, open to interpretation and different according to perspective and circumstance, ultimately as much a social performance or construction as a measurable fact.

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