essay about covid 19 in isixhosa

SA Covid-19 Vaccine strategy (isiXhosa translation)

Imiyalezo engundoqo yesicwangciso kunye nokukhutshwa kwechiza lokugonyela i-covid-19 emzantsi afrika.

Ukufikelela kumachiza okugonyela i-COVID-19 yeyona nto ibalulekileyo kuthi.

• UMzantsi Afrika uza kufumana isigidi esinye samathamo echiza lokugonyela i-COVID-19 kweyoMqungu kunye namathamo angama-500 000 kweyoMdumba echiza lokugonya le-Oxford University-AstraZeneca elivela kwi-Serum Institute yase India (i-SII).
• Siza kuqala ngokugonya abasebenzi bezempilo belizwe lethu abaqikelelwa kwi-1.25 yezigidi.
• Urhulumente usebenza ngokusondeleyo neGunya loLawulo lweeMveliso zeMpilo loMzantsi Afrika (i-SAHPRA) ukuqinisekisa ukuba akukho kulibaziseka ekuvumeleni ukusetyenziswa kwechiza lokugonya.
• Ichiza lokugonya le-Oxford University-AstraZeneca sele livunyiwe ngabalawuli abohlukeneyo kwihlabathi liphela kwaye lizakhutshwa nakwamanye amazwe.
• Sifikelele kwisivumelwano neZiko le-COVAX lokuba sizakufumana amachiza okugonya alingene ukugonya iipesenti ezili-10 zabemi.
• La mathamo alindeleke ekuqaleni kwekota yesibini yonyaka.
• Siyaqhubeka nokusebenza neenkampani ezahlukeneyo zoxubo-mayeza ukuqinisekisa ukuba unyaka ka-2021 uphela sigonye iipesenti ezingama-67 zabemi.

Ichiza lokugonya liza kukhutshwa ngezigaba.

• Khange kubekho kulibaziseka kwangabom ekufikeleleni kwichiza lokugonyela i-COVID-19, njengoko imeko ihlala imaxongo; zonke izinto kufuneka zithathelwe ingqalelo.
• Sikhetha amachiza okugonya sijonge ukhuseleko nokusebenza kwawo, ukusebenziseka lula, ukugcinakala, ukuhanjiswa, ubulula bokufumaneka kwawo kunye neendleko.
• Ichiza lokugonya siza kulikhupha sisebenzisa izigaba ezintathu siqala ngabona bantu basesichengeni.
• Sijonge ukuba uthi uphela unyaka ka-2021 sibe sesigonye iipesenti ezingama-67 zabemi, nto leyo eza kwenza ukuba sikwazi ukuphumeza ukhuseleko labemi abaninzi (i-herd immunity).
• Kwisigaba sokuqala siza kugxila kubasebenzi bezempilo abajongene ngqo nobhubhane.
• Kwisigaba sesibini siza kugonya abasebenzi abasisiseko, abantu abakwiindawo zendibanisela, abantu abaneminyaka engaphezulu kwama-60 kunye nabantu abaneminyaka engaphezulu kwe-18 abahleli benezigulo abanazo.
• Kwisigaba sesithathu siza kugxila kubantu abaneminyaka engaphezulu kwe-18, sijolise kubemi abangama-22 500 000.

Urhulumente uza kufumana, ahambise ze abeke iso ukukhutshwa kwechiza lokugonya.

• Urhulumente njengomthengi wamachiza okugonya ekukuphela kwakhe uzakulihambisa koorhulumente bamaphondo nakwicandelo labucala.
• Siza kufumana izitokhwe ezikhoyo kubavelisi abohlukeneyo.
• Ngoko ke kuza kubakho amachiza okugonya amaninzi ohlukeneyo kwinkqubo yethu, kodwa awunakugonywa ngamachiza okugonya amabini ohlukeneyo.
• Inkqubo yokugonya iza kusekelwa kubhaliso lwangaphambi kokugonya kunye nenkqubo yokuchongwa.
• Bonke abo bagonyiweyo bazakufakwa kwirejista yesizwe baze banikwe amakhadi okugonya.
• Ikomiti yesizwe yokukhutshwa izakongamela ukuphunyezwa kwenkqubo yokugonya kuwo omabini amacandelo elikarhulumente nelabucala.

Amachiza okugonya asindisa ubomi!

• Kukho ubungqina obuninzi bezenzululwazi bokuba ukugonya yeyona ndlela ilungileyo yokuzikhusela kusuleleko oluxhalabisayo.
• Amachiza okugonya awakuniki intsholongwane, koko afundisa amajoni omzimba wakho ukuba aqonde kwaye alwe nosuleleko.
• Ichiza lokugonyela i-COVID-19 linika umzimba imiyalelo yokwakha ukuxhathisa kusuleleko kwaye alitshintshi iiseli zomntu.
• Amachiza okugonya sele enciphise ukugula nokubulawa zizifo ezosulelayo ezifana nengqakaqa, ipoliyo, ukudumba isibindi, imasisi, uminxano-mihlathi,isifo sokukhohlela unkonkonko kunye nokukrala kwemiphunga kwihlabathi liphela.
• Ukugonya abantu aboneleyo kunga nceda ukudala ukhuseleko lwabemi abaninzi ze kutshabalalise esi sifo.

Amachiza okugonya afakwa phantsi kovavanyo olungqongqo ukuqinisekisa ukuba akhuselekile kwaye ayasebenza.

• Onke amachiza okugonya adlula kwinkqubo ebanzi yovavanyo ngabalawuli bezonyango ukuqinisekisa ukuba akhuselekile.
• Iinkampani zoxubo-mayeza zinikezela ngazo zonke iziphumo zovavanyo lwaselabhoretri kunye nezeemvavanyo zokhuseleko ukuqinisekisa ukuba ichiza lokugonya liyasebenza.
• Naziphi na iinkxalabo zokhuseleko ziyafunyanwa ngabalawuli xa behlolisisa idatha.
• Amachiza okugonya enzelwe ukusindisa ubomi hayi ukucinezela, ukuthakatha, ukubanga okanye ukuhlohla iingqondo zabantu ukuze bacinge ngendlela ethile.

Ichiza lokugonyela i-COVID-19 yinkonzo edalelwe ukuphila koluntu.

• UNondyebo weSizwe uzibophelele ekuqinisekiseni ukuba inkxaso-mali ayingomqobo ekufikeleleni kumachiza okugonya.
• Ulwabiwo olupheleleyo lohlahlo lwabiwo-mali lokufumana amachiza okugonyela i-COVID-19 luzakukwaziswa kuHlahlo Lwabiwo-mali lweSizwe lonyaka ka-2021. Oku kusisongezelelo samalungiselelo enkxaso-mali enziwe kunyaka-mali wangoku wokuthenga i-odolo yokuqala yamachiza okugonya, ejolise kuqala kubasebenzi abajongene ngqo nobhubhane.
• Ngokubanzi, inkxaso-mali izakuvela kuhlahlo lolwabiwo-mali olongezelekileyo, uhlenga-hlengiso kwakhona lwemali, ukunyuka kweengeniso, kukho nethemba lokuba ingavela nasekubambisaneni necandelo labucala.
• Urhulumente utyikitye isibophelelo sezezimali ezibophelela ekuhlawuleni iipesenti ezingama-85 zazo zonke iindleko zexesha elizayo, malunga ne-R2.2 yezigidigidi, kwiZiko le-COVAX. Amanye amalungiselelo kuxoxwa ngawo ngokudibeneyo kunye nabavelisi abohlukeneyo bechiza lokugonya.
• INgxowa-mali yeManyano ibe nesisa yenza umnikelo wentlawulo yangaphambili emalunga neepesenti ezili-15 zeendleko zizonke.

Sisebenza ngokubambisana ukukhusela ichiza lokugonyela i-COVID-19.

• Urhulumente uza kuba nakho ukufumana ichiza lokugonya ngemali esuka kwingxowa-mali yakhe.
• Amashishini kunye nezicwangciso zoncedo lonyango zize ngaphambili ukuxhasa iinzame zikarhulumente kwaye oku kwamkelekile. Le ntsebenziswano iza kukhokelwa yimigaqo-nkqubo yemanyano yezentlalo nokunganyanyezelwa kwaphela korhwaphilizo
• ISebe lezeMpilo lityikitye izilungiso kwimimiselo ukuvumela ukuba amachiza okugonya kunye nezinye iindlela zonyango zibe yinxalenye yesibonelelo esincinci sezicwangciso zonyango esimiselweyo.

Iinkcukacha ezithe vetshe ziyafumaneka ku https://sacoronavirus.co.za/category/mac-advisories/

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A multimodal discourse study of selected COVID-19 online public health campaign texts in Nigeria

Tunde ope-davies (opeibi).

University of Lagos, Nigeria

Mojisola Shodipe

This paper discusses web-based public health discursive practices during the Coronavirus (COVID-19) pandemic in Nigeria. It utilises a multimodal discourse approach to explore how a combination of textual and visual resources was deployed to communicate informative and educative public health safety campaigns during the period. Essentially, this study discusses multimodal resources as a rhetorical technique for creating a public discursive engagement space designed to educate the public and mitigate the effect of the pandemic. The dataset was collected during and after the lockdown in 2020 (March–September) through media monitoring and manual downloading of relevant online COVID-19 posts, messages and public health advisories largely from WhatsApp platforms and the portals of some Nigerian national newspapers. Using insights from relevant approaches in discourse analysis (e.g. Multimodal Discourse and Critical Discourse Analysis), we adopted a qualitative content analysis approach to analyse on how online posts as multimodal resources amplify the role of social media affordances in producing and promoting public safety messages helped to control the spread and mitigate the effects of the pandemic. The study also shows that discursive and multimodal resources were deliberately deployed to increase the effectiveness of the technology-driven public health campaign. To a large extent, multimodal resources were found to complement lexico-semantic properties of online communication, where social media messages are created, crafted and reconstructed within a uniquely Nigerian public discourse context. The study further illustrates the increasing importance of web-based platforms as discursive sites for enacting and negotiating meanings during event-driven social activities and public engagement in the Global South.

Introduction

The global pandemic that broke out in Wuhan, China towards the end of 2019 has thrown up a variety of discursive practices designed to promote global information on the transmissibility and containment of the virus and its phenomenal impact on the populace. As the global community grapples with the devastating and lingering impact of the pandemic, both the mainstream and social media platforms have continued to play a key role in creating awareness, providing updates on the spread, containment, public health advisories and strategies to prevent or curb fatality. More significantly, web-based platforms became the more dominant discourse space during the lockdown and travel restrictions as public health officials, state actors and average online users became producers and publishers of public health awareness campaign messages. The information overload assumed a frightening dimension that experts had to describe it as ‘infodemic’ (e.g. Banerje and Meena, 2021 ) due to the massive online transmission of facts, misinformation and disinformation on the virus. In Nigeria, a number of public health communication strategies were adopted in the dissemination of information to the Nigerian public on the nature, spread and containment of COVID-19 as well as its serious public health implications. Beginning from early March 2020 to the end of year 2020 and beyond, the Nigerian social media space was inundated with messages, posts, memes and statistics about the virus.

Background to the present study

It is a fact that Covid-19 global health emergency has thrown more light on the increasingly role that digital media technologies can play during public crises. Although these new platforms have been accused of fuelling the spread of fake news, false information and disinformation, they became important tools for sustaining relationship, educating, informing, motivating and empowering individuals and groups, across different spheres of human and social endeavours, during the global health crisis. The emergence of Covid-19 public health discourses pushed the debates further on how the socio-technical affordances and interactive architecture of the new media platforms permit anyone to create and transmit online content.

The emergent public health discourses are primarily shaped by the need to provide an inclusive community-based participation in managing public health crises. To a large extent, the use of these new technologies to transmit and broadcast public health awareness, public safety and wellness messages impact on proactive, preventive and personalised healthcare initiatives.

Since the outbreak of the pandemic, a huge number of academic and policy literature has been published within the traditional and mainstream sciences and epidemiology discipline. We equally recognise some efforts in corpus-based and critical discourse analysis of news reports on COVID-19 in the United Kingdom, China (e.g. Mu et al., 2021 ; Yu et al., 2021 ) and the United States of America as well some parts of Africa (e.g. Dezhkameha et al., 2021 ). However, similar research efforts are still largely very few in Nigeria. Although scholars such as Unuabonah and Oyebode (2021) have adopted a multimodal discourse approach to study covid-19 memes as political protests in Nigeria, literature on multimodal discourse analysis of the pandemic as a public health enlightenment campaign is sparse. Generally, the study of online public health discourse is yet to receive adequate attention among scholars in Nigeria. This study therefore addresses the dearth of literature on online public health discourse in Nigeria. By focussing on Covid-19 discourse event, we show how digital technologies and social media networks can aggregate and escalate discursive elements in public health campaigns to mitigate the impact of the pandemic on the populace. Exploring such a crucially-important socio-discursive and topical event has two main motivations: (1) analysing the pandemic as a socio-semiotic event is aimed at presenting technology-enabled relatable images and posts from the Nigerian discursive setting; and (2) exploring the variety of COVID-19 public awareness messages is aimed at providing interpretations of the messages, incorporating the written, visual or non-linguistic elements that reflect social, cultural and psychological configurations, as a product of the public health crisis.

This study thus explores digital public health discourse within the prism of the dynamics of multimodal online discursive practices, throwing light on how web-based affordances escalate effective public healthcare campaigns in Nigeria.

Public health and online multimodal discourse

The pervasive influence of these wireless technologies has elevated public health awareness to a new level despite some of the drawbacks, such as fuelling the spread of fake news, hate speech false information and disinformation. They were used extensively to create awareness, educate and inform individuals and groups about the pandemic. These new media platforms enabled stakeholders, state actors and ordinary citizens to create and transmit public health-related online contents during the period. Since public health discourse is primarily shaped by the need to provide an inclusive community-based participation in public health care policy implementation, creative online contents played a major in the management of the crisis.

The integrative perspective of online discourses (e.g. Oprea, 2019 ) presents a framework which views the Web as a device composed of ‘techniques’, ‘actors’ and ‘statements’. The use of ‘discursive technology’ in this perspective now indicates the interconnections between the intra-linguistic manifestations (textual and verbal elements) of online discourses and their extra-linguistic constraints (hashtags, memes). This integrative perspective is described as non-dualist or post-dualist ( Oprea, 2019 ), wherein the Internet is viewed as a ‘technolinguistic ecosystem’ which contains affordances that activate and sustain a democratised discourse space with online users now as creators and consumers of online contents. This means that technology is no longer a support system, but an essential component of the discursive process.

Herring (2004) has earlier used some principles in computer-mediated discourse analysis to describe these technolinguistic features which must be identified and carefully analysed when they occur in the online environment. Among other assumptions, Herring (ibid.) discusses how online behaviour is shaped by language use and how discourse may be ‘shaped by the technological features of computer-mediated communication systems’ (p.4). Therefore, the statements produced in online environments are regarded as composite discursive technologies which consist not only of linguistic elements, but a combination of language resources which combine with Internet affordances to define the discursive landscapes of online communication practices.

COVID-19 public healthcare messages generally explore the interpersonal dimension in the communicative paradigm by presenting the public (receptors) with recognisable features which identify closely with socio-cultural life in a specific setting. They generally create interpersonal meaning by exploring both textual and semiotic resources in the process of maintaining the social connections between the originator of the message and the public who constantly search the social media for information on how to cope with the pandemic. Zappavigna (2012 : 7) describes social search as ‘a mode of searching that leverages a user’s social networks’. The various uses of language as socio-semiotic resources for forming social connectivity in the dissemination of healthcare information on the COVID-19 pandemic in Nigeria provide some of the motivations for this study.

Memes as multimodal features of the WhatsApp messages on the pandemic became a prominent component of the awareness campaigns. Their characteristic creativity, visibility and replicability particularly make these affordances easily attractive and transferable from one social media platform to another. Their socio-technical features actually support the multimodal fluidity of these internet-based messages across the inter/multi-modal platforms. Memes usually reflect the socio-cultural settings of their production and indicate different types of information (ideas, habits, figures) that spread, multiply and change in the environment of human culture ( Dawkins, 2006 ). Milosavljevic (2020 : 11–12) observes that Internet memes are a recent phenomenon and refer to the most popular often funny concepts that are created, user-generated discourse materials and transmitted through different online channels. In most cases, memes also reflect the socio- economic, religious and political dynamics, and a whole configuration of the discourse environment designed to convey serious messages on private, public, national or global issues in creative and humorous manners. Milosavljevic (2020) identifies the following key features of internet memes that are found in some of the COVID-19 texts used in this study: imitation, cultural and social conditionality, specificity and visibility; humour and satire, simplicity, combination of visual and textual elements and high compactness to the meanings. They were prominent features of the online public health awareness campaign texts and general purpose internet discourse materials produced and shared during the COVID-19 period in Nigeria. These memes usually in multimodal formats, are often a creation of the topical socio-discursive event, and encoded with shared meanings, they directly imitate the reality in the socio-cultural setting from which they emanate ( Milosavljevic, 2020 ). Their witty, satiric or comic content; and the simplicity of their structure make them easily recognisable to all members of the society. Indeed, it is the simplicity and their socio-cultural representativeness that enhances their visibility as powerful statements of the various stages in the evolution of the pandemic discourse in the Nigerian setting. Fairclough (1992 : 14) supports this view in his observation that discourses are an ‘active relation to reality’. Against this background, this study explores how the social media platforms and socio-technical affordances of the online multimodal discourse now shape the nature and content of the COVID-19 public health awareness and public safety messages in Nigeria.

Theoretical framework

Generally speaking, a combination of images and text used in web-based discursive space animates interactions and communicative acts reflecting social, cultural, discursive and technical elements that support the entire discourse ecosystem. Scholars such as Matthiessen (2007) , Vovilas et al., (2010) see Multimodal Discourse Analysis (MDA) as an approach to analyse how different semiotic systems interact in the creation and negotiation of meaning within a discursive platform. These semiotic (multimodal) resources such as pictures, text, graphology and graphetics often interact within the larger frame of the text to create meaning (e.g. O’Halloran, 2008 , 2009 ). Scholars like Kress and van Leeuwen (2006 , 2021 ; Kress, 2009 ); and Machin (2007) have explored the social significance of multimodal elements in online discourse. They view multimodal discourse as a form of communication that involves the use of multiple semiotic resources to achieve socio-discursive appeal through visual, textual and other non-linguistic elements. Multimodality is often associated with an attempt to highlight one of two analytical concerns: first: the awareness that all texts are produced and encountered not only as words but also as images, colours, textures, layouts and designs; and, second: the awareness that social interactions are simultaneously embodied as spoken language, gesture, posture, dress, or movement. Machin et al. (2016 : 303) argue that ‘“Multimodality” was to follow the works of CDA, but its main innovation was to include not just language but all the semiotic modes that make up a social context’. Multimodal discourse analysts believe that text should be analysed therefore along with the combination of semiotic resources such as text, images and layout that usually form an important and inseparable component of the text. To a large extent therefore, both written and visual elements in texts are considered together as providing comprehensive reading and interpretation of the meaning the text is designed to convey. The multimodality thrust of COVID-19 online texts works within the pragmatic and socio-discursive networks of the online affordances to produce context-based meaning negotiated through a multiplicity of sociocultural elements. Observably, digital discourse has brought along with it multimodal features and formats (text, images, audio and video) that dominated various user-generated social media platforms (e.g. Instagram, Twitter, Facebook, WhatsApp). These multimodal trends in contemporary social media discursive processes enhance the impact of the public health enlightenment discourse and other messages that were published and transmitted, across traditional media and new media handles during the period.

While other approaches may have been developed, the contextual ( Kress and van Leeuwen’s, 2006 ) and grammatical approaches ( O’Toole, 2010 ) seem to be the two most influential perspectives in the study of MDA. Significantly, most insights in MDA derived their inspirations from Michael Halliday’s (1978) socio-semiotic approach to the study of text, society and culture ( O’Halloran, 2011 ). Kress and van Leeuwen’s (2006) Reading Images: The Grammar of Visual Design provides an extensive discussion on theoretical resources that highlight the use of multimodal approaches for analysing discursive practices. For instance, the framework incorporates three major metafunctions: representational, interactive and compositional with each encompassing a set of subcategories. Kress and van Leeuwen’s concept of visual social semiotics is particularly useful in showing how the unpacking of multimodality relies on the interaction of three systems: information value, salience and framing. This visual semiotics model, as a (top-down) contextual approach, embeds a particular orientation to ideology, deriving general principles of visual design which are illustrated through text analysis.

As mentioned earlier, Machin (2016: 303) establishes some connection between multimodality and critical discourse approaches. Public health awareness campaign texts that contain multimodal resources are designed to drive public enlightenment campaigns where power and control may be embedded and negotiated within the contested discourse space. Some scholars in Critical Discourse Analysis (CDA) (e.g. Fairclough 2001 ; van Dijk, 2001 ; Wodak, 1989 ; Wodak & Meyer, 2001 ) agree that power may be enacted through the creative use of language (text and images) to persuade, convince, or subtly coerce the other person to act according to the wishes of the speaker. They affirm that public/institutional discourses create the space for such demonstration of (unequal) power relations because some participants have access to some critical social privileges above others. As exemplified in most public emergency situations, state actors and relevant agencies of government may need to deploy state and institutional resources to enforce compliance. Discourse thus plays a central role in actualising such government policies as witnessed during the lockdown period in Nigeria. The COVID-19 public healthcare campaigns exhibit such creative discursive patterns which underscore a gradual awareness of the power of multimodal discursive practices to promote and enforce social good.

Methodology

We harvested the dataset for this study primarily from web-based platforms, online portals of national newspapers and the general web that were widely patronised and utilised as sources for receiving and transmitting information on the pandemic in Nigeria. The texts were extracted from a collection of data being compiled for our Corpus of Digital Health Discourse project (ww.cedhul.com.ng). Online posts, images and memes generated from WhatsApp platforms and other social media networks form the bulk of data on the COVID-19 public health awareness campaigns. The data collection methods included media monitoring and manual download of relevant social media posts on the discursive event. The posts were downloaded and saved in easily retrievable media, such as dedicated cloud-based repository on personal mobile handsets, emails and laptops. These were subsequently converted to word format to promote editing and cropping of the visual data. The data falls roughly into the following formats:

• Sponsored public health campaigns by non-governmental organisations or government bodies who have the primary duty to disseminate information and create awareness on the pandemic. They are mostly in poster format, with a combination of textual and visual content, which may be adjusted to other media formats.
• Internet memes often created by active online users to share information, views and values with others on social media networks. Mostly in the form of pictures and texts but often display the dominance of visual content over textual content. They are evocative, emotive, humorous and often present phenomena common to all people.
• Visual messages with social or political underpinning. They portray issues of power, or may have components of framing, power and control embedded in their content.

The dataset thus covers the different stages in the public education process occasioned by the pandemic and its social implications. In the context of this study therefore, the selected texts used for analysis were largely public enlightenment campaign messages deployed during the period. Oprea (2019) has suggested that discursive materials consisting of multimodal elements cannot be considered wholesome analytical tools if they are removed from the environment in which they were formulated in order to signify meaning. The use of multimodal and critical discourse approaches based on qualitative content analysis aligns with Oprea’s (2019) view which recommends the combination of both textual and contextual information of a multimodal-based discursive practice in order to provide a holistic interpretation of the meanings which are made.

Data analysis: Multi-modal communicative format in public health awareness/enlightenment campaigns on Covid-19

A large number of the data sourced from social media sites exhibits multimodal features. While this may tend to indicate some form of exclusivity in terms of the domain of linguistic interventions in the discourse of the COVID-19 pandemic, it is useful, and indeed necessary, to point out that certain components of the internet-based corpus may be viewed as having ‘bi/trans-modal’ features. Since print media content is increasingly becoming available in electronic formats which are uploaded on social media platforms, social media coverage of the coronavirus discourse naturally includes: stretches of texts in user-defined online formats, electronic versions of print media enlightenment campaigns (in the form of informative colour posters and pictures); user created memes which express people’s thoughts and emotions on the pandemic, ranging from the political, cultural, to the humorous. In promoting public enlightenment and advisories during the COVID-19 season, the communicative impact of multimodal public health campaign messages on social media platforms underlies the discursive content of activities that permeated the public space. Government authorities and other relevant public health management agencies such as the Nigeria Centre for Disease Control (NCDC) initiated massive public enlightenment campaigns, to create public awareness and public safety guidelines and enforce compliance.

Social media harnessed all of these platforms to exhibit an assemblage of colourful, eye-catching and attention-getting awareness campaign pieces that reflected the public health emergency occasioned by the pandemic.

As shown in the images below, Figures 1 and ​ and2, 2 , public awareness posters were transmitted from their original public spaces, and posted on the social media portals of the national newspapers to sensitise the public on the transmission of the virus; and to disseminate preventive measures to curb its spread.

Stop the spread.

Source . Posted and shared on public online platforms by the Coalition Against COVID-19[CA- COVID, Nigeria].

COVID-19 case update.

Source . Posted and shared on public online platforms by the coalition against COVID-19[CA- COVID] and Nigeria Centre for Disease Control [NCDC].

A common feature in these picture messages is the interplay of both textual and visual resources ( Kress and van Leeuwen’s, 2006 ) pictorial and verbal information). While the main message is conveyed through the textual content, the visual content reinforces the message or vice versa. In these figures, the discursive construction of the pandemic situation sets forth a global response to the spread of the virus and local initiatives to curb the spread. Kress and van Leeuwen’s (2006) compositional metafunctions that espouse three interactive systems: information value , salience and framing provide some useful insight. The concepts demonstrate how the composition of images and meaning extrapolation from the multimodal components may underpin the importance of the public health education posters.

In Figure 1 , the information focus of the posters, for instance, consists of verbal and pictorial elements. While the pictorial information appears on the left, the verbal/textual information is placed conspicuously on the right. The logo as pictorial information on the right bottom of the poster is used to provide information authentication technique emanating from a legal authority, the represented participant (i.e. CACOVID.NG). The verbal or textual information at the bottom of the poster, Staying Alive Together, deliberately positioned beside the identity of the promoter of the campaign poster conveys the main message of the public health communication. The structural division of the poster into ‘left’ and ‘right’ columns may roughly equates ‘given’ and ‘new’ information ( Kress and Van Leeuwen, 2006 ). The images as ‘given information’ (in this case, traffic signs) are existentially and contextually located within the transportation space while the ‘new information’ relates directly to the existing Covid-19 advisory guidelines. The represented participant that sponsored the campaign is a registered non-state actor established to support government efforts in sponsoring public enlightenment campaigns and in sourcing and sharing COVID-19 relief materials. Their call for support is visually and textually depicted through icons such as their telephone number, email address and social media handles. This important information is well placed in the middle of the composition to attract the attention of citizens and potential donors. Information-centring strategy has become very important in persuasive discourse to achieve focus and maximum comprehension of the message.

In terms of salience, the visual component contains some foregrounding elements that are designed as attention getters and persuasive strategies. Scholars (e.g. Belgrime and Rabab’ah, 2021 : 198) have identified factors such as size, sharpness of focus, colour contrasts and placement in the visual field as multimodal elements that provide complementary information in the text. The images and the graphologically-designed textual information in bold and light fonts case letters are the most salient information in Figure 1 . The conspicuous positions that the traffic signs occupy are designed to provide a sharper focus for the instructional texts placed parallel to the images. The traffic signs as semiotic resources are connected with familiar social activities of commuting, vehicular movement, journey and travels. They are deliberately placed alongside the text – ‘ Stop the spread , Go back home’ crafted in bold and normal font to provide a striking warning-based public information message to citizens. The graphological technique deployed here is designed to attract the attention of citizens and serve as a mandatory [pre]-cautionary measure that must be observed. It is interesting to notice the semiotics of progressive movement or journey as indicated in the choice of the traffic signs. It begins with the ‘caution’ sign, followed by the ‘stop’ sign and concludes with the ‘u-turn’ sign. The accompanying text expresses and affirms what the semiotic resources communicate non-linguistically within the context of COVID-19 safety measures which are being adopted.

In framing the bigger objective of the campaign, the sponsor of the poster (i.e. represented participant) creates some degree of connection between the different visual and textual elements that constitute the entire discourse. Since the more these elements are connected to each other, the more likely they are to convey and/or reinforce the same information ( Belgrime and Rabab’ah, 2021 ), one can argue that the structural positioning of the elements vertically and horizontally supports the single objective of communicating advisory information that can help to mitigate the spread of the virus. The distance between the frames is carefully managed to avoid any degree of difficulty in linking the images and texts to achieve the same goal. It is evident that each type of information is thus created to complement each other within the larger frame of the poster.

In Figure 2 , a top-to-bottom multimodal approach is adopted to project the information value, salience and framing of the message. The mixture of the pictorial and verbal information promotes both visual and cognitive impact that enhances comprehension and persuasion. The instant effect of the graphology and colour mixture and statistics of the daily COVID-19 cases in Nigeria as depicted in the post increases citizens’ consciousness and awareness about the impact of the pandemic. It opens with the pictorial information of the represented participants, the Federal Government of Nigeria and the Nigeria Centre for Disease Control (NCDC) visually represented by the Nigerian coat of arms and the NCDC logo respectively. The black background of the poster foregrounds a sense of sadness and mourning, while providing a colour contrast to figures which are provided. The vertical compartmentalisation of the text into ‘new’ and ‘given’ information provides a top-bottom reading of the message. The pictorial information through the images at the top streams from given information supported by the legitimate legal authorities mandated to communicate information on the pandemic. By foregrounding the represented participants, the information is considered credible and authentic. The headline, COVID-19 CASE UPDATE written with bold text fonts and upper case letters attracts attention easily and creates a sense of suspense that draws the people to seek additional information. The use of statistics or data to convey information value in public discourse is regarded as ethical proof or persuasion through reasoning or logical proof ( Aristotle, 1962 ; Cockroft and Cockroft, 1992 ). This poster makes effective use of different figures to reveal the current state of the pandemic. NEW CONFIRMED CASES-20, TOTAL CONFIRMED-343, DISCHARGED-91, DEATH-10.

While the caption: COVID-19 CASE UPDATE written in bold upper case letters is one of the most salient pieces of information in the text, the presentation of the details in accurate figures supports the salience of the key information being transmitted. Font sizes of the text, sharpness of focus, colour contrasts and placement in the visual field are other important multimodal elements that supports and projects the salience of the public enlightenment message. The presentation of data and time of the report/update, in smaller font size and sentence case letters, is meant to further enhance the credibility of the information. The graphological effect is equally significant as the combination of colour and text projects the information more vividly. We have earlier observed the deliberate foregrounding of the two legal represented participants, the Nigerian government and NCDC, the infectious diseases control agency carries a quantum of salient information needed to authenticate the accuracy and authenticity of the information in the document. Notice the significance and meaning potential of the types of colour used in the different figures presented. Black colour is placed on yellow for confirmed cases; white colour is placed on green for the discharged cases while white colour is placed on red for the number of deaths. Multiplicity of images, colours, symbols, signs and written messages and their corresponding meanings often characterise public enlightenment texts designed to inform, persuade, warn and alter the behaviour of the consumers of the messages. The predominance of black and red colours that usually indicate danger and death sends forth the message of warning. The yellow colour in this context indicates neutral emotion since it is placed against the background of dark colour. The white colour used here suggests hope, helpfulness and positive sense of victory. It also downplays the sense of anxiety and panic generated during the peak period of the pandemic, Green and white are Nigeria’s national colour codes and they are used to represent the agency fighting the virus and number of discharged cases. One may deduce a subtle sense of effective governance being conveyed through the successes recorded by the government’s disease control agency. The signature line of coda of the poster presents ‘new’ information in the form of NCDC’s toll-free telephone number and social media platforms through which citizens can seek additional information or report cases of infection or transmission.

This poster particularly shows the degree of connection that exists between the different elements in the construction of the message. The framing features here provide a fine thread that links the different parts of the poster with the use of a multiplicity of statistics, colours and images. The different layers of relevant information presented in the poster are included in one bigger frame and are designed to convey the same meaning and message about the rising cases of infection, and the possible fatal consequences if public health guidelines are ignored. They also convey a sense of hope and ultimate victory over the virus if people follow the necessary precautions and official advice.

Figures 1 and ​ and2 2 represent the social signification and communicative act of multimodality in the COVID-19 public health advisory texts in Nigeria as transmitted through social media. We can identify two distinct patterns of public advisory which are signified by each of these messages as follows:

(i) Directive or instructional ; signalling the public to a specific action, through recognisable symbols of social cognition and cohesion. Such messages have the feature of enabling obedience and adherence to social order (as seen in Figure 1 ). The imperative statements: ‘Stop the spread’, and ‘Go back home’ reinforce the impact of the three traffic signs which symbolise the message- the ‘danger’ sign, the ‘stop’ sign and the ‘u-turn’ sign.

(ii) Informative ; represented in Figure 2 – ‘COVID-19 CASE UPDATE’, a daily listing of COVID-19 ‘new cases’, showing the ‘total number of confirmed cases’, the ‘discharged’ and the ‘dead’. The case updates not only serve as daily information advisories on the state of the pandemic, but more significantly, specific facets of the healthcare implications were transmitted by the growing figures, such that they became reliable tools for charting the trajectory of the virus in different parts of the country. For government officials, notably state governors, and state ministers of health, the COVID-19 CASE UPDATEs soon became iconic information tools for documenting the pandemic and for rolling out healthcare initiatives to citizens in their various communities. Apart from serving as a means of communicating to the citizenry, the precarious nature of the raging virus, the ‘case updates’ became a tool of government propaganda, a means of showing the public that ‘government was working’. Furthermore, the underlying reference to the public healthcare situation as occasioned by the pandemic can be easily discerned in the key points of the message: ‘total number of confirmed cases’; the ‘discharged’ and the ‘dead’ allude most poignantly to the healthcare system, not just as the source of these figures, but as an index of the healthcare challenges which confront both the government and the citizenry on a daily basis.

Narrative memes: Telling the story of COVID-19 with visual elements

As discussed earlier, the internet and social media networks have provided a new platform for the production and transmission of memes as creative discourse tools. Memes are one of the most prominent, and frequently used online multimodal public health awareness messages. Their frequent usages online have generated creativity in terms of style and presentation. Therefore, the use of narrative memes to promote COVID-19 safety guidelines was created to leverage the existing oral tradition mode to relate the messages to the audience in a more engaging and interesting manner. Some of the COVID-19 healthcare messages were thus presented in multiple picture formats with story-telling features. As the pandemic progressed, the need arose for more comprehensive information on the nature of the virus and its social implications. Active online users and stakholders devised more detailed information that chronicled the various stages of transmission of the virus in more visually informative and educative formats. The goal, as in the other formats, was to adequately sensitise the public to the needed knowledge for appropriate action on fighting the virus at the individual and community levels.

This section illustrates a peculiar category of healthcare messages, which we may refer to as the ‘story-board’ public health advisories ( Figures 3 and ​ and4). 4 ). These ‘story-board’ formats are quite significant in the analysis of COVID-19 messages as they represent the heightened public enlightenment process that followed the lifting of the ‘stay at home’ directives and restriction of movement in many parts of the country. As people began to move around again, it became imperative to increase the depth of information and also elevate the visual content of the awareness campaigns. The public health advisories thus took on a more dramatic and more visual format, as represented by Figures 3 and ​ and4 4 .

‘Added preventive measures’ meme.

Source . Nigeria Centre for Disease Control: Posted and shared on public online platforms.

COVID-19 mask protection campaign

Source . Lagos State Government/ State Ministry of Health public enlightenment campaign on social media platforms.

Framing as used here (e.g. Goffman, 1974 ; Scheufele, 1999 ) shows how information is presented in a format that creates a unique attention for it. In practical terms, it describes a process involving a consious choice of elements for presenting and organising an idea or topic; focussing on the essence or importance of an issue at hand, rather than the issue itself. Thus, by framing specific COVID-19 messages in story-board format, the message producer sets an agenda by placing the message in a particular sphere of meaning-making.

The format or ‘frame’ is therefore intended to influence the choices which the public has in processing that piece of information. It follows thus that while any social media user may easily look past the messages in Figures 1 and ​ and2, 2 , the peculiar framing of the messages in Figures 3 and ​ and4 4 will most likely have a more compelling influence on the audience, simply by virtue of their peculiar presentation format. If we consider the messages as news items for instance, then we may liken their presentation to the agenda-setting format or the framing technique where the producer seeks to structure or influence how the message will be received or perceived. In other words, these two examples of COVID-19 healthcare messages are specially designed, not only to tell the public what to think about the pandemic, but crucially how to think about the issue.

The story-board memes as public awareness discourse

Figure 3 typifies the story-board format in displaying content that summarises, in graphic form, the variety of social practices engendered by the pandemic safety guidelines. It basically outlines the social protocols established by the government, at state and federal levels, for COVID-19 safety procedures in both indoor and outdoor situations, as well as the compliance guidelines for Nigerian citizens. The ‘story’ indicates through illustrative semiotic elements, specific actions required of citizens and their social implications on pandemic safety.

In Figure 3 , the interplay of text and images narrates the COVID-19 advisory and public awareness strategy to draw readers into an inclusive and participatory engagement discourse space. The use of illustrations to depict different social contexts where people can easily contract and transmit the virus utilises non-linguistic resources to communicate the messages more forcefully and persuasively. Social settings identified in the story board include, public markets, shopping malls, transportation infrastructure and outdoor social events such as wedding ceremonies, and religious events among others. The instructional material reminds the citizens that wearing of a mask is mandatory in all these public spaces. In fact, the graphological techniques used in the image reinforce the seriousness of the guidelines. The deliberate choice and highlight of words such as NO GATHERING, MANDATORY, CONTROLLED ACCESS, MAINTAIN, Curfew Time, RESTRICTED ACCESS, Travel Outside Nigeria, are all lexicalisation of enforcement rules that attract sanctions when flouted. Lexiconising the COVID-19 safety guidelines has increased the pool of words now being used in public health discourse (see Table 1 ). The use of multimodal strategies such as capitalisation, font sizes, bold formats and colour codes further amplify the seriousness of the pandemic that must be matched with the seriousness in enforcing the public health guidelines. The use of imperative tone in the instructions manual underpins the authority that controls such discourses in institutional settings.

Analysis of COVID-19 added preventive measures.

Demonstrating the typical structure of advertising discourse ( Awonusi, 1996 ; Cook, 1992 ), the structure of the story board falls roughly into the three main parts: Headline, Body and Coda. The flow of the discourse patterns promotes easy communication and comprehension of the message. The graphological features as a multimodal resource creates an instant impact on the participants. The headline has a bold black text with a special font: ‘COVID-19: Added Preventive Measures’ to attract attention and persuade the reader to seek further information in the body copy. The foregrounding of the word, ‘Added’ in the headline seeks to heighten the anxiety and seriousness that accompanied the increase in the rate of transmission, contagiousness and fatality arising from the pandemic when it reached the plateau level in many countries. The presupposition embedded in the word, ‘added’ within the context of the text suggests that increased efforts are being made to provide up-to-date information that will assist the citizens to stay safe. The body copy encodes the main thrust of the public health enlightenment guidelines presented in a combinatory format of text and images as discussed above. It is worthy of note that the arrangement of the images and the text in different font sizes and colour codes makes it easy for easy comprehension of the message. It supports the salience of the information value encoded in the message. The short, crisp nature and features of the texts coupled with the appropriate images provide freshness and vividness in conveying the import of the message and enabling the people to understand the meaning of the message and remember the instructions. The coda concludes the message with a slogan that is meant to reinforce the message and enhance memorability. It also contains a message-authentication device by sighting the source of the message and the state actor responsible for issuing the guideline. This has become important in order to affirm the institutional and legal authorities that issue the guidelines. This may be viewed as message-authentication strategy or demonstration of discursive power to enforce compliance and the possibility of sanctions. ‘Take Responsibility-Prevent the Spread of COVID-19’ presented with the image of tick/correct/right mark – ✔. The mark is allowed to split the image of the virus to suggest that if we all take responsibility we can break the virus.

The two hashtags: #Takeresponsiblity and #COVID19nigeria further enhance the role that citizens are expected to play in curbing the spread of the disease. COVID19NCDC.GOV.NG presented in black bold text forms part of the rhetorical strategy adopted to further affirm the authenticity of the message and the credibility of the source. The Nigerian coat of arms and the logo of the Nigeria Centre for Disease Control (NCDC) are instances of a double affirmation credibility strategy ( Figure 3 ).

The post demonstrates the use of multimodal resources as a discursive instrument to legitimise authority and as instrument of power and control. The pandemic period produced public health campaigns that were used as tools for controlling individual and public views. The spiral effect of the persuasive public campaigns ossifies towards instituting a new culture of aggressive personal and public hygiene with mask mandate, hand washing and social distancing protocols among other COVID-19 public safety guidelines. Authorities used discourse deftly and creatively to compel citizens to comply with those guidelines in order to mitigate the effect of the pandemic.

Reframing COVID-19 discourse through memes

Memes are presented in ways that amplify the socio-communicative intention in the online campaigns. For example, the meme in Figure 5 is a pictorial illustration of the gradual progression of the risk factor involved in the person-to-person transmission of the coronavirus. Against the background of official guidelines on social distancing to prevent local transmission of the pandemic, the meme is graphically framed to depict emblematic images of safety requirements (mask wearing) and risk levels (social distancing) while coping with the virus. The meme thus signifies the relationship between ‘pandemic tasks as social practice’ and observable results in percentages of compliance success or failure. Using similar images, with different patterns of iconicity, the meme provides vivid illustrations of social distancing as social action. The dominant semiotic feature is ‘social distancing’ which serves as a consistent emblem of the pandemic risk calculation through social practice. The use of statistics provides some sense of objective and accuracy in information presentation to further persuade and convince the people of the risk of contracting the virus. The multimodal elements deepen the visual impact and instructional protocols for public safety ( Figures 5 and ​ and7 7 ).

Social distance and risk of transmission.

Source . Nigeria Centre for Disease Control: Posted and Shared on Public Online Platforms.

Body parts multimodality as COVID-19 safety campaign.

Source . The safety advocates: Posted on public online platforms.

COVID-19 memes tend to reframe the discourses they represent by promoting specific aspects of the pandemic public education processes in discursive patterns which represent a different perspective. Invariably, these new memes form additional sources of information which extend or explicate the discourse, or an important aspect of it. The discursive elements in the post contain several composite aspects: text, data and static visuals (pictures, images, posters). All these affordances form the bedrock of discursive elements that escalate the written and visual impact of the message. They connect the discourse to vast audiences, promote the space and tool to negotiate meaning and maintain human interactions through an increasingly visual mode.

Reframing COVID-19 discourse for social consciousness

In order to draw global attention to the discriminatory global public health policy, Figure 6 was created for the purpose of promoting some level of social consciousness on the basis of the on-going controversy on the development and testing of COVID-19 vaccines ( Figure 6 ).

Reframing COVID-19 Discourse for social consciousness.

Source . Anonymous-Posted on Public Online Platforms-WhatsApp

The post was created in reaction to the suggestion by some foreign doctors that the COVID-19 vaccine be first tested on Africans. The meme thus presents Africa as the helpless lab-rat (i.e. a guinea pig) at the mercy of the European scientists while the picture on the wall depicts previous trial testings conducted on Africans for various vaccines. The meme’s caption: ‘ French doctors say COVID-19 vaccine tests be done in Africa ’ aptly captures the tread of the on-going social media debate and parodies the situation. The images and texts communicate a strong message of condemnation of the stereotypes, injustice, racial profiling and discrimination against Africa and the developing world in general. It artfully scorns the hypocrisy of the west against the backdrop of their false expectation about the possible devastating effect of COVID-19 in Africa. It also serves as a pushback discourse strategy on the previous vaccination testing-scandals conducted by developed nations in Africa and against populations of colour even in some of those western countries (e.g. Pfizer’s court case in Nigeria over illegal meningitis vaccine test). When situated within the critical discourse analytic frame, the meme becomes a tool to resist power domination conveyed through the statement credited to the French doctors. It thus tactfully calls out the west to have a change of mind and consider Africans as fellow humans that deserve equity and respect because, afterall, ‘African lives also matter’.

Figure 7 below presents another creative reframing of existing COVID-19 public awareness campaigns as discourse power to enforce social distancing. One of the first major directives on the public safety protocols was that citizens should keep their hands away from their faces in order not to spread the virus. This virus containment and control advisory is here being reframed in a somewhat indirect, humorous but creative meme captioned: ‘ To be safe from COVID-19 virus, do not touch MEN with unclean hands ’. Using iconic images of the Mouth, Eye and Nose, this meme acronymises the initial letters of the key words ‘Mouth’, ‘Eyes’ and ‘Nose’ to form the word MEN, thus using the caption as an indirect proposition for dramatic effect. M.E.N. obviously represents the collective community of humans as potential carrier and transmitter of the virus. If individuals can control themselves, then we can contain the spread of the virus.

The use of body parts as multimodal elements in the post is designed to highlight the delicateness and ferocious impact of the virus in using the windows as entry points to attack vital organs of its victims. It is also aimed at further emphasising and promoting personal and community health during the pandemic as means of stemming the tide of infection and community transmission. The visual effect of the post drawn from a combination of images, text, use of special fonts, admixture of colours and graphology further amplify the persauasive effect of the message. The memorability impact of the multimodal elements are designed to make people more conscious about the devastating effect of the virus and thus engender necessary precautionary and safety actions.

In sum, by reframing the linguistic content of COVID-19 texts, the online memes represent a major discursive application of the socio-cultural affordances which may be observed in many online discursive texts on the coronavirus pandemic. These COVID-19 public health campaign texts have the potential to trace the contours of social, cultural and socio-political dimensions of language use in contemporary society.

Based on the discussion so far, we may sum up the discourse features of the online COVID-19 public awareness campaigns in terms of three broad communicative strands which illustrate their purposes:

(a) Information for public education : The primary goal of the COVID-19 public awareness campaign was to provide adequate information on the nature of the virus and the implications for public health. To this end, the flow of information followed the trend outlined by the World Health Organization (WHO) in conjunction with the Nigerian local health agencies, namely the Nigeria Centre for Disease Control (NTDC) and the state and federal ministries of health. While the WHO COVID -19 awareness campaign focused on global-scale information, the local health agencies provided ‘local content’ information on the pandemic, basically focused on individual and social implications of the virus in the Nigerian setting. To facilitate this, government and health agencies employed mostly visual and minimally textual informative strategies such as colour posters, and billboards using bold pictures, eye-catching images and memorable textual elements to convey the danger and urgency of the pandemic.

(b) Safety Awareness : Information on COVID-19 was largely supported by safety awareness directives which comprised a variety of visually educative pieces (videos, interviews, comic skits, etc.) and creative enlightenment memes, emoticons in the form of pictures, texts or a combination of both. All of these were aimed at disseminating maximum safety guidelines toward preventing the spread of the virus. The most dominant emblems of COVID-19 safety precautions were typified by the introduction of healthy lifestyle patterns like: the wearing of masks (‘the mask mandate’), avoiding crowded spaces, frequent washing of hands and ‘hands-free’ social behaviour (social restriction on hand – shaking, touching of bodies, faces, surfaces, clothing, etc.).

(c) Redirecting social behaviour : The COVID-19 public health awareness campaign presented Nigerians with multi-faceted directives on novel social interactive processes necessitated by the pandemic. These include directives on the restriction of movement (‘stay at home’, ‘lock-downs’, travel bans, curfews); restrictions on interpersonal interaction (social distancing), personal health protection guidelines (COVID-19 testing, and structured vaccinations) ( Table 1 ).

This study has shown that the use of new technologies to transmit and share messages on public health emergencies is, to a large extent, designed to enhance proactive, preventive and personalised healthcare initiatives. The use of multimodal discourse strategies thus amplify the awareness messages and public advisories in order to achieve maximum impact on the audience.

In this study, we have discussed how social media users in Nigeria participated actively in the public health discourses on COVID-19 public health crisis, drawing extensively and creatively on a combination of text and images rooted in the country’s diverse linguistic and cultural repertoire. Situating the work in the context of public health discourse, we have relied on the use of sociolinguistic and discourse-oriented methods in exploring how the participants use multimodal computer-mediated techniques to create and negotiate meaning as social action. Specifically, the study uses theoretical concepts from multimodal and critical discourse analysis to investigate the communicative and sociocultural implications of the ‘new normal’ deriving from the pandemic. Our approach featured the investigation of verbal and visual text in the (re)presentation and (re)contextualisation of social, cultural, economic and political issues on COVID-19 across mainstream and online media. Essentially, public health campaigns as socio-institutional discourse space exhibits features of language use to demonstrate power and control as well as legitimise the authority of state actors and public health officials while enforcing the guidelines for public safety and wellness. This systematic [re-]framing of COVID-19 discourses and public health awareness campaigns has achieved some form of socio-psychological [re-] configurations and public health consciousness among the citizens leading to low level of transmission and few cases of fatality resulting from the pandemic in Nigeria.

Author biographies

Mojisola Shodipe is a Senior Lecturer in the Department of English, University of Lagos, Nigeria. She is the editor of the LAGOS REVIEW OF ENGLISH STUDIES, A Journal of the Department of English, University of Lagos, Nigeria.Her areas of specialization include Sociolinguistics, Discourse Studies and Media Studies. She has published papers in learned journals in Europe, USA and Africa.

Tunde Ope-Davies (Opeibi) is Professor of English & Digital Linguistics, Discourse Studies & Digital Cultures at the University of Lagos, Nigeria. He is the founder and director of the Centre for Digital Humanities, University of Lagos (CEDHUL). He is former Chair, Department of English, University of Lagos and former Dean, Faculty of Humanities, Anchor University, Lagos. He is a fellow of the Alexander von Humboldt Foundation, Germany, and convener, Lagos Summer School in Digital Humanities (LSSDH). He is Visiting Research Professor at Chemnitz University of Technology, Germany. He is the Founding President of the Digital Humanities Association in Nigeria and a former Board member of the Global Outlook for Digital Humanities (GO::DH). His research interests are in Digital Linguistics & Discourse Studies, Digital Humanities, Digital Cultures & Applied Linguistics.

Acknowledgement/Funding: The Lead Author would like to acknowledge the support received from the Alexander von Humboldt Foundation, Germany during his research stay at the University of Hamburg in 2022.

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Contributor Information

Tunde Ope-Davies (Opeibi), University of Lagos, Nigeria.

Mojisola Shodipe, University of Lagos, Nigeria.

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• Published: 28 October 2021

Discursive structures and power relations in Covid-19 knowledge production

• Mario Bisiada   ORCID: orcid.org/0000-0002-3145-1512 1  

Humanities and Social Sciences Communications volume  8 , Article number:  248 ( 2021 ) Cite this article

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• Cultural and media studies
• Language and linguistics

This article critically examines the discourse around the Covid-19 pandemic to investigate the widespread polarisation evident in social media debates. The model of epidemic psychology holds that initial adverse reactions to a new disease spread through linguistic interaction. The main argument is that the mediation of the pandemic through social media has fomented the effects of epidemic psychology in the reaction to the Covid-19 pandemic by providing continued access to commentary and linguistic interaction. This social interaction in the absence of any knowledge on the new disease can be seen as a discourse of knowledge production, conducted largely on social media. This view, coupled with a critical approach to the power relations inherent in all processes of knowledge production, provides an approach to understanding the dynamics of polarisation, which is, arguably, issue-related and not along common ideological lines of left and right. The paper critiques two discursive structures of exclusion, the terms science and conspiracy theory , which have characterised the knowledge production discourse of the Covid-19 pandemic on social media. As strategies of dialogic contraction, they are based on a hegemonic view of knowledge production and on the simplistic assumption of an emancipated position outside ideology. Such an approach, though well-intentioned, may ultimately undermine social movements of knowledge production and thus threaten the very values it aims to protect. Instead, the paper proposes a Foucauldian approach that problematises truth claims and scientificity as always ideological and that is aware of power as inherent to all knowledge production.

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The first truly global, digitally mediated event.

The Covid-19 pandemic is the first truly global event:

Not the Black Plague, not the transatlantic slave trade nor the two World Wars, not the 9/11 terrorist attacks have affected everyone, on every continent, as instantly and intimately and acutely as the spread of coronavirus, uniting us as we fear and think and hope about the same thing. (Badhken, 2020 )

While other events of historical magnitude had a global impact, they “were not experienced by the entire world at the same time” (Milanović, 2020 )—though this experience takes a different form for each of us, in terms of both our personal reaction and that of the country we live in. What unites these personal experiences is that they have been largely digital because, apart from being the first truly global event, it is also “the first epidemic in history in which people around the world have been collectively expressing their thoughts and concerns on social media” (Aiello et al., 2021 , p. 1). So our first global event is also the one “where we never met face-to-face in real-time with other people who lived through it” (Milanović, 2020 ).

Social media turned into the prime channel of the public sphere in quarantined societies, and a rigid and noxious polarisation evidently dominates the discourse (European Court of Human Rights, 2021 ; Yang, 2021 ). The question of why a crisis that should unite us in our communal struggle against a virus has produced such a divided society has put the spotlight on social media, which are still commonly assumed to be geared to create polarisation. The banning of @realdonaldtrump from Twitter may be read by future media scholars as to the beginning of an era of control of social media, as the end of Silicon Valley companies’ innocence as mediators of discourse. Since the global communities’ engagement in a fight against information disorder may produce other bans and regulations of free speech on public networks, the discussion of the role of social media as a public sphere will take important turns in the coming years.

In Rosenberg’s ( 1989 , p. 2) terms, as particular societies construct their characteristic responses following dramaturgic forms, epidemics are extraordinary opportunities to gain an “understanding of the relationship among ideology, social structure, and the construction of particular selves”. To understand “our contemporary reaction to a traditional stimulus”, we must distinguish between what is unique and what seems to be universal to pandemic responses (Rosenberg, 1989 , p. 2). This article tries to take the first step towards this goal through a critical approach to the discourse on the Covid-19 pandemic. An aspect unique to this pandemic is that it has been mediated primarily by social media. How this has shaped the response will be subject to extensive study in years to come, and the large amount of language data this has produced will be of great interest to social media discourse analysts. I propose that the mediating role of social media has provided the opportunity to approach the pandemic through the mode of knowledge production practice that is already exhibited by social movements. Contests over this knowledge production, however, led to a polarisation that cannot be explained comprehensively by common partisan affiliations but that should be understood to be interpretative, that is, predominantly issue-related. I argue that this polarisation has caused, and is caused by, among other things, discursive structures of exclusion, specifically through the hegemonic use of terms such as conspiracy theories and science . The following section will begin this argument by introducing the model of epidemic psychology that I adopt to understand our reaction to the Covid-19 pandemic.

Epidemic psychology and the virtual public sphere

Strong ( 1990 ) proposes the “epidemic psychology” model to describe the early reaction to new fatal diseases. He comments on the “striking problems that large, fatal epidemics seem to present to social order; on the waves of fear, panic, stigma, moralising, and calls to action that seem to characterise the immediate reaction” and the “extraordinary emotional maelstrom which seems, at least for a time, to be beyond anyone’s immediate control” (Strong, 1990 , p. 249), descriptions that fit our experience in the first year of the Covid-19 pandemic quite well. Strong sees the capacity of language to enable coordinated action among large groups of people, our “shared intentionality” (Tomasello, 2008 , p. 343), as the key factor in epidemic psychology, making human societies “complex and, though elaborately organised, still potentially subject to fundamental change, simultaneously massively ordered and extraordinarily fragile” (Strong, 1990 , p. 256).

Most social action is based on routine: Strong ( 1990 , p. 257) cites Alfred Schütz’s idea that everyday life is “a matter neither of rationality nor irrationality, but of routine”. Similarly, Berger and Luckmann ( 1966 , p. 172) have argued that “the most important vehicle of reality-maintenance is casual conversation”, which “can afford to be casual precisely because it refers to the routines of a taken-for-granted world. The loss of casualness signals a break in the routines and, at least potentially, a threat to the taken-for-granted reality” (Berger and Luckmann, 1966 , p. 172). Such a threat to routine can lead to “epidemic psychology in which contagious waves of panic rip unpredictably through both individuals and the body politic, disrupting all manner of everyday practices, undermining faith in conventional authority” (Strong, 1990 , p. 257). In sum,

the human origin of epidemic psychology lies not so much in our unruly passions as in the threat of epidemic disease to our everyday assumptions, in the potential fragility of human social structure and interaction, and in the huge diversity and elaboration of human thought, morality and technology; based as all of these are upon words rather than genes. (Strong, 1990 , p. 258).

With language at the heart of epidemic psychology, the threshold at which epidemic psychology sets in may be lower in the digital age due to greater connectedness and thus exposure to language and conversation. The study of language use on social media is thus fundamental to understanding the social processes and transformations that will result from the Covid-19 pandemic. The Internet and social media are by now fundamentally important for all types of linguistic acts including casual conversation and coordinated social action. We produce and receive more language on a daily basis than ever (McCullock, 2019 , p. 2). In Foucauldian terms, social media provides the environment of commentary that keep alive a large amount of discourses which would otherwise disappear (Foucault, 1981 , pp. 56–57), thus creating the impression that particular knowledges are established. If we consider social media “important engines of context collapse, rather than enablers of ideological segregation” (Bruns, 2019 , p. 99), it should come as no surprise that the symptoms of epidemic psychology described by Strong ( 1990 ) set in so quickly and transversally in our societies (see, e.g. Esses and Hamilton, 2021 ; Aiello et al., 2021 ).

Social media use has increased vastly during the Covid-19 pandemic (Nguyen et al., 2020 ), and it is the connectedness through social media that makes this pandemic unlike any other (Aiello et al., 2021 ; Madrigal, 2020 ; Tsao et al., 2021 ). The possibility to experience it in a socially distanced way is afforded to us only by our digitalised world. As Harari ( 2021 ) observes, “[i]n 1918, […] if you ordered the entire population of a country to stay at home for several weeks, it would have resulted in economic ruin, social breakdown and mass starvation. In contrast, in 2020, […] automation and the Internet made extended lockdowns viable, at least in developed countries”. How viable they are in terms of long-term effects remains to be seen, and, as Harari ( 2021 ) rightfully notes, even this digital world could not function without “the crucial role that many low-paid professions play in maintaining human civilisation: nurses, sanitation workers, truck drivers, cashiers, delivery people”. Given this fundamental importance of digital access, the #StayHome narratives of lockdown life have been particularly developed-world, digitalised, middle class, childless narratives. But the key point is that “after 2020, we know that life can go on even when an entire country is in physical lockdown” (Harari, 2021 ).

How will this new importance of social media affect society? Whether virtual public spaces also constitute a virtual public sphere has long been discussed (for an overview, see Bruns and Highfield, 2016 ). While using social media empowers users by broadcasting their opinions more widely, “the same anonymity and absence of face-to-face interaction that expands our freedom of expression online keeps us from assessing the impact and social value of our words” (Papacharissi, 2002 , p. 16). In fact, this sense of empowerment may misrepresent the true impact of our opinions (Papacharissi, 2002 , p. 17) and also of those held by others: Because a few vocal users can create a lot of activity, browsing social media may give us a distorted view of society, making it appear more polarised than it actually is.

A case in point is the (now deleted) Twitter thread that made Eric Feigl-Ding famous: He summarised a paper about the new coronavirus with the words “HOLY MOTHER OF GOD—the new coronavirus is a 3.8!!!” and called this infectiousness “thermonuclear pandemic level bad” (24 January 2020). In a response thread on Twitter, science writer Ferris Jabr shows that Feigl-Ding’s thread “missed essential context and contains numerous errors” and argues that his “claim that ‘we are now faced with the most virulent virus epidemic the world has ever seen’ and that the new coronavirus is 8x as infectious as SARS is completely untrue” ( https://twitter.com/ferrisjabr/status/1220963553911271424 ). Feigl-Ding’s viral thread thus

exemplified a deep problem on Twitter: The most extreme statements can be far more amplified than more measured messages. In the information sphere, while public-health researchers are doing their best to distribute scientific evidence, viral Twitter threads, context-free videos, and even conspiracy theories are reaching far more people. (Madrigal, 2020 )

Some argue, however, that it’s exactly this recognition of constant evolution that should inform modern science, that Feigl-Ding has just understood how social media work and “committed the unpardonable sin of failing to act on Twitter like enough of a scientist—you know, terrified of getting something wrong, because science never does ” (Science+Story, 2020 ). As social media come under increasing pressure through debates over misinformation, one task the pandemic sets us is to work towards a virtual public sphere that goes beyond the imagined communities (Anderson, 1983 ) or virtual spheres “consist[ing] of several spheres of counterpublics that have been excluded from mainstream political discourse, yet employ virtual communication to restructure the mainstream that ousted them” (Papacharissi, 2002 , p. 21).

Most theorisations on the virtual public sphere consider it in conjunction with the non-virtual sphere. The new situation we face now is the temporary quasi-disappearance of physical interactions. As I have argued in this section, while epidemic psychology had been constrained in previous pandemics by the sheer absence of contact, it is now able to continue unchecked, simply because a lockdown no longer keeps us from conversing with the world. The public sphere has been forcibly moved into the virtual space, for a short yet decisive amount of time: Public shaming of “irresponsible” people, insults (“Covidiot”), dubious model predictions and all the other effects of epidemic psychology could be observed. This, as I argue in the following section, has made the Covid-19 pandemic a phenomenon of communal knowledge production practice.

The Covid-19 pandemic as process of knowledge production

The Covid-19 pandemic is a unique phenomenon of knowledge production practice in the history of humanity because the phenomena of epidemic psychology described by Strong ( 1990 ) are for the first time mediated by a global network, that is, social media. The knowledge production in the Covid-19 pandemic resembles, in an accelerated form, that of climate change. Our first global event also gave us the opportunity to learn together, in real time, across the globe. Social media turn not only politics from a closed space into “a conversation that can be joined by outsiders” (Ausserhofer and Maireder, 2013 , p. 306), but also science, by way of knowledge production practices. There has long been a discussion in the philosophy of science on how knowledge gets subsumed into “scientism”, defined as “the conviction that we can no longer understand science as one form of possible knowledge, but rather must identify knowledge with science” (Habermas, 1972 , p. 4). The Covid-19 pandemic has placed science along with its hegemonies in the spotlight of society, and it is thus informative to reflect on the relation between science and knowledge.

As a response to public fear, the Covid-19 pandemic has followed the model of epidemic psychology in generating an “exceptionally volatile intellectual state” (Strong, 1990 , p. 254), as little is known about the new disease (Davey Smith et al., 2020 ) and there was uncertainty about whether “a new disease or a new outbreak is trivial or whether it is really something enormously important”, leading to “collective disorientation” (Strong, 1990 , p. 254). This volatile intellectual state and disorientation have created discourses of knowledge production (Casas-Cortés et al., 2008 ; Della Porta and Pavan, 2017 ; Pavan and Felicetti, 2019 ), defined as “practices through which local and highly personal experiences, rationalities, and competences get connected and coordinated within shared cognitive systems which, in turn, provide movements and their supporters with a common orientation for making claims and acting collectively” (Pavan and Felicetti, 2019 , p. 3).

Such practices create what Foucault ( 1980 ) calls local, subjugated knowledges, defined as an “autonomous, non-centralised kind of theoretical production, one that is to say whose validity is not dependent on the approval of the established regimes of thought” (Foucault, 1980 , p. 81). While such theoretical production consists of “local, discontinuous, disqualified, illegitimate knowledges”, it does not constitute a right to ignorance or non-knowledge: it is opposed “not to the contents, methods or concepts of a science, but to the effects of the centralising powers which are linked to the institution and functioning of an organised scientific discourse” (Foucault, 1980 , p. 84). More recently, Fischer ( 2000 ) has shown how local contextual knowledge by citizens can help solve complex social and environmental problems. One example of these from the current pandemic are mutual aid groups (Engler, 2020 ; Mahanty and Phillipps, 2020 ; Sitrin and Colectiva Sembrar, 2020 ). However, the often centralising, heavy-handed or even authoritarian responses of governments, coupled with blanket policies that reflected little trust in the intelligence or autonomy of its citizens, hindered such knowledge production movements. Citizens were delegated to a passive role while a selected group of experts led the response, which mirrors the dynamics experienced by environmental movements (Fischer, 2000 , pp. 92–93).

A ready response to this volatile intellectual state tends to be that educated citizens should trust in science and condemn those who believe conspiracy theories, who spread fake news, who usher in an era of post-truth. Such a response, however, is often undergirded by a simplistic understanding of ideology, by the idea that we can and must somehow combat ideology and promote scientific truth through critical scrutiny of language and discourse in the media. Foucault criticised the usefulness of the notion of ideology for the fact that it “always stands in virtual opposition to something else which is supposed to count as truth” (Foucault, 1980 , p. 180). Rather than exploring a knowable reality, scientific enquiry has been described as constructive practice, that is, “oriented toward ‘making things work’ successfully and embedded in a reality which is highly artificial and essentially self-created” (Knorr-Cetina, 1977 , p. 670). In other words, assuming some kind of “false consciousness” within ideology presupposes the existence of a “consciousness which is not false (the position of critique)” (Mills, 2004 , p. 29), but such a position does not exist: “All knowledge is determined by a combination of social, institutional and discursive pressures” (Mills, 2004 , p. 30).

The dominating theoretical approaches to critical discourse studies hold that, through an awareness of linguistic/ideological oppression based on neo-Marxist or rationalist analysis, people are empowered to bring about social change and thus achieve emancipation (Hart and Cap, 2014 , p. 2). While this is a useful approach to studying language and social change, Pennycook ( 2001 , pp. 36–41) criticises such “emancipatory modernist” approaches as potentially patronising and argues that they lack the means to respond to the awareness of ideological oppression. Emancipatory modernist approaches to discourse are often grounded in a simplistic view of ideology juxtaposed with some “knowable reality” and hold the problematic notion that “scientific knowledge of reality can help us escape from the falsity of ideology” (Pennycook, 2001 , p. 41), a rationale that is itself often used by populist agitators (Bruns, 2019 , p. 114). Messianic attempts to help people see the light often fail, overlooking that many discourse practices aim to “explore others’ reaction to one’s identity and have it confirmed in interactions, including hostile reactions that confirm one’s status as a critical outsider” (Krämer, 2017 , p. 1302), thus cementing the very status one seeks to challenge into an emancipated position of its own. When studying epidemic psychology and the uncertain intellectual state it produces, it is thus more important than ever to remember that all language is political (Gee, 2011 , p. 10), all knowledge production is ideological and there is no truth or knowledge outside ideology (Pennycook, 2001 , p. 89).

As is the case with climate action, science’s indeterminacy, its raising more questions than it could answer, has led to its politicisation (Fischer, 2000 , p. 95). My argument in this section has been that, in the volatile intellectual state the Covid-19 pandemic has caused, the hegemonies of knowledge production, while always existing below the surface, have been made exceptionally visible. The restlessness of hypermediativity, fuelled by a constant generation and availability of data, allowed everyone to conduct “fact-based” statistical analyses and share them, around the clock. The fast exchange through social media and the way it empowers users to broadcast opinions and knowledge to wide audiences have caused a politicisation and polarisation of scientific debates (Clarke, 2020 ; Bhopal and Munro, 2021 ). In the context of the Covid-19 pandemic as a process of knowledge production, it is necessary to differentiate the concept of polarisation a bit further, as I will do in the next section.

Interpretative polarisation

In this paper, I understand polarisation as a dynamic phenomenon, driven by “interpretative” polarisation, “the process wherein different groups in a society contextualise a common topic in starkly different ways” so that “frames used by one camp are deemed unfounded, inappropriate, or illegitimate by other camps” (Kligler-Vilenchik et al., 2020 , p. 2). Social media are so rooted in our daily lives that they receive attention from a range of disciplines, and many commentators still purport that social media “foster extreme viewpoints by design” (Bhopal and Munro, 2021 ) and are thus inherently geared to produce polarisation.

A range of evidence argues against this deterministic view, however. In a review of a range of studies, Tucker et al. ( 2018 , pp. 15–16) argue that “[t]he consumption of political information through social media increases cross-cutting exposure, which has a range of positive effects on civic engagement, political moderation, and the quality of democratic politics, but also facilitates the spread of misinformation”. Bruns ( 2019 ) has cast doubt on Pariser’s ( 2011 ) concept of the “filter bubble”, and the popular idea that social bots on Twitter “pretend to be a human user and [are] operated by some sinister actor to manipulate public opinion” seems unfounded according to recent research (Gallwitz and Kreil, 2021 ). Frequent use of ever more available social media diversifies individuals’ networks, which may alleviate concerns about echo chambers on social media (Lee et al., 2014 ), though may not necessarily “create more informed citizens” (Papacharissi, 2002 , p. 15), or a public sphere as such: While social media use “may reduce ideological polarisation as a result of leading to higher cross-cutting exposure, it may simultaneously increase affective polarisation because of the negative nature of these interactions” (Tucker et al., 2018 , p. 21), of which the Covid-19 pandemic has provided many.

In the absence of knowledge on the disease, the reactions to the Covid-19 pandemic subverted the established ideological standpoints. The range of ideological persuasions observed at anti-lockdown protests and the fact that liberal thinkers argue for closed borders while conservative thinkers question night-time curfews and police presence shows that the conflict cannot be thought along the usual partisan lines. Research on polarisation has argued for the recognition of various dimensions of opinion polarisation: Where new issues arise, people are prepared to deviate from their regular partisan or ideological direction (Wojcieszak and Rojas, 2011 ). Studies suggest that partisan/ideological affiliation is not as directly influenced by knowledge as issue-related opinions:

[K]nowledge is found to predict the variance of two issue-related measures of polarisation, whereas there is no such association between knowledge and partisan/ideological polarisation. This is consistent with previous research that the more knowledgeable are likely to move to more extreme issue positions by counter arguing claims incompatible with their political predisposition. (Lee et al., 2014 , pp. 716–717)

People evaluate objects that they encounter frequently along different lines to rare but impactful objects: differing findings for party/ideology and issue-related polarisation suggest that the underlying mechanism of partisan and ideological polarisation is distinct from that of issue-related processes (Tucker et al., 2018 , pp. 40–48). This recognition shows that studies or surveys linking attitudes towards the Covid-19 pandemic to partisan affiliations are not entirely informative.

In a study of how citizens evaluate arguments about contested issues, Taber and Lodge ( 2006 ) find that prior attitudes decisively guide how new information is processed:

Far from the rational calculator portrayed in enlightenment prose and spatial equations, homo politicus would seem to be a creature of simple likes and prejudices that are quite resistant to change. […] Skepticism is valuable and attitudes should have inertia. But skepticism becomes bias when it becomes unreasonably resistant to change and especially when it leads one to avoid information as with the confirmation bias. (Taber and Lodge, 2006 , pp. 767–768)

The “boundary line between rational skepticism and irrational bias” (Taber and Lodge, 2006 , p. 768) is a key issue in discussions about the Covid-19 pandemic, and one that can perhaps not be established in a normative way.

To address the question of why a newly arisen issue that could not be addressed by existing political schemes has polarised society so quickly, we may argue, then, that different contextualisations of the same issue have produced different evaluations in people (Kligler-Vilenchik et al., 2020 ). While people can generally process multiple frames and evaluate different angles, this ability may be hampered where “competing groups rely exclusively on contrasting frames and reject (or are unaware of) those frames underlying divergent preferences”, which may lead to “contrasting interpretations that sustain irreconcilable positions”. It is this configuration that, I argue, leads to interpretative polarisation, which may make “meaningful conversation between groups almost impossible” (Kligler-Vilenchik et al., 2020 , p. 2) and reinforce political polarisation.

Examples of such contrasting interpretations abound. The term lockdown has had differing definitions in each country, which led to shadings such as hard/soft lockdown . The term new normal was perhaps meant to anchor hygiene measures in people’s thoughts, but is seen by many as an attempt to normalise draconian restrictions and situations that are clearly anything but normal. The dichotomy of health vs economy is another example of how the same issue can be presented in different lights, depending on the angle one takes.

Interpretative polarisation can explain why partisan analysis does not apply to the Covid-19 pandemic as an extraordinary phenomenon whose epidemic psychology, as I have argued so far, made necessary new reflections, a process of knowledge production. The Covid-19 pandemic challenges existing ideological boundaries, so an analysis of its discourse requires an approach that goes beyond seeing ideology as a given structural object and instead analyses hegemonies and power struggles inherent in all discourses of knowledge production.

Discursive structures of exclusion

Exclusion through dialogic contraction.

An oft-repeated charge in debates on the Covid-19 pandemic is that particular voices or opinions have been ignored or excluded from the debate, that particular things cannot be said. This is then countered by the reminder that there is free speech, that anyone can publish anything after all. Both positions forget that discourses are generally considered to be “principally organised around practices of exclusion” (Mills, 2004 , p. 11): Any notion of what seems natural to say or what seems unsayable is the result of such exclusion practices, of “battles ‘for truth’” where, in the words of Foucault, “by truth I do not mean ‘the ensemble of truths which are to be discovered and accepted’, but rather ‘the ensemble of rules according to which the true and the false are separated and specific effects of power attached to the true’” (Foucault, 1980 , p. 132).

Foucault ( 1981 , pp. 52–54) proposes three procedures of exclusion: prohibition, the division of reason/madness and the opposition between true/false (the “will to truth”). The argument that nobody is excluded because everyone is free to publish anything misunderstands practices of discursive exclusion by reducing them to the first of those principles (prohibition) while ignoring the existence of the other two. Based on Bakhtin’s concept of “centripetal-centrifugal struggle”, Baxter ( 2011 ) argues that, as it is “difficult to presume that all discourses are equal in the play for meaning, […] competing discourses are not equally legitimated. Some are centred (the centripetal) and others are marginalised (centrifugal). In the instance of monologue, all but a single totalising discourse is erased” (Baxter, 2011 , p. 14). Thus, the struggles of exclusion are regular phenomena of hegemony in discourse, made visible through the extraordinary process of knowledge generation. The fact that free speech is constrained and certain things become dominant in discourses while others become unsayable is a product of competing power relations in a discourse (see Mills, 2004 , p. 64). These power relations, as usual in Foucauldian thought, are not inherently negative or positive, but potentially dangerous if not questioned, which is the aim of this section.

In what follows, I investigate two discursive structures of exclusion via dialogic contraction that originate in the emancipatory modernist approach to ideology in discourse identified above: First, the reference to an abstract authority ( the science ) and second, accusations of conspiracy theories . I understand dialogic contraction with reference to Bakhtinian dialogism (for an introduction, see Robinson, 2011 ) as used in various theories of discourse analysis such as Appraisal Theory (Martin and White, 2005 ) and Relational Dialectics Theory. In the latter, discourses (defined roughly as systems of meaning or “voices”) compete in discursive struggle, on a cline between monologic and idealised dialogic (Baxter, 2011 ). While in idealised dialogism all discourses are given equal weight, monologism consists of “a discursive playing field so unequal that all but one monologic, authoritative discourse is silenced” (Baxter, 2011 , p. 9). This model is useful for analysing the discourse on the Covid-19 pandemic because it reflects the accusation that the public debate has increasingly become monologic, with the authoritative discourse of the respective political leaders and their close circles of experts in the dominant position.

One of the first demands on social media at the beginning of the pandemic was that people should be quiet and “let experts talk”. These calls were meant to reduce noise in the discourse, a defence mechanism to the heated reactions in the networks, in line with early reactions of epidemic psychology. They were initial reactionary attempts to exclude voices from commenting on what was from the beginning a complex social crisis that concerns everyone. Attempts to restrict the discourse to “experts” only later crystallised into the two frequent formulas that we should follow the science and that we must combat conspiracy theories .

This simplistic binary choice juxtaposing the science/experts/evidence with conspiracy theories/fake news is at the heart of the dialogic contraction in the Covid-19 pandemic. It makes it seem as though the only available positions are either to believe Covid-19 to be a global threat that eclipses all other threats or to deny its existence altogether, thus mirroring labellings used in the climate debate, which “isolate, exclude, ignore, and dismiss claim-makers of all types from constructive dialogue” (Howarth and Sharman, 2015 , p. 239).

These strategies of dialogic contraction work by appealing to taken-for-granted truths (science is good, populism is bad) and to an imagined neutral position outside ideology, power and discourse. This position is workable in routine debates, where challenges are either confined to academic circles or addressed by societies’ “general politics of truth” (Foucault, 1980 , p. 131). In an epistemologically disruptive event such as the Covid-19 pandemic, however, as I argue in this article, the role of science in the public enters the spotlight, epistemic psychology challenges our established routines, and discursive structures of dialogic contraction towards a monologic extreme rapidly translate into social polarisation.

Critical approaches to discourse that are conscious of and able to consider power relations as they emerge from discursive practice thus seem better suited to study our present situation. To study language with the aim of explaining power rather than just reveal it, we must show how power operates in discourses rather than how it is held by particular, pre-categorised actors or institutions (Pennycook, 2001 , p. 93). As Katsambekis and Stavrakakis ( 2020 ) argue:

In many cases, understanding the policies of certain actors through the lens of ‘populism’ […] and the vague notion of a ‘populist threat to democracy’, often adopted in typical anti-populist discourses, seems to be diverting attention from other imminent dangers to democracy, most importantly: nativism, nationalism, authoritarianism, racism. (Katsambekis and Stavrakakis, 2020 , p. 7)

Having established discursive structures of exclusion as inherent to all discourse, I now discuss two strategies of dialogic contraction that I consider to be fundamental to the polarisation that we have seen in this pandemic and that let us answer why a global health crisis and the knowledge production that ensued, where we are all on the same side, has become such a polarising topic.

The science as legitimating authority

A central claim made by most leaders throughout the Covid-19 pandemic has been that they “follow the science” (Pérez-González, 2020b ; Stevens, 2020 ; Pierce, 2021 ). In his first prime-time address to the nation on 11 March, Joe Biden said, “we know what we need to do to beat this virus. Tell the truth. Follow the scientists and the science”. What is unclear about such statements is what exactly “the science” refers to. Sweden, under Anders Tegnell’s advice, also “follows the science”, and the rate of agreement of the Swedish scientific community, when asked whether scientific advice had been taken into account, does not differ from that reported for other countries (Rijs and Fenter, 2020 ). Yet the Swedish approach, generally described as at best “unorthodox”, differs radically to that of many other countries, and mentioning “Sweden” in a current social network discussion is a safe way of being delegitimised as a reasonable discourse actor (Torjesen, 2021 ).

This suggests that the reductive notion of the science , like the similar formula the evidence (see Furedi, 2020 ), is defined based on particular principles of authority, established, though not overtly specified, by dominant discourse actors. It disclaims the multivoicedness, interdisciplinarity and plurality of processes of knowledge production (Knorr-Cetina, 1999 ) and serves as a discursive strategy of dialogic contraction, an expression of discursive hegemony: “The debate becomes polarised and binary: if the science says yes to face coverings, then challenging the orthodoxy or even questioning its universality becomes heretical” (Martin et al., 2020 , p. 506).

Taylor ( 2010 ) conducts a corpus-assisted study of the use of the term the science in UK press articles between 1993 and 2008. Referring to Aristotle’s model of rhetoric and argumentation, she argues that science , instead of being used as part of logos, providing logical proof, “is increasingly used as a part of ethos, that is, persuasion at the interpersonal level”, projecting a particular stance towards the audience and appealing to an unspecified or unexplained authority, “making the writer’s personal character appear more credible by enroling ‘science’ on their side of an argument” (Taylor, 2010 , p. 222). This is especially the case where authors “refer to some unspecified, autonomous, authoritative entity” such as the science (Taylor, 2010 , p. 236). These findings are echoed by Pérez-González’s ( 2020a , p. 13) study of a corpus of a wide range of climate change blogs, where bloggers attempt to construct authoritative voices of consensus by using the the science formula.

While scientific discourse in general is rarely characterised by consensus, it is much less so in the context of the Covid-19 pandemic. A review of studies shows that a lot of research on the issue has been biased or of low quality (Raynaud et al., 2021 ). Critiques of bias in the acceptation and rejection of evidence have long existed (Stevens, 2007 ) and are echoed in a cross-country report on populism in the Covid-19 pandemic:

“Experts” are not neutral actors that will save liberal democracy from “bad populists”. […] [T]he pandemic has rather revealed the deeply political character of scientific input in critical junctures as well as the very political agency of experts themselves. […] It becomes apparent then that exactly as populists do not form a coherent bloc in the pandemic, experts too cannot be treated as a unified front, thus the dichotomy “ experts vs populists” is exposed as fundamentally flawed once more in the context of the ongoing crisis. (Katsambekis and Stavrakakis, 2020 , pp. 7–8)

Many righteous approaches to the Covid-19 pandemic, but also to the climate emergency, succeed in identifying ideologically motivated harmful practices, but succumb to the emancipatory modernist lack of self-reflexivity on whether its messages, which are meant to convince the targeted audience, do not just patronise it, as discussed above. Populists will respond to this not by accepting that they are wrong, but by rejecting the entire frame of knowledge: “We’ll probably also start to hear calls for climate lockdowns. I know, right now that sounds completely preposterous, but don’t these kooky ideas always find a way to bleed into the mainstream? […] Don’t worry though, they’re just following the science ” (Miller, 2021 ).

It is understandable to want to reinforce a society that bases its actions on informed opinion, especially in the age of Trumpism. However, it is the very reductionism of an approach that makes an unspecified truth-claim to the science and disqualifies everything else as unreasonable that allows populist actors like Trump to gain power by turning the same simple strategy on its head. The postmodernist challenges of a simplified, messianic notion of the science remain valid. The formula represents a simplistic and hegemonic view of what “science” is and threatens to turn it into a buzzword of discursive exclusion and disciplining, undermining equal engagement in knowledge production.

Conspiracy theory as a sanctioning device

The second structure of exclusion I discuss is the term conspiracy theory . Husting and Orr ( 2007 ) critique this term as a metadiscursive “vocabulary of motive in struggles over the meaning of social and political worlds, events, and ideas” ( 2007 , p. 132). In simple terms, its use signifies a discursive move of “going meta”, that is, “elect[ing] to step back from the immediacy of a question to question the questioner’s motives, or tone, or premises, or right to ask certain questions, or right to ask any questions at all” (Simons, 1994 , p. 470). Invoking the label conspiracy theory thus has the function of “shifting the focus of discourse to reframe another’s claims as unwarranted or unworthy of full consideration” (Husting and Orr, 2007 , p. 129). While research has put into question whether applying the label has any negative effect on the targeted actor’s beliefs (Wood, 2016 ), the accusation of conspiracy theory seeks to discursively expel actors from the community of reasonable interlocutors, thus “protecting certain decisions and people from question in arenas of political, cultural, and scholarly knowledge construction” (Husting and Orr, 2007 , p. 130) by reverting the focus of attention onto the questioner.

This discursive structure is often used in “cultures of fear” that “generate new mechanisms of social control” (Husting and Orr, 2007 , p. 128). Considering that many European countries are still in constant alert mode from terrorism, the description of such a culture fits the past year quite well:

fear and threat become the means for media, politicians, and corporations to sell commodities, buy votes, and justify policies reducing civil rights and promoting war (Altheide, 2000 ). As a mythos of consensus has turned into a mythos of fear, we would expect to find new interactional mechanisms to shield authority and legitimacy from challenge or accountability. (Husting and Orr, 2007 , p. 130)

More recently, Husting ( 2018 ) identifies two problems with current academic and journalist discourse around conspiracy. First, a cognitive approach, which “attempts to diagnose traits like character and intelligence, intent on identifying hidden, usually individualised causes of constructing, believing in, and circulating conspiracy theories” (Husting, 2018 , p. 111). By psychologising the subjects of its analysis in this way, “it misses the political work done by the labels themselves” and overstates their coherence to argue for their danger to society (Husting, 2018 , p. 112). Husting argues that this cognitive analysis expresses a neoliberal responsibilisation of the individual in various ways to “follow expert advice to optimise well-being and health of body, mind, and polis” (Husting, 2018 , p. 113). As citizens, we “regulate ourselves by regulating, judging, and contemning others, and keeping our own thoughts and styles of reason and emotion clear” (Husting, 2018 , p. 123). The disputes over truth, falsity and conspiracy theories thus “serve to construct, circulate, and enact a ‘well-tempered’ citizen in liberal politics” (Husting, 2018 , p. 113).

The second problem Husting ( 2018 ) identifies with current conspiracy theory discourse is its affective register. According to dominant analyses, conspiracy theorists “step out of the sphere of reason and logic, and enter the terrain of the emotional and the psychotic” (Husting, 2018 , p. 117). Yet conspiracy discourse is itself “a form of emotional and political engagement driven by contempt and laced with anger and fear” by policing the boundaries of reasonable political doubt and theorising an “uncorrupted democratic sphere” (Husting, 2018 , p. 117) outside ideology. By constructing conspiracy theories as threats to the order of the state and to the uncorrupted citizen, conspiracy theory discourse falls victim to the same pseudo-messianic discursive approach it seeks to unravel.

In a study of Wikipedia edits of the article on the German word for conspiracy theory, Verschwörungstheorie , Vogel ( 2018 ) argues that the term is not used with a descriptive, analytical function, but is part of an established metadiscursive accusatory, stigmatising and disciplinary pattern to sanction views from a position or epistemology outside the collectivism and the “sayable” in the ingroup, whose validity is assumed to be taken for granted (Vogel, 2018 , p. 281). As Husting ( 2018 , p. 120) says, “[o]nce the label ‘conspiracy theory’ sticks to someone, it impugns their intellectual and moral competence and relieves hearers of the need to consider the validity of her or his claims”. The use of the term, thus, lacks a problematisation of one’s own supposed neutrality. Its use is hegemonic, not analytical.

Vogel ( 2018 ) studies Wikipedia discourse specifically, but his observations are transferable to general social media discourse. And in the pandemic knowledge production, the epistemological conditions and power relations among participants within such knowledge production movements (Esteves, 2008 ) are comparable. Due to the shift of the public sphere into the digital as discussed above, most people will have experienced debates in online worlds along with everything this entails.

In a comprehensive survey of the usage of conspiracy theory , Butter ( 2018 ) writes that, while the Internet and social media have made conspiracy theories more visible and fast-moving, they are no more frequent or influential than they used to be because they are still regarded as “stigmatised knowledge”. In the wake of the current surge of populism combined with the fragmentation of society through the Internet, Butter ( 2018 , p. 18) argues, the fragmented public sphere and the different notions of truth condition the current debate in which some are afraid again of conspiracies while others are still worried about the fatal effects of conspiracy theories. The dialogic contraction we are arguably seeing can thus be traced to a particular constellation of fears for the public sphere combined with the fear of the pandemic.

In sum, value-laden terms such as conspiracy theory are attempts to exercise discursive power over others by excluding them from being reasonable participants in the debate, both in everyday interactions by users and in official government acts. Mechanisms that define limits of the sayable “weaken public spaces that are central for interaction, contest, and deliberation: the spaces where we define our world” (Husting and Orr, 2007 , p. 147).

In this section, I have discussed two structures of exclusion by dialogic contraction: the science and conspiracy theory . These are common terms in everyday discourse, but, as I have shown, their appropriateness for academic study and debate is questionable due to their hegemonic nature and unreflected reference to accepted and sanctioned knowledge. This is not to say, of course, that we should endorse conspiracy theories or reject science. The aim is rather to become aware of how all types of knowledge are related to power. I am not interested here in evaluating the veracity of particular discourses on the Covid-19 pandemic (cf. Husting and Orr, 2007 , p. 131), or even in whether conspiracy theories are dangerous or not, but in the mechanisms whereby one discourse becomes considered dominant and thus supported by financial and social capital whereas the other becomes confined to the margins of society (Mills, 2004 , p. 17).

In this paper, I have adopted the model of epidemic psychology, which functions fundamentally through linguistic interaction, and argued that social media use has fomented its effects in the reaction to the Covid-19 pandemic by providing sustained access to commentary and linguistic interaction. I have suggested that this social interaction in a context of a volatile intellectual state can be seen as a discourse of knowledge production, conducted largely on social media. This view, along with the power relations it implies, provides an approach to understanding the dynamics of polarisation as interpretative, outside established partisan lines. To understand the polarisation better, I have discussed two discursive structures of exclusion, the terms the science and conspiracy theory , which have characterised the knowledge production discourse of the Covid-19 pandemic on social media. I have argued that these are strategies of dialogic contraction which are based on a hegemonic view of knowledge and a simplistic view of ideology based in the emancipatory modernist view of language that represents the currently dominant form of discourse analysis.

With this line of argument, I have intended to make sense of the Covid-19 pandemic discourse and take a step towards understanding the polarisation in our societies. As I have argued, this polarisation is due to discourse practices and not attributable to social media technology. The Covid-19 pandemic has forced us to reflect on many things, not just ourselves, but also the way we study society and (means of) communication. A great amount of data is being collected (see, e.g. Chen et al., 2020 ) and many studies will investigate the role of language and social media in the social transformation we are going to see in the coming years. I hope that the literature review conducted in this article has contributed some reflections on pertinent concepts and possible methodologies, or at least heuristics, for these future studies to consider.

From the perspective of discourse studies, I have endorsed the practice of Critical Applied Linguistics (Pennycook, 2001 ), which identifies both strengths and weaknesses of current approaches to discourse and seeks to improve on them by a greater foundation in critical theory and by a series of paradigmatic characteristics to problematise practice. Arguments are to be sought in texts, not in author profiles, so constructing corpora of texts harvested in “conspiracy theory” or “anti-vaxxer” forums or that consist of “fake news” means starting from a value position, a truth claim that can only confirm ideologies we already look for, but hardly explain their working in society. As Butter and Knight ( 2016 , p. 23) argue, “the aim of producing empirical, value-neutral research on the phenomenon of ‘conspiracy theory’ is misguided, because the term itself is not value-neutral”.

Categories such as “class”, “gender”, but also “identity” are often assumed to “exist prior to language”, to be reflected in language use, when really they need to be explained themselves, with language being a part of this explanation (Cameron, 1995 , p. 15). Like other conflicts, the polarisation in the wake of the Covid-19 pandemic has unveiled “the processes of norm-making and norm-breaking, bringing into the open the arguments that surround rules […] and how unquestioned (‘conventional’) ways of behaving are implicitly understood by social actors” (Cameron, 1995 , p. 17). It is this kind of processes that should be studied from a self-reflexive position that is aware of its own subjection to ideology and power relations.

A promising approach might be found in the Critical Disinformation Studies syllabus (Marwick et al., 2021 ), which argues, among other things, that fake news do not originate in extremism, but that “strategic disinformation and its cousin ‘propaganda’ are state and media industry practices with very long histories”, so instead of “plac[ing] the responsibility on individuals to become better consumers of media”, this approach seeks to “foreground questions of power, institutions, and economic, social, cultural, and technological structures as they shape disinformation”. Research shows that greater public awareness of how science communication works increases the acceptance of scientific findings regardless of partisan ideologies (Weisberg et al., 2021 ).

The process of knowledge production on social media I envision in this paper in many ways resembles what is taking place in climate action and environmentalism (Pérez-González, 2020a ). One might counter that the pandemic response cannot be called a social movement, but has been more of an emergency response to a problem that was always short-lived, and much more fast-paced than climate change, so is not perfectly comparable. But the knowledge production conducted on social media, and some of the movements born from this (see Sitrin and Colectiva Sembrar, 2020 ), provides a blueprint for environmentalism, a social movement that could benefit from the same kind of knowledge-practice. Some see the Covid-19 pandemic as a “test run” for the climate emergency, as there is hope “that the great mobilisations of state resources currently being unspooled to address Covid-19 prove the possibility of a comparable or greater mobilisation against ecological catastrophe” (Clover, 2021 , p. S28). Nevertheless, the climate emergency has only recently been labelled thus and its perceived and mediatised urgency does not match that of Covid-19, though of course its destructive potential is far greater. The debate on science and knowledge in our societies and the ways in which these discourses are structured and mediated in social networks are thus of prime importance.

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Yang A (2021) Politicisation and polarisation of Covid-19. Frontiers. https://frontiersmag.wustl.edu/2021/01/10/politicization-and-polarization-of-covid-19/ . Accessed 11 Oct 2021

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Acknowledgements

This work is part of the project Frames and narratives of translation and of migration in Europe , funded by the Spanish Ministry for Science, Innovation and Universities (MCIU) and the Agencia Estatal de Investigación (AEI), with grant number PID2019-107971GA-I00.

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• http://orcid.org/0000-0003-1512-4471 Emily Long 1 ,
• Susan Patterson 1 ,
• Karen Maxwell 1 ,
• Carolyn Blake 1 ,
• http://orcid.org/0000-0001-7342-4566 Raquel Bosó Pérez 1 ,
• Ruth Lewis 1 ,
• Mark McCann 1 ,
• Julie Riddell 1 ,
• Kathryn Skivington 1 ,
• Rachel Wilson-Lowe 1 ,
• http://orcid.org/0000-0002-4409-6601 Kirstin R Mitchell 2
• 1 MRC/CSO Social and Public Health Sciences Unit , University of Glasgow , Glasgow , UK
• 2 MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing , University of Glasgow , Glasgow , UK
• Correspondence to Dr Emily Long, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR, UK; emily.long{at}glasgow.ac.uk

This essay examines key aspects of social relationships that were disrupted by the COVID-19 pandemic. It focuses explicitly on relational mechanisms of health and brings together theory and emerging evidence on the effects of the COVID-19 pandemic to make recommendations for future public health policy and recovery. We first provide an overview of the pandemic in the UK context, outlining the nature of the public health response. We then introduce four distinct domains of social relationships: social networks, social support, social interaction and intimacy, highlighting the mechanisms through which the pandemic and associated public health response drastically altered social interactions in each domain. Throughout the essay, the lens of health inequalities, and perspective of relationships as interconnecting elements in a broader system, is used to explore the varying impact of these disruptions. The essay concludes by providing recommendations for longer term recovery ensuring that the social relational cost of COVID-19 is adequately considered in efforts to rebuild.

• inequalities

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Data sharing not applicable as no data sets generated and/or analysed for this study. Data sharing not applicable as no data sets generated or analysed for this essay.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/ .

https://doi.org/10.1136/jech-2021-216690

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Introduction

Infectious disease pandemics, including SARS and COVID-19, demand intrapersonal behaviour change and present highly complex challenges for public health. 1 A pandemic of an airborne infection, spread easily through social contact, assails human relationships by drastically altering the ways through which humans interact. In this essay, we draw on theories of social relationships to examine specific ways in which relational mechanisms key to health and well-being were disrupted by the COVID-19 pandemic. Relational mechanisms refer to the processes between people that lead to change in health outcomes.

At the time of writing, the future surrounding COVID-19 was uncertain. Vaccine programmes were being rolled out in countries that could afford them, but new and more contagious variants of the virus were also being discovered. The recovery journey looked long, with continued disruption to social relationships. The social cost of COVID-19 was only just beginning to emerge, but the mental health impact was already considerable, 2 3 and the inequality of the health burden stark. 4 Knowledge of the epidemiology of COVID-19 accrued rapidly, but evidence of the most effective policy responses remained uncertain.

The initial response to COVID-19 in the UK was reactive and aimed at reducing mortality, with little time to consider the social implications, including for interpersonal and community relationships. The terminology of ‘social distancing’ quickly became entrenched both in public and policy discourse. This equation of physical distance with social distance was regrettable, since only physical proximity causes viral transmission, whereas many forms of social proximity (eg, conversations while walking outdoors) are minimal risk, and are crucial to maintaining relationships supportive of health and well-being.

The aim of this essay is to explore four key relational mechanisms that were impacted by the pandemic and associated restrictions: social networks, social support, social interaction and intimacy. We use relational theories and emerging research on the effects of the COVID-19 pandemic response to make three key recommendations: one regarding public health responses; and two regarding social recovery. Our understanding of these mechanisms stems from a ‘systems’ perspective which casts social relationships as interdependent elements within a connected whole. 5

Social networks

Social networks characterise the individuals and social connections that compose a system (such as a workplace, community or society). Social relationships range from spouses and partners, to coworkers, friends and acquaintances. They vary across many dimensions, including, for example, frequency of contact and emotional closeness. Social networks can be understood both in terms of the individuals and relationships that compose the network, as well as the overall network structure (eg, how many of your friends know each other).

Social networks show a tendency towards homophily, or a phenomenon of associating with individuals who are similar to self. 6 This is particularly true for ‘core’ network ties (eg, close friends), while more distant, sometimes called ‘weak’ ties tend to show more diversity. During the height of COVID-19 restrictions, face-to-face interactions were often reduced to core network members, such as partners, family members or, potentially, live-in roommates; some ‘weak’ ties were lost, and interactions became more limited to those closest. Given that peripheral, weaker social ties provide a diversity of resources, opinions and support, 7 COVID-19 likely resulted in networks that were smaller and more homogenous.

Such changes were not inevitable nor necessarily enduring, since social networks are also adaptive and responsive to change, in that a disruption to usual ways of interacting can be replaced by new ways of engaging (eg, Zoom). Yet, important inequalities exist, wherein networks and individual relationships within networks are not equally able to adapt to such changes. For example, individuals with a large number of newly established relationships (eg, university students) may have struggled to transfer these relationships online, resulting in lost contacts and a heightened risk of social isolation. This is consistent with research suggesting that young adults were the most likely to report a worsening of relationships during COVID-19, whereas older adults were the least likely to report a change. 8

Lastly, social connections give rise to emergent properties of social systems, 9 where a community-level phenomenon develops that cannot be attributed to any one member or portion of the network. For example, local area-based networks emerged due to geographic restrictions (eg, stay-at-home orders), resulting in increases in neighbourly support and local volunteering. 10 In fact, research suggests that relationships with neighbours displayed the largest net gain in ratings of relationship quality compared with a range of relationship types (eg, partner, colleague, friend). 8 Much of this was built from spontaneous individual interactions within local communities, which together contributed to the ‘community spirit’ that many experienced. 11 COVID-19 restrictions thus impacted the personal social networks and the structure of the larger networks within the society.

Social support

Social support, referring to the psychological and material resources provided through social interaction, is a critical mechanism through which social relationships benefit health. In fact, social support has been shown to be one of the most important resilience factors in the aftermath of stressful events. 12 In the context of COVID-19, the usual ways in which individuals interact and obtain social support have been severely disrupted.

One such disruption has been to opportunities for spontaneous social interactions. For example, conversations with colleagues in a break room offer an opportunity for socialising beyond one’s core social network, and these peripheral conversations can provide a form of social support. 13 14 A chance conversation may lead to advice helpful to coping with situations or seeking formal help. Thus, the absence of these spontaneous interactions may mean the reduction of indirect support-seeking opportunities. While direct support-seeking behaviour is more effective at eliciting support, it also requires significantly more effort and may be perceived as forceful and burdensome. 15 The shift to homeworking and closure of community venues reduced the number of opportunities for these spontaneous interactions to occur, and has, second, focused them locally. Consequently, individuals whose core networks are located elsewhere, or who live in communities where spontaneous interaction is less likely, have less opportunity to benefit from spontaneous in-person supportive interactions.

However, alongside this disruption, new opportunities to interact and obtain social support have arisen. The surge in community social support during the initial lockdown mirrored that often seen in response to adverse events (eg, natural disasters 16 ). COVID-19 restrictions that confined individuals to their local area also compelled them to focus their in-person efforts locally. Commentators on the initial lockdown in the UK remarked on extraordinary acts of generosity between individuals who belonged to the same community but were unknown to each other. However, research on adverse events also tells us that such community support is not necessarily maintained in the longer term. 16

Meanwhile, online forms of social support are not bound by geography, thus enabling interactions and social support to be received from a wider network of people. Formal online social support spaces (eg, support groups) existed well before COVID-19, but have vastly increased since. While online interactions can increase perceived social support, it is unclear whether remote communication technologies provide an effective substitute from in-person interaction during periods of social distancing. 17 18 It makes intuitive sense that the usefulness of online social support will vary by the type of support offered, degree of social interaction and ‘online communication skills’ of those taking part. Youth workers, for instance, have struggled to keep vulnerable youth engaged in online youth clubs, 19 despite others finding a positive association between amount of digital technology used by individuals during lockdown and perceived social support. 20 Other research has found that more frequent face-to-face contact and phone/video contact both related to lower levels of depression during the time period of March to August 2020, but the negative effect of a lack of contact was greater for those with higher levels of usual sociability. 21 Relatedly, important inequalities in social support exist, such that individuals who occupy more socially disadvantaged positions in society (eg, low socioeconomic status, older people) tend to have less access to social support, 22 potentially exacerbated by COVID-19.

Social and interactional norms

Interactional norms are key relational mechanisms which build trust, belonging and identity within and across groups in a system. Individuals in groups and societies apply meaning by ‘approving, arranging and redefining’ symbols of interaction. 23 A handshake, for instance, is a powerful symbol of trust and equality. Depending on context, not shaking hands may symbolise a failure to extend friendship, or a failure to reach agreement. The norms governing these symbols represent shared values and identity; and mutual understanding of these symbols enables individuals to achieve orderly interactions, establish supportive relationship accountability and connect socially. 24 25

Physical distancing measures to contain the spread of COVID-19 radically altered these norms of interaction, particularly those used to convey trust, affinity, empathy and respect (eg, hugging, physical comforting). 26 As epidemic waves rose and fell, the work to negotiate these norms required intense cognitive effort; previously taken-for-granted interactions were re-examined, factoring in current restriction levels, own and (assumed) others’ vulnerability and tolerance of risk. This created awkwardness, and uncertainty, for example, around how to bring closure to an in-person interaction or convey warmth. The instability in scripted ways of interacting created particular strain for individuals who already struggled to encode and decode interactions with others (eg, those who are deaf or have autism spectrum disorder); difficulties often intensified by mask wearing. 27

Large social gatherings—for example, weddings, school assemblies, sporting events—also present key opportunities for affirming and assimilating interactional norms, building cohesion and shared identity and facilitating cooperation across social groups. 28 Online ‘equivalents’ do not easily support ‘social-bonding’ activities such as singing and dancing, and rarely enable chance/spontaneous one-on-one conversations with peripheral/weaker network ties (see the Social networks section) which can help strengthen bonds across a larger network. The loss of large gatherings to celebrate rites of passage (eg, bar mitzvah, weddings) has additional relational costs since these events are performed by and for communities to reinforce belonging, and to assist in transitioning to new phases of life. 29 The loss of interaction with diverse others via community and large group gatherings also reduces intergroup contact, which may then tend towards more prejudiced outgroup attitudes. While online interaction can go some way to mimicking these interaction norms, there are key differences. A sense of anonymity, and lack of in-person emotional cues, tends to support norms of polarisation and aggression in expressing differences of opinion online. And while online platforms have potential to provide intergroup contact, the tendency of much social media to form homogeneous ‘echo chambers’ can serve to further reduce intergroup contact. 30 31

Intimacy relates to the feeling of emotional connection and closeness with other human beings. Emotional connection, through romantic, friendship or familial relationships, fulfils a basic human need 32 and strongly benefits health, including reduced stress levels, improved mental health, lowered blood pressure and reduced risk of heart disease. 32 33 Intimacy can be fostered through familiarity, feeling understood and feeling accepted by close others. 34

Intimacy via companionship and closeness is fundamental to mental well-being. Positively, the COVID-19 pandemic has offered opportunities for individuals to (re)connect and (re)strengthen close relationships within their household via quality time together, following closure of many usual external social activities. Research suggests that the first full UK lockdown period led to a net gain in the quality of steady relationships at a population level, 35 but amplified existing inequalities in relationship quality. 35 36 For some in single-person households, the absence of a companion became more conspicuous, leading to feelings of loneliness and lower mental well-being. 37 38 Additional pandemic-related relational strain 39 40 resulted, for some, in the initiation or intensification of domestic abuse. 41 42

Physical touch is another key aspect of intimacy, a fundamental human need crucial in maintaining and developing intimacy within close relationships. 34 Restrictions on social interactions severely restricted the number and range of people with whom physical affection was possible. The reduction in opportunity to give and receive affectionate physical touch was not experienced equally. Many of those living alone found themselves completely without physical contact for extended periods. The deprivation of physical touch is evidenced to take a heavy emotional toll. 43 Even in future, once physical expressions of affection can resume, new levels of anxiety over germs may introduce hesitancy into previously fluent blending of physical and verbal intimate social connections. 44

The pandemic also led to shifts in practices and norms around sexual relationship building and maintenance, as individuals adapted and sought alternative ways of enacting sexual intimacy. This too is important, given that intimate sexual activity has known benefits for health. 45 46 Given that social restrictions hinged on reducing household mixing, possibilities for partnered sexual activity were primarily guided by living arrangements. While those in cohabiting relationships could potentially continue as before, those who were single or in non-cohabiting relationships generally had restricted opportunities to maintain their sexual relationships. Pornography consumption and digital partners were reported to increase since lockdown. 47 However, online interactions are qualitatively different from in-person interactions and do not provide the same opportunities for physical intimacy.

Recommendations and conclusions

In the sections above we have outlined the ways in which COVID-19 has impacted social relationships, showing how relational mechanisms key to health have been undermined. While some of the damage might well self-repair after the pandemic, there are opportunities inherent in deliberative efforts to build back in ways that facilitate greater resilience in social and community relationships. We conclude by making three recommendations: one regarding public health responses to the pandemic; and two regarding social recovery.

Recommendation 1: explicitly count the relational cost of public health policies to control the pandemic

Effective handling of a pandemic recognises that social, economic and health concerns are intricately interwoven. It is clear that future research and policy attention must focus on the social consequences. As described above, policies which restrict physical mixing across households carry heavy and unequal relational costs. These include for individuals (eg, loss of intimate touch), dyads (eg, loss of warmth, comfort), networks (eg, restricted access to support) and communities (eg, loss of cohesion and identity). Such costs—and their unequal impact—should not be ignored in short-term efforts to control an epidemic. Some public health responses—restrictions on international holiday travel and highly efficient test and trace systems—have relatively small relational costs and should be prioritised. At a national level, an earlier move to proportionate restrictions, and investment in effective test and trace systems, may help prevent escalation of spread to the point where a national lockdown or tight restrictions became an inevitability. Where policies with relational costs are unavoidable, close attention should be paid to the unequal relational impact for those whose personal circumstances differ from normative assumptions of two adult families. This includes consideration of whether expectations are fair (eg, for those who live alone), whether restrictions on social events are equitable across age group, religious/ethnic groupings and social class, and also to ensure that the language promoted by such policies (eg, households; families) is not exclusionary. 48 49 Forethought to unequal impacts on social relationships should thus be integral to the work of epidemic preparedness teams.

Recommendation 2: intelligently balance online and offline ways of relating

A key ingredient for well-being is ‘getting together’ in a physical sense. This is fundamental to a human need for intimate touch, physical comfort, reinforcing interactional norms and providing practical support. Emerging evidence suggests that online ways of relating cannot simply replace physical interactions. But online interaction has many benefits and for some it offers connections that did not exist previously. In particular, online platforms provide new forms of support for those unable to access offline services because of mobility issues (eg, older people) or because they are geographically isolated from their support community (eg, lesbian, gay, bisexual, transgender and queer (LGBTQ) youth). Ultimately, multiple forms of online and offline social interactions are required to meet the needs of varying groups of people (eg, LGBTQ, older people). Future research and practice should aim to establish ways of using offline and online support in complementary and even synergistic ways, rather than veering between them as social restrictions expand and contract. Intelligent balancing of online and offline ways of relating also pertains to future policies on home and flexible working. A decision to switch to wholesale or obligatory homeworking should consider the risk to relational ‘group properties’ of the workplace community and their impact on employees’ well-being, focusing in particular on unequal impacts (eg, new vs established employees). Intelligent blending of online and in-person working is required to achieve flexibility while also nurturing supportive networks at work. Intelligent balance also implies strategies to build digital literacy and minimise digital exclusion, as well as coproducing solutions with intended beneficiaries.

Recommendation 3: build stronger and sustainable localised communities

In balancing offline and online ways of interacting, there is opportunity to capitalise on the potential for more localised, coherent communities due to scaled-down travel, homeworking and local focus that will ideally continue after restrictions end. There are potential economic benefits after the pandemic, such as increased trade as home workers use local resources (eg, coffee shops), but also relational benefits from stronger relationships around the orbit of the home and neighbourhood. Experience from previous crises shows that community volunteer efforts generated early on will wane over time in the absence of deliberate work to maintain them. Adequately funded partnerships between local government, third sector and community groups are required to sustain community assets that began as a direct response to the pandemic. Such partnerships could work to secure green spaces and indoor (non-commercial) meeting spaces that promote community interaction. Green spaces in particular provide a triple benefit in encouraging physical activity and mental health, as well as facilitating social bonding. 50 In building local communities, small community networks—that allow for diversity and break down ingroup/outgroup views—may be more helpful than the concept of ‘support bubbles’, which are exclusionary and less sustainable in the longer term. Rigorously designed intervention and evaluation—taking a systems approach—will be crucial in ensuring scale-up and sustainability.

The dramatic change to social interaction necessitated by efforts to control the spread of COVID-19 created stark challenges but also opportunities. Our essay highlights opportunities for learning, both to ensure the equity and humanity of physical restrictions, and to sustain the salutogenic effects of social relationships going forward. The starting point for capitalising on this learning is recognition of the disruption to relational mechanisms as a key part of the socioeconomic and health impact of the pandemic. In recovery planning, a general rule is that what is good for decreasing health inequalities (such as expanding social protection and public services and pursuing green inclusive growth strategies) 4 will also benefit relationships and safeguard relational mechanisms for future generations. Putting this into action will require political will.

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Twitter @karenmaxSPHSU, @Mark_McCann, @Rwilsonlowe, @KMitchinGlasgow

Contributors EL and KM led on the manuscript conceptualisation, review and editing. SP, KM, CB, RBP, RL, MM, JR, KS and RW-L contributed to drafting and revising the article. All authors assisted in revising the final draft.

Funding The research reported in this publication was supported by the Medical Research Council (MC_UU_00022/1, MC_UU_00022/3) and the Chief Scientist Office (SPHSU11, SPHSU14). EL is also supported by MRC Skills Development Fellowship Award (MR/S015078/1). KS and MM are also supported by a Medical Research Council Strategic Award (MC_PC_13027).

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

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Students’ Essays on Infectious Disease Prevention, COVID-19 Published Nationwide

As part of the BIO 173: Global Change and Infectious Disease course, Professor Fred Cohan assigns students to write an essay persuading others to prevent future and mitigate present infectious diseases. If students submit their essay to a news outlet—and it’s published—Cohan awards them with extra credit.

As a result of this assignment, more than 25 students have had their work published in newspapers across the United States. Many of these essays cite and applaud the University’s Keep Wes Safe campaign and its COVID-19 testing protocols.

Cohan, professor of biology and Huffington Foundation Professor in the College of the Environment (COE), began teaching the Global Change and Infectious Disease course in 2009, when the COE was established. “I wanted very much to contribute a course to what I saw as a real game-changer in Wesleyan’s interest in the environment. The course is about all the ways that human demands on the environment have brought us infectious diseases, over past millennia and in the present, and why our environmental disturbances will continue to bring us infections into the future.”

Over the years, Cohan learned that he can sustainably teach about 170 students every year without running out of interested students. This fall, he had 207. Although he didn’t change the overall structure of his course to accommodate COVID-19 topics, he did add material on the current pandemic to various sections of the course.

“I wouldn’t say that the population of the class increased tremendously as a result of COVID-19, but I think the enthusiasm of the students for the material has increased substantially,” he said.

To accommodate online learning, Cohan shaved off 15 minutes from his normal 80-minute lectures to allow for discussion sections, led by Cohan and teaching assistants. “While the lectures mostly dealt with biology, the discussions focused on how changes in behavior and policy can solve the infectious disease problems brought by human disturbance of the environment,” he said.

Based on student responses to an introspective exam question, Cohan learned that many students enjoyed a new hope that we could each contribute to fighting infectious disease. “They discovered that the solution to infectious disease is not entirely a waiting game for the right technologies to come along,” he said. “Many enjoyed learning about fighting infectious disease from a moral and social perspective. And especially, the students enjoyed learning about the ‘socialism of the microbe,’ how preventing and curing others’ infections will prevent others’ infections from becoming our own. The students enjoyed seeing how this idea can drive both domestic and international health policies.”

A sampling of the published student essays are below:

Alexander Giummo ’22 and Mike Dunderdale’s ’23  op-ed titled “ A National Testing Proposal: Let’s Fight Back Against COVID-19 ” was published in the Journal Inquirer in Manchester, Conn.

They wrote: “With an expansive and increased testing plan for U.S. citizens, those who are COVID-positive could limit the number of contacts they have, and this would also help to enable more effective contact tracing. Testing could also allow for the return of some ‘normal’ events, such as small social gatherings, sports, and in-person class and work schedules.

“We propose a national testing strategy in line with the one that has kept Wesleyan students safe this year. The plan would require a strong push by the federal government to fund the initiative, but it is vital to successful containment of the virus.

“Twice a week, all people living in the U.S. should report to a local testing site staffed with professionals where the anterior nasal swab Polymerase Chain Reaction (PCR) test, used by Wesleyan and supported by the Broad Institute, would be implemented.”

Kalyani Mohan ’22 and Kalli Jackson ’22 penned an essay titled “ Where Public Health Meets Politics: COVID-19 in the United States ,” which was published in Wesleyan’s Arcadia Political Review .

They wrote: “While the U.S. would certainly benefit from a strengthened pandemic response team and structural changes to public health systems, that alone isn’t enough, as American society is immensely stratified, socially and culturally. The politicization of the COVID-19 pandemic shows that individualism, libertarianism and capitalism are deeply ingrained in American culture, to the extent that Americans often blind to the fact community welfare can be equivalent to personal welfare. Pandemics are multifaceted, and preventing them requires not just a cultural shift but an emotional one amongst the American people, one guided by empathy—towards other people, different communities and the planet. Politics should be a tool, not a weapon against its people.”

Sydnee Goyer ’21 and Marcel Thompson’s ’22  essay “ This Flu Season Will Be Decisive in the Fight Against COVID-19 ” also was published in Arcadia Political Review .

“With winter approaching all around the Northern Hemisphere, people are preparing for what has already been named a “twindemic,” meaning the joint threat of the coronavirus and the seasonal flu,” they wrote. “While it is known that seasonal vaccinations reduce the risk of getting the flu by up to 60% and also reduce the severity of the illness after the contamination, additional research has been conducted in order to know whether or not flu shots could reduce the risk of people getting COVID-19. In addition to the flu shot, it is essential that people remain vigilant in maintaining proper social distancing, washing your hands thoroughly, and continuing to wear masks in public spaces.”

An op-ed titled “ The Pandemic Has Shown Us How Workplace Culture Needs to Change ,” written by Adam Hickey ’22 and George Fuss ’21, was published in Park City, Utah’s The Park Record .

They wrote: “One review of academic surveys (most of which were conducted in the United States) conducted in 2019 found that between 35% and 97% of respondents in those surveys reported having attended work while they were ill, often because of workplace culture or policy which generated pressure to do so. Choosing to ignore sickness and return to the workplace while one is ill puts colleagues at risk, regardless of the perceived severity of your own illness; COVID-19 is an overbearing reminder that a disease that may cause mild, even cold-like symptoms for some can still carry fatal consequences for others.

“A mandatory paid sick leave policy for every worker, ideally across the globe, would allow essential workers to return to work when necessary while still providing enough wiggle room for economically impoverished employees to take time off without going broke if they believe they’ve contracted an illness so as not to infect the rest of their workplace and the public at large.”

Women’s cross country team members and classmates Jane Hollander ’23 and Sara Greene ’23 wrote a sports-themed essay titled “ This Season, High School Winter Sports Aren’t Worth the Risk ,” which was published in Tap into Scotch Plains/Fanwood , based in Scotch Plains, N.J. Their essay focused on the risks high school sports pose on student-athletes, their families, and the greater community.

“We don’t propose cutting off sports entirely— rather, we need to be realistic about the levels at which athletes should be participating. There are ways to make practices safer,” they wrote. “At [Wesleyan], we began the season in ‘cohorts,’ so the amount of people exposed to one another would be smaller. For non-contact sports, social distancing can be easily implemented, and for others, teams can focus on drills, strength and conditioning workouts, and skill-building exercises. Racing sports such as swim and track can compete virtually, comparing times with other schools, and team sports can focus their competition on intra-team scrimmages. These changes can allow for the continuation of a sense of normalcy and team camaraderie without the exposure to students from different geographic areas in confined, indoor spaces.”

Brook Guiffre ’23 and Maddie Clarke’s ’22  op-ed titled “ On the Pandemic ” was published in Hometown Weekly,  based in Medfield, Mass.

“The first case of COVID-19 in the United States was recorded on January 20th, 2020. For the next month and a half, the U.S. continued operating normally, while many other countries began their lockdown,” they wrote. “One month later, on February 29th, 2020, the federal government approved a national testing program, but it was too little too late. The U.S. was already in pandemic mode, and completely unprepared. Frontline workers lacked access to N-95 masks, infected patients struggled to get tested, and national leaders informed the public that COVID-19 was nothing more than the common flu. Ultimately, this unpreparedness led to thousands of avoidable deaths and long-term changes to daily life. With the risk of novel infectious diseases emerging in the future being high, it is imperative that the U.S. learn from its failure and better prepare for future pandemics now. By strengthening our public health response and re-establishing government organizations specialized in disease control, we have the ability to prevent more years spent masked and six feet apart.”

In addition, their other essay, “ On Mass Extinction ,” was also published by Hometown Weekly .

“The sixth mass extinction—which scientists have coined as the Holocene Extinction—is upon us. According to the United Nations, around one million plant and animal species are currently in danger of extinction, and many more within the next decade. While other extinctions have occurred in Earth’s history, none have occurred at such a rapid rate,” they wrote. “For the sake of both biodiversity and infectious diseases, it is in our best interest to stop pushing this Holocene Extinction further.”

An essay titled “ Learning from Our Mistakes: How to Protect Ourselves and Our Communities from Diseases ,” written by Nicole Veru ’21 and Zoe Darmon ’21, was published in My Hometown Bronxville, based in Bronxville, N.Y.

“We can protect ourselves and others from future infectious diseases by ensuring that we are vaccinated,” they wrote. “Vaccines have high levels of success if enough people get them. Due to vaccines, society is no longer ravaged by childhood diseases such as mumps, rubella, measles, and smallpox. We have been able to eradicate diseases through vaccines; smallpox, one of the world’s most consequential diseases, was eradicated from the world in the 1970s.

“In 2000, the U.S. was nearly free of measles, yet, due to hesitations by anti-vaxxers, there continues to be cases. From 2000–2015 there were over 18 measles outbreaks in the U.S. This is because unless a disease is completely eradicated, there will be a new generation susceptible.

“Although vaccines are not 100% effective at preventing infection, if we continue to get vaccinated, we protect ourselves and those around us. If enough people are vaccinated, societies can develop herd immunity. The amount of people vaccinated to obtain herd immunity depends on the disease, but if this fraction is obtained, the spread of disease is contained. Through herd immunity, we protect those who may not be able to get vaccinated, such as people who are immunocompromised and the tiny portion of people for whom the vaccine is not effective.”

Dhruvi Rana ’22 and Bryce Gillis ’22 co-authored an op-ed titled “ We Must Educate Those Who Remain Skeptical of the Dangers of COVID-19 ,” which was published in Rhode Island Central .

“As Rhode Island enters the winter season, temperatures are beginning to drop and many studies have demonstrated that colder weather and lower humidity are correlated with higher transmissibility of SARS-CoV-2, the virus that causes COVID-19,” they wrote. “By simply talking or breathing, we release respiratory droplets and aerosols (tiny fluid particles which could carry the coronavirus pathogen), which can remain in the air for minutes to hours.

“In order to establish herd immunity in the US, we must educate those who remain skeptical of the dangers of COVID-19.  Whether community-driven or state-funded, educational campaigns are needed to ensure that everyone fully comprehends how severe COVID-19 is and the significance of airborne transmission. While we await a vaccine, it is necessary now more than ever that we social distance, avoid crowds, and wear masks, given that colder temperatures will likely yield increased transmission of the virus.”

Danielle Rinaldi ’21 and Verónica Matos Socorro ’21 published their op-ed titled “ Community Forum: How Mask-Wearing Demands a Cultural Reset ” in the Ewing Observer , based in Lawrence, N.J.

“In their own attempt to change personal behavior during the pandemic, Wesleyan University has mandated mask-wearing in almost every facet of campus life,” they wrote. “As members of our community, we must recognize that mask-wearing is something we are all responsible and accountable for, not only because it is a form of protection for us, but just as important for others as well. However, it seems as though both Covid fatigue and complacency are dominating the mindsets of Americans, leading to even more unwillingness to mask up. Ultimately, it is inevitable that this pandemic will not be the last in our lifespan due to global warming creating irreversible losses in biodiversity. As a result, it is imperative that we adopt the norm of mask-wearing now and undergo a culture shift of the abandonment of an individualistic mindset, and instead, create a society that prioritizes taking care of others for the benefit of all.”

Shayna Dollinger ’22 and Hayley Lipson ’21  wrote an essay titled “ My Pandemic Year in College Has Brought Pride and Purpose. ” Dollinger submitted the piece, rewritten in first person, to Jewish News of Northern California . Read more about Dollinger’s publication in this News @ Wesleyan article .

“I lay in the dead grass, a 6-by-6-foot square all to myself. I cheer for my best friend, who is on the stage constructed at the bottom of Foss hill, dancing with her Bollywood dance group. Masks cover their ordinarily smiling faces as their bodies move in sync. Looking around at friends and classmates, each in their own 6-by-6 world, I feel an overwhelming sense of normalcy.

“One of the ways in which Wesleyan has prevented outbreaks on campus is by holding safe, socially distanced events that students want to attend. By giving us places to be and things to do on the weekends, we are discouraged from breaking rules and causing outbreaks at ‘super-spreader’ events.”

An op-ed written by Luna Mac-Williams ’22 and Daëlle Coriolan ’24 titled “ Collectivist Practices to Combat COVID-19 ” was published in the Wesleyan Argus .

“We are embroiled in a global pandemic that disproportionately affects poor communities of color, and in the midst of a higher cultural consciousness of systemic inequities,” they wrote. “A cultural shift to center collectivist thought and action not only would prove helpful in disease prevention, but also belongs in conversation with the Black Lives Matter movement. Collectivist models of thinking effectively target the needs of vulnerable populations including the sick, the disenfranchised, the systematically marginalized. Collectivist systems provide care, decentering the capitalist, individualist system, and focusing on how communities can work to be self-sufficient and uplift our own neighbors.”

An essay written by Maria Noto ’21 , titled “ U.S. Individualism Has Deadly Consequences ,” is published in the Oneonta Daily Star , based in Oneonta, N.Y.

She wrote, “When analyzing the cultures of certain East Asian countries, several differences stand out. For instance, when people are sick and during the cold and flu season, many East Asian cultures, including South Korea, use mask-wearing. What is considered a threat to freedom by some Americans is a preventive action and community obligation in this example. This, along with many other cultural differences, is insightful in understanding their ability to contain the virus.

“These differences are deeply seeded in the values of a culture. However, there is hope for the U.S. and other individualistic cultures in recognizing and adopting these community-centered approaches. Our mindset needs to be revolutionized with the help of federal and local assistance: mandating masks, passing another stimulus package, contact tracing, etc… However, these measures will be unsuccessful unless everyone participates for the good of a community.”

A published op-ed by Madison Szabo ’23 , Caitlyn Ferrante ’23 ran in the Two Rivers Times . The piece is titled “ Anxiety and Aspiration: Analyzing the Politicization of the Pandemic .”

John Lee ’21 and Taylor Goodman-Leong ’21 have published their op-ed titled “ Reassessing the media’s approach to COVID-19 ” in Weekly Monday Cafe 24 (Page 2).

An essay by Eleanor Raab ’21 and Elizabeth Nefferdorf ’22 titled “ Preventing the Next Epidemic ” was published in The Almanac .

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Read these 12 moving essays about life during coronavirus

Artists, novelists, critics, and essayists are writing the first draft of history.

by Alissa Wilkinson

The world is grappling with an invisible, deadly enemy, trying to understand how to live with the threat posed by a virus . For some writers, the only way forward is to put pen to paper, trying to conceptualize and document what it feels like to continue living as countries are under lockdown and regular life seems to have ground to a halt.

So as the coronavirus pandemic has stretched around the world, it’s sparked a crop of diary entries and essays that describe how life has changed. Novelists, critics, artists, and journalists have put words to the feelings many are experiencing. The result is a first draft of how we’ll someday remember this time, filled with uncertainty and pain and fear as well as small moments of hope and humanity.

• The Vox guide to navigating the coronavirus crisis

At the New York Review of Books, Ali Bhutto writes that in Karachi, Pakistan, the government-imposed curfew due to the virus is “eerily reminiscent of past military clampdowns”:

Beneath the quiet calm lies a sense that society has been unhinged and that the usual rules no longer apply. Small groups of pedestrians look on from the shadows, like an audience watching a spectacle slowly unfolding. People pause on street corners and in the shade of trees, under the watchful gaze of the paramilitary forces and the police.

His essay concludes with the sobering note that “in the minds of many, Covid-19 is just another life-threatening hazard in a city that stumbles from one crisis to another.”

Writing from Chattanooga, novelist Jamie Quatro documents the mixed ways her neighbors have been responding to the threat, and the frustration of conflicting direction, or no direction at all, from local, state, and federal leaders:

Whiplash, trying to keep up with who’s ordering what. We’re already experiencing enough chaos without this back-and-forth. Why didn’t the federal government issue a nationwide shelter-in-place at the get-go, the way other countries did? What happens when one state’s shelter-in-place ends, while others continue? Do states still under quarantine close their borders? We are still one nation, not fifty individual countries. Right?

• A syllabus for the end of the world

Award-winning photojournalist Alessio Mamo, quarantined with his partner Marta in Sicily after she tested positive for the virus, accompanies his photographs in the Guardian of their confinement with a reflection on being confined :

The doctors asked me to take a second test, but again I tested negative. Perhaps I’m immune? The days dragged on in my apartment, in black and white, like my photos. Sometimes we tried to smile, imagining that I was asymptomatic, because I was the virus. Our smiles seemed to bring good news. My mother left hospital, but I won’t be able to see her for weeks. Marta started breathing well again, and so did I. I would have liked to photograph my country in the midst of this emergency, the battles that the doctors wage on the frontline, the hospitals pushed to their limits, Italy on its knees fighting an invisible enemy. That enemy, a day in March, knocked on my door instead.

In the New York Times Magazine, deputy editor Jessica Lustig writes with devastating clarity about her family’s life in Brooklyn while her husband battled the virus, weeks before most people began taking the threat seriously:

At the door of the clinic, we stand looking out at two older women chatting outside the doorway, oblivious. Do I wave them away? Call out that they should get far away, go home, wash their hands, stay inside? Instead we just stand there, awkwardly, until they move on. Only then do we step outside to begin the long three-block walk home. I point out the early magnolia, the forsythia. T says he is cold. The untrimmed hairs on his neck, under his beard, are white. The few people walking past us on the sidewalk don’t know that we are visitors from the future. A vision, a premonition, a walking visitation. This will be them: Either T, in the mask, or — if they’re lucky — me, tending to him.

Essayist Leslie Jamison writes in the New York Review of Books about being shut away alone in her New York City apartment with her 2-year-old daughter since she became sick:

The virus. Its sinewy, intimate name. What does it feel like in my body today? Shivering under blankets. A hot itch behind the eyes. Three sweatshirts in the middle of the day. My daughter trying to pull another blanket over my body with her tiny arms. An ache in the muscles that somehow makes it hard to lie still. This loss of taste has become a kind of sensory quarantine. It’s as if the quarantine keeps inching closer and closer to my insides. First I lost the touch of other bodies; then I lost the air; now I’ve lost the taste of bananas. Nothing about any of these losses is particularly unique. I’ve made a schedule so I won’t go insane with the toddler. Five days ago, I wrote Walk/Adventure! on it, next to a cut-out illustration of a tiger—as if we’d see tigers on our walks. It was good to keep possibility alive.

At Literary Hub, novelist Heidi Pitlor writes about the elastic nature of time during her family’s quarantine in Massachusetts:

During a shutdown, the things that mark our days—commuting to work, sending our kids to school, having a drink with friends—vanish and time takes on a flat, seamless quality. Without some self-imposed structure, it’s easy to feel a little untethered. A friend recently posted on Facebook: “For those who have lost track, today is Blursday the fortyteenth of Maprilay.” ... Giving shape to time is especially important now, when the future is so shapeless. We do not know whether the virus will continue to rage for weeks or months or, lord help us, on and off for years. We do not know when we will feel safe again. And so many of us, minus those who are gifted at compartmentalization or denial, remain largely captive to fear. We may stay this way if we do not create at least the illusion of movement in our lives, our long days spent with ourselves or partners or families.

• What day is it today?

Novelist Lauren Groff writes at the New York Review of Books about trying to escape the prison of her fears while sequestered at home in Gainesville, Florida:

Some people have imaginations sparked only by what they can see; I blame this blinkered empiricism for the parks overwhelmed with people, the bars, until a few nights ago, thickly thronged. My imagination is the opposite. I fear everything invisible to me. From the enclosure of my house, I am afraid of the suffering that isn’t present before me, the people running out of money and food or drowning in the fluid in their lungs, the deaths of health-care workers now growing ill while performing their duties. I fear the federal government, which the right wing has so—intentionally—weakened that not only is it insufficient to help its people, it is actively standing in help’s way. I fear we won’t sufficiently punish the right. I fear leaving the house and spreading the disease. I fear what this time of fear is doing to my children, their imaginations, and their souls.

At ArtForum , Berlin-based critic and writer Kristian Vistrup Madsen reflects on martinis, melancholia, and Finnish artist Jaakko Pallasvuo’s 2018 graphic novel Retreat , in which three young people exile themselves in the woods:

In melancholia, the shape of what is ending, and its temporality, is sprawling and incomprehensible. The ambivalence makes it hard to bear. The world of Retreat is rendered in lush pink and purple watercolors, which dissolve into wild and messy abstractions. In apocalypse, the divisions established in genesis bleed back out. My own Corona-retreat is similarly soft, color-field like, each day a blurred succession of quarantinis, YouTube–yoga, and televized press conferences. As restrictions mount, so does abstraction. For now, I’m still rooting for love to save the world.

At the Paris Review , Matt Levin writes about reading Virginia Woolf’s novel The Waves during quarantine:

A retreat, a quarantine, a sickness—they simultaneously distort and clarify, curtail and expand. It is an ideal state in which to read literature with a reputation for difficulty and inaccessibility, those hermetic books shorn of the handholds of conventional plot or characterization or description. A novel like Virginia Woolf’s The Waves is perfect for the state of interiority induced by quarantine—a story of three men and three women, meeting after the death of a mutual friend, told entirely in the overlapping internal monologues of the six, interspersed only with sections of pure, achingly beautiful descriptions of the natural world, a day’s procession and recession of light and waves. The novel is, in my mind’s eye, a perfectly spherical object. It is translucent and shimmering and infinitely fragile, prone to shatter at the slightest disturbance. It is not a book that can be read in snatches on the subway—it demands total absorption. Though it revels in a stark emotional nakedness, the book remains aloof, remote in its own deep self-absorption.

• Vox is starting a book club. Come read with us!

In an essay for the Financial Times, novelist Arundhati Roy writes with anger about Indian Prime Minister Narendra Modi’s anemic response to the threat, but also offers a glimmer of hope for the future:

Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.

From Boston, Nora Caplan-Bricker writes in The Point about the strange contraction of space under quarantine, in which a friend in Beirut is as close as the one around the corner in the same city:

It’s a nice illusion—nice to feel like we’re in it together, even if my real world has shrunk to one person, my husband, who sits with his laptop in the other room. It’s nice in the same way as reading those essays that reframe social distancing as solidarity. “We must begin to see the negative space as clearly as the positive, to know what we don’t do is also brilliant and full of love,” the poet Anne Boyer wrote on March 10th, the day that Massachusetts declared a state of emergency. If you squint, you could almost make sense of this quarantine as an effort to flatten, along with the curve, the distinctions we make between our bonds with others. Right now, I care for my neighbor in the same way I demonstrate love for my mother: in all instances, I stay away. And in moments this month, I have loved strangers with an intensity that is new to me. On March 14th, the Saturday night after the end of life as we knew it, I went out with my dog and found the street silent: no lines for restaurants, no children on bicycles, no couples strolling with little cups of ice cream. It had taken the combined will of thousands of people to deliver such a sudden and complete emptiness. I felt so grateful, and so bereft.

And on his own website, musician and artist David Byrne writes about rediscovering the value of working for collective good , saying that “what is happening now is an opportunity to learn how to change our behavior”:

In emergencies, citizens can suddenly cooperate and collaborate. Change can happen. We’re going to need to work together as the effects of climate change ramp up. In order for capitalism to survive in any form, we will have to be a little more socialist. Here is an opportunity for us to see things differently — to see that we really are all connected — and adjust our behavior accordingly. Are we willing to do this? Is this moment an opportunity to see how truly interdependent we all are? To live in a world that is different and better than the one we live in now? We might be too far down the road to test every asymptomatic person, but a change in our mindsets, in how we view our neighbors, could lay the groundwork for the collective action we’ll need to deal with other global crises. The time to see how connected we all are is now.

The portrait these writers paint of a world under quarantine is multifaceted. Our worlds have contracted to the confines of our homes, and yet in some ways we’re more connected than ever to one another. We feel fear and boredom, anger and gratitude, frustration and strange peace. Uncertainty drives us to find metaphors and images that will let us wrap our minds around what is happening.

Yet there’s no single “what” that is happening. Everyone is contending with the pandemic and its effects from different places and in different ways. Reading others’ experiences — even the most frightening ones — can help alleviate the loneliness and dread, a little, and remind us that what we’re going through is both unique and shared by all.

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Pandemics Don’t Really End—They Echo

T he public health emergency related to the COVID-19 pandemic officially ended on May 11, 2023. It was a purely administrative step. Viruses do not answer to government decrees. Reported numbers were declining, but then started coming up again during the summer. By August, hospital admissions climbed to more than 10,000 a week. This was nowhere near the 150,000 weekly admissions recorded at the peak of the pandemic in January 2022.

The new variant is more contagious. It is not yet clear whether it is more lethal. Nor is it clear whether the recent rise is a mere uptick or foreshadows a more serious surge. More than 50,000 COVID-19 deaths have been reported in the U.S. in 2023. Somehow, this has come to be seen as almost normal.

Even while health authorities are keeping their eyes on new “variables of concern,” for much of the public COVID has been cancelled. The news media have largely moved on to other calamities. The pandemic is over. Is it?

History shows that pandemics have ragged endings. Some return again and again. The Justinian Plague that swept through the Roman Empire in the 6 th century returned in waves over the next 200 years. The Black Death that killed half the population of Europe between 1347 and 1351 came back more than 40 times over the next 400 years.

Read More: Will the New Vaccine Work Against the Latest Variant?

The effect of the COVID-19 pandemic will be felt long after the last rapid test comes back positive. Millions today are still suffering from “ long COVID ”—a range of medical conditions that can appear long after the initial infection. This concept can be applied to the whole of society.

Pandemics have always frayed the social fabric, disrupted economies, deepened social divides, and intensified prejudices, leaving behind psychological scars—all of which have lasting political repercussions.

Angered by the British crown’s attempt to restore the inequalities of the pre-pandemic feudal system, which had been weakened by the massive depopulation caused by the plague, English peasants marched on London and nearly brought down the king. Repeated waves of cholera in Europe during the 19 th century increased social tensions and contributed to growing class warfare. A sharp increase in labor strife followed the 1918 flu pandemic.

Today, society seems similarly on edge and quick to violence, an observation that was also made about medieval society following the plague. The U.S. homicide rate in 2020 and 2021 increased by nearly 40 percent. It appears to have come down in some cities, but violent crime remains above pre-pandemic levels. Mass shootings have hit an all-time high, while random unprovoked aggression has increased in public spaces. The pandemic is not entirely to blame, but it has likely been a contributing factor.

Many Americans quit their jobs after the pandemic. Others are refusing to give up working from home . The so-called great resignation appears to be ending, but the labor militancy that featured in post-pandemic societies continues.

While the COVID-19 pandemic comes nowhere near the depopulation effects of the plague, it emptied the sidewalks in many major American cities. Office buildings have fewer workers. Restaurants have lost business. It is not uncommon to see rows of boarded up retail shops. COVID does not get all the blame. The rise in crime in many city centers keeps many away. Urban geography may be permanently altered.

As it often did after past pandemics, pessimism pervades the post-pandemic moodscape. Its explanation lies beyond the pathogens. A Biblical host of natural and man-made disasters—pestilence, war, famine, floods, drought, fire, contribute to a sense of foreboding.

The 1918 flu pandemic left a legacy of distrust in institutions and each other, which was passed down to children and grandchildren, COVID may have similar long-term effects.

Americans are a cantankerous lot, increasingly suspicious of malevolent motives behind anything government does. Partisan news outlets look for conflict and stoke outrage. In past pandemics, conspiracy theories flourished, often blaming immigrants and Jews. So too, some COVID conspiracy theories suggest that the virus was designed to kill Whites or Blacks, while sparing Asians and Jews. Nothing changes.

Some believe the government created the pandemic hoax or deliberately misled the public about the seriousness of the situation. They argue that needless lockdown orders and business shutdown ruined the economy; providing financial relief to businesses and families opened the way for massive corruption and left the country with insupportable debt; mask and vaccine mandates were assaults on personal liberty for the benefit of big Pharma profits. Some still claim that the vaccines themselves rivaled the virus in their lethality. Defiance has been elevated to patriotism.

Owing to response measures, improved medications, life-saving procedures for treating critically-ill patients, and the rapid availability of a vaccine, the outbreak did not replicate the death tolls of previous pandemics.

Although it sounds perverse, saving lives ended up contributing to the controversy. Simply put: The pandemic was not deadly enough . The 2 nd century Antonine Plague killed a quarter of the Roman Empire’s population. The 6 th century Justinian plague killed half the population of Europe. According to some historians, the first wave of the plague in the 14 th century again wiped out half of Europe’s inhabitants.

COVID has killed more than a million Americans, roughly a third of one percent—or about the same percentage of the population killed in World War II. As a percentage of the total population, the 1918 flu was twice as deadly.

The demographics of the death toll are important. The 1918 flu killed many younger people—those 25-40 years old accounted for 40% of the fatalities—while COVID killed mainly older Americans, as three-quarters of the dead were 65 or older. Those under 40 accounted for just 2.5% of the fatalities.

Some questioned why the country’s well-being should be jeopardized to save the elderly, many of whom already had other afflictions anyway. Expressed in the cruelest terms, nature was culling the herd. Indeed, some of the same groups that during earlier debates about national health care expressed outrage at the prospect of death panels “pulling the plug on grandma” suggested during the pandemic that the elderly would be willing to die to save the economy.

The COVID pandemic lacked visual impact. Except for those directly affected, COVID’s toll remained abstract. There was no modern equivalent of town criers calling “Bring out your dead” accompanied by carts making the rounds to collect corpses. Had COVID led to bodies piled in the streets, shared dread might have outweighed our differences. As it turned out, we had the science to address the pandemic. What we lacked was the social accord.

Discord continues in the political arena. The tradeoffs between preserving individual rights and protecting the public are legitimate areas to explore, but rather than looking for lessons to be learned, some politicians appear determined to settle scores. Pandemic disputes will almost certainly feature in the 2024 presidential election.

Any future outbreak of disease will likely again see cable news, the internet, and social media play major roles in shaping the information individuals choose in their decision making. This will inevitably make emergency control measures more difficult to impose. COVID’s biggest political casualty may be governability itself.

We are unable to join hands to remember the more than a million Americans that have succumbed to the virus—that are succumbing still. We cannot express a nation’s gratitude to the scientists, public health officials, and heroic frontline health workers, thousands of whom died saving lives during the pandemic. Stuck in the well-worn paths of previous pandemic prejudices and conspiracy theory re-runs, we cannot come together to mourn our losses and celebrate our survival.

There will be no collective thanksgiving, no elegies, no closure. As we have seen time and time again throughout human history, pandemics do not end—they echo.

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Contact us at [email protected]

• Open access
• Published: 26 August 2024

Paramedics’ experiences and observations: work-related emotions and well-being resources during the initial months of the COVID-19 pandemic—a qualitative study

• Henna Myrskykari 1 , 2 &
• Hilla Nordquist 3  

BMC Emergency Medicine volume  24 , Article number:  152 ( 2024 ) Cite this article

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Metrics details

As first responders, paramedics are an extremely important part of the care chain. COVID-19 significantly impacted their working circumstances. We examined, according to the experiences and observations of paramedics, (1) what kinds of emotions the Emergency Medical Service (EMS) personnel experienced in their new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic.

This qualitative study utilized reflective essay material written by experienced, advanced-level Finnish paramedics ( n  = 30). The essays used in this study were written during the fall of 2020 and reflected the period when Finland had declared a state of emergency (on 17.3.2020) and the Emergency Powers Act was implemented. The data was analyzed using an inductive thematic analysis.

The emotions experienced by the EMS personnel in their new working circumstances formed three themes: (1) New concerns arose that were constantly present; (2) Surviving without proper guidance; and (3) Rapidly approaching breaking point. Three themes were formed from work-related factors that were identified as resources for the well-being of the EMS personnel. These were: (1) A high level of organizational efficiency was achieved; (2) Adaptable EMS operations; and (3) Encouraging atmosphere.

Conclusions

Crisis management practices should be more attentive to personnel needs, ensuring that managerial and psychological support is readily available in crisis situations. Preparedness that ensures effective organizational adaptation also supports personnel well-being during sudden changes in working circumstances.

Peer Review reports

At the onset of the COVID-19 pandemic, healthcare personnel across the globe faced unprecedented challenges. As initial responders in emergency healthcare, paramedics were quickly placed at the front lines of the pandemic, dealing with a range of emergencies in unpredictable conditions [ 1 ]. The pandemic greatly changed the everyday nature of work [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Those working on the front line were suddenly forced to adjust to personal protective equipment (PPE) requirements [ 9 , 10 ] and rapidly changing instructions that caused significant adjustments to their job description [ 11 , 12 ]. For instance, it has been reported that during the initial stages of the COVID-19 pandemic, Emergency Medical Services (EMS) personnel, including paramedics working in prehospital emergency care, experienced a significant increase in stress [ 10 , 13 ] due to several reasons, such as the lack of protection and support, increased demands, lack of personnel, fear of exposure to COVID-19 during missions, concerns of spreading the virus to family members, and frustration over quickly changing work policies [ 11 , 14 , 15 ].

With the unprecedented challenges posed by the COVID-19 pandemic, some research has been directed toward identifying available resources that help in coping with such situations. For example, Sangal et al. [ 15 ] underscored the association between effective communication and reduced work stress and burnout, and emphasized the critical need for two-way communication, consistent messaging, and the strategic consolidation of information prior to its dissemination. In parallel, Dickson et al. [ 16 ] highlight the pivotal role of leadership strategies in fostering a healthful work environment. These strategies include being relationally engaging, visibly present, open, and caring for oneself and others, while embodying core values such as compassion, empathy, courage, and authenticity. Moreover, Awais et al. [ 14 ] identify essential measures to reduce mental distress and support EMS personnel’s overall well-being in pandemic conditions, such as by providing accessible mental health and peer support, ensuring a transparent information flow, and the implementation of clear, best-practice protocols and guidelines. As a lesson learned from COVID-19, Kihlström et al. (2022) add that crisis communication, flexible working conditions, compensation, and allowing for mistakes should be part of crisis management. They also emphasize the importance of psychological support for employees. [ 12 ]

Overall, the COVID-19 pandemic had a multifaceted impact on EMS personnel, highlighting the necessity for comprehensive support and resilience strategies to safeguard their well-being [ 11 , 17 , 18 ] alongside organizational functions [ 12 , 19 ]. For example, in Finland, it has been noted in the aftermath of COVID-19 that the availability and well-being of healthcare workers are key vulnerabilities of the resilience of the Finnish health system [ 12 ]. Effective preparedness planning and organizational resilience benefit from learning from past events and gaining a deeper understanding of observations across different organizational levels [ 12 , 19 , 20 ]. For these reasons, it is important to study how the personnel experienced the changing working circumstances and to recognize the resources, even unexpected ones, that supported their well-being during the initial phase of the COVID-19 pandemic [ 12 , 19 ].

The aim of this study was to examine the emotions experienced and the resources identified as supportive of work well-being during the initial months of the COVID-19 pandemic, from the perspective of the paramedics. Our research questions were: According to the experiences and observations of paramedics, (1) what kinds of emotions did the EMS personnel experience in the new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic? In this study, emotions are understood as complex responses involving psychological, physiological, and behavioral components, triggered by significant events or situations [ 21 ]. Resources are understood as physical, psychological, social, or organizational aspects of the work that help achieve work goals, reduce demands and associated costs [ 22 ].

Materials and methods

This qualitative study utilized reflective essay material written in the fall of 2020 by experienced, advanced-level paramedics who worked in the Finnish EMS during the early phase of the pandemic, when Finland had declared (March 17, 2020 onward) a state of emergency and implemented the Emergency Powers Act. This allowed for new rules and guidelines from the government to ensure the security of healthcare resources. Some work rules for healthcare personnel changed, and non-urgent services were limited.

Data collection procedures

This study is part of a broader, non-project-based research initiative investigating the work well-being of paramedics from various perspectives, and the data was collected for research purposes from this standpoint. The data collection for this study was conducted at the South-Eastern Finland University of Applied Sciences as part of the Current Issues in EMS Management course. The course participants were experienced, advanced-level Finnish paramedics who were students of the master’s degree program in Development and Management of Emergency Medical Services. A similar data collection method has been utilized in other qualitative studies [for example, 23 , 24 ].

The South-Eastern Finland University of Applied Sciences granted research permission for the data collection on August 20, 2020. The learning platform “Learn” (an adapted version of Moodle [ 25 ]) was used to gather the data. A research notice, privacy statement, and essay writing instructions were published on the platform on August 21, 2020. The paramedics were asked to write about their own experiences and observations regarding how the state of emergency impacted the work well-being of EMS personnel. They were instructed not to use references but only their own reflections. Three guiding questions were asked: “What kind of workloads did EMS personnel experience during the state of emergency?” “How has this workload differed from normal conditions?” and “What effects did this workload have on the well-being of the EMS personnel?”. The assignment did not refer solely to paramedics because the EMS field community may also include individuals with other titles (such as EMS field supervisors or firefighters performing prehospital emergency care); hence the term “EMS personnel” was used.

The essay was part of the mandatory course assignments, but submitting it for research purposes was voluntary. The paramedics were informed that their participation in the study would not affect their course evaluations. They had the freedom to decline, remove parts of, or withdraw the essay before analysis. None of the paramedics exercised these options. They were also informed that the last author removes any identifying details (such as names, places, and organizational descriptions that could reveal their workplace) before sharing the data with other, at the time unnamed, researchers. The last author (female) is a senior researcher specializing in EMS and work well-being topics, a principal lecturer of the respective course, and the head of the respective master’s program, and familiar to all of them through their studies. The paramedics were aware that the essays were graded by the last author on a pass/fail scale as part of the course assessment. However, comprehensive and well-reasoned reflections positively influenced the course grade. The evaluation was not part of this study. The paramedics had the opportunity to ask further questions about the study directly from the last author during and after the essay writing process and the course.

The paramedics wrote the essays between August 23, 2020, and November 30, 2020. Thirty-two paramedics (out of 39) returned their essays using the Learn platform during this timeframe. Thus, seven of the course completions were delayed, and the essays written later were no longer appropriate to include in the data due to the time elapsed since the initial months of the COVID-19 pandemic.

All 32 gave their informed consent for their essays to be included in the study. Essays written by paramedics who had not actively participated in EMS field work during exceptional circumstances were excluded from the material ( n  = 2), because they wrote the essay from a different perspective, as they could not reflect on their own experiences and observations. Thus, a total of 30 essays were included in the study. The total material was 106 pages long and comprised 32,621 words in Finnish.

Study participants

Thirty advanced-level paramedics from Finland participated in this study. They all had a bachelor’s degree in emergency care or nursing with additional emergency care specialization. At the time of the study, they were pursuing their master’s studies. Thirteen of them were women, and seventeen were men. The average age of the participants was 33.5 years among women and 35.9 years among men. Women had an average of 8.7 years of work experience, and men had 8.8 years. All the participating paramedics worked in EMS in different areas across Finland (except northern Finland) during their studies and the early phase of the pandemic.

Data analysis

The data was analyzed with a thematic analysis following the process detailed by Braun & Clarke [ 26 ]. First, the two researchers thoroughly familiarized themselves with the data, and the refined aim and research questions of the study were formulated inductively in collaboration based on the content of the data (see [ 26 ], page 84). After this, a thorough coding process was mainly carried out by the first author (female), who holds a master’s degree, is an advanced-level paramedic who worked in EMS during the pandemic, and at the time of the analysis was pursuing her doctoral studies in a different subject area related to EMS. Generating the initial codes involved making notes of interesting features of anything that stood out or seemed relevant to the research question systematically across the entire dataset. During this process, the original paragraphs and sentences were copied from the essay material into a table in Microsoft Word, with each research question in separate documents and each paragraph or sentence in its own row. The content of these data extracts was then coded in the adjacent column, carefully preserving the original content but in a more concise form. Then, the content was analyzed, and codes were combined to identify themes. After that, the authors reviewed the themes together by moving back and forth between the original material, the data in the Word documents, and the potential themes. During this process, the authors worked closely and refined the themes, allowing them to be separated and combined into new themes. For example, emotions depicting frustration and a shift to indifference formed their own theme in this kind of process. Finally, the themes were defined into main, major and minor themes and named. In the results, the main themes form the core in response to the research questions and include the most descriptions from the data. The major themes are significant but not as central as the main themes. Major themes provide additional depth and context to the results. One minor theme was formed as the analysis process progressed, and it provided valuable insights and details that deepened the response to the research question. All the coded data was utilized in the formed themes. The full content of the themes is reported in the Results section.

The emotions experienced by the EMS personnel in their new working circumstances formed three themes: New concerns arose that were constantly present (main theme); Surviving without proper guidance (major theme); and Rapidly approaching breaking point (major theme) (Fig.  1 ). Work-related factors identified as resources for the well-being of EMS personnel formed three themes: A high level of organizational efficiency was achieved (main theme); Adaptable EMS operations (major theme); and Encouraging atmosphere (minor theme) (Fig.  2 ).

Emotions experienced by the EMS personnel in their new working circumstances

Main theme: New concerns arose that were constantly present

The main theme included several kinds of new concerns. In the beginning, the uncertainty about the virus raised concerns about work safety and the means to prevent the spread of the disease. The initial lack of training and routines led to uncertainty. In addition, the decrease in the number of EMS missions raised fears of units being reduced and unilateral decisions by the management to change the EMS personnel’s work responsibilities. The future was also a source of uncertainty in the early stages. For example, the transition to exceptional circumstances, concerns about management and the supervisors’ familiarity with national guidelines and lack of information related to sickness absence procedures, leave, personal career progression, and even the progress of vaccine development, all contributed to this feeling of uncertainty. The initial uncertainty was described as the most challenging phase, but the uncertainty was also described as long-lasting.

Being on the front line with an unknown, potentially dangerous, and easily transmissible virus caused daily concerns about the personnel’s own health, especially when some patients hid their symptoms. The thought of working without proper PPE was frightening. On the other hand, waiting for a patient’s test result was stressful, as it often resulted in many colleagues being quarantined. A constant concern for the health of loved ones and the fear of contracting the virus and unknowingly bringing it home or transmitting it to colleagues led the EMS personnel to change their behavior by limiting contact.

Being part of a high-risk group , I often wondered , in the case of coronavirus , who would protect me and other paramedics from human vanity and selfishness [of those refusing to follow the public health guidelines]? (Participant 25)

The EMS personnel felt a weight of responsibility to act correctly, especially from the perspective of keeping their skills up to date. The proper selection of PPE and aseptic procedures were significant sources of concern, as making mistakes was feared to lead to quarantine and increase their colleagues’ workloads. At the same time, concerns about the adequacy of PPE weighed on the personnel, and they felt pressure on this matter to avoid wastage of PPEs. The variability in the quality of PPE also caused concerns.

Concerns about acting correctly were also tied to ethical considerations and feelings of inadequacy when the personnel were unable to explain to patients why COVID-19 caused restrictions on healthcare services. The presence of students also provoked such ethical concerns. Recognizing patients’ symptoms correctly also felt distressing due to the immense responsibility. This concern was also closely tied to fear and even made some question their career choices. The EMS personnel were also worried about adequate treatment for the patients and sometimes felt that the patients were left alone at home to cope. A reduction in patient numbers in the early stages of the pandemic raised concerns about whether acutely ill individuals were seeking help. At the same time, the time taken to put on PPE stressed the personnel because it increased delays in providing care. In the early phase of the pandemic, the EMS personnel were stressed that patients were not protected from them.

I’m vexed in the workplace. I felt it was immediately necessary to protect patients from us paramedics as well. It wasn’t specifically called for , mostly it felt like everyone had a strong need to protect themselves. (Participant 30)

All these concerns caused a particularly heavy psychological burden on some personnel. They described feeling more fatigued and irritable than usual. They had to familiarize themselves with new guidelines even during their free time, which was exhausting. The situation felt unjust, and there was a looming fear of the entire healthcare system collapsing. COVID-19 was omnipresent. Even at the base station of the EMS services, movement was restricted and social distancing was mandated. Such segregation, even within the professional community, added to the strain and reduced opportunities for peer support. The EMS personnel felt isolated, and thoughts about changing professions increased.

It was inevitable that the segregation of the work community would affect the community spirit , and a less able work community has a significant impact on the individual level. (Participant 8)

Major theme: Surviving without proper guidance

At the onset of the pandemic, the job description of the EMS personnel underwent changes, and employers could suddenly relocate them to other work. There was not always adequate support for familiarizing oneself with the new roles, leading to a feeling of loss of control. The management was described as commanding and restricting the personnel’s actions. As opportunities to influence one’s work diminished, the sense of job satisfaction and motivation decreased.

Some felt that leadership was inadequate and neglectful, especially when the leaders switched to remote work. The management did not take the situation seriously enough, leaving the EMS personnel feeling abandoned. The lack of consistent leadership and failure to listen to the personnel caused dissatisfaction and reduced occupational endurance. In addition, the reduced contact with colleagues and close ones reduced the amount of peer support. The existing models for psychological support were found to be inadequate.

Particularly in the early stages, guidelines were seen as ambiguous and deficient, causing frustration, irritation, and fear. The guidelines also changed constantly, even daily, and it was felt that the information did not flow properly from the management to the personnel. Changes in protection recommendations also led to skepticism about the correctness of the national guidance, and the lack of consistent guidelines perplexed the personnel. Internalizing the guidelines was not supported adequately, but the necessity to grasp new information was described as immense and cognitively demanding.

At times , it felt like the work was a kind of survival in a jungle of changing instructions , one mission at a time. (Participant 11)

Major theme: Rapidly approaching breaking point

Risking one’s own health at work caused contentious feelings while concurrently feeling angry that management could work remotely. The arrogant behavior of people toward COVID-19 left them frustrated, while the EMS personnel had to limit their contacts and lost their annual leave. There were fears about forced labor.

Incomplete and constantly changing guidelines caused irritation and indifference, as the same tasks had to be performed with different levels of PPE within a short time. Some guidelines were difficult to comply with in practice, which was vexing.

Using a protective mask was described as distressing, especially on long and demanding missions. Communication and operation became more difficult. Some described frustration with cleaning PPE meant for single use.

Ensuring the proper implementation of a work pair’s aseptic and equipment maintenance was burdensome, and explaining and repeating guidelines was exhausting. A feeling of indifference was emphasized toward the end of a long shift.

After the initial stage, many began to slip with the PPE guidelines and found the instructions excessive. COVID-19 information transmitted by the emergency center lost its meaning, and instructions were left unheeded, as there was no energy to believe that the patient would have COVID-19, especially if only a few disease cases had been reported in their area.

It was disheartening to hear personnel being labeled as selfish for demanding higher pay during exceptional circumstances. This lack of recognition eroded professionalism and increased thoughts of changing professions.

However , being a doormat and a human toilet , as well as a lack of appreciation , undermines my professionalism and the prolonged situation has led me to seriously consider a different job , where values other than dedication and constant flexibility carry weight. I have heard similar thoughts from other colleagues. None of us do this for money. (Participant 9)

Work-related factors identified as resources for the well-being of EMS personnel

Main theme: A high level of organizational efficiency was achieved

The main theme held several different efficient functions. In the early stages of the pandemic, some felt that the information flow was active. Organizations informed the EMS personnel about the disease, its spread, and its impact on the workplace and emergency care activities.

Some felt that managers were easily accessible during the pandemic, at least remotely. Some managers worked long days to be able to support their personnel.

The response to hate and uncertainty was that one of the supervisors was always present in the morning and evening meetings. Supervisors worked long hours so as to be accessible via remote access. (Participant 26)

The organizations took effective steps to control infections. Quick access to COVID-19 tests, clear guidelines for taking sick leave, and permission to take sick leave with a low threshold were seen as positive things. The consideration of personnel belonging to risk groups by moving them to other work tasks was also perceived as positive. In addition, efforts were made to prevent the emergence of infection chains by isolating EMS personnel in their own social facilities.

Established guidelines, especially on the correct use of protective measures, made it easier to work. Some mentioned that the guidelines were available in ambulances and on phones, allowing the protection guidelines to be checked before going on a mission.

The employers took into account the need for psychological support in a diverse manner. Some organizations provided psychological support such as peer debriefing activities, talking therapy with mental health professionals, actively inquiring about their personnel’s feelings, and training them as support workers. The pandemic situation also caused organizations to create their own standard operating models to decrease mental load.

Fortunately , the problem has now been addressed actively , as a peer-to-peer defusing model was built up at our workplace during the crisis , and group defusing has started , the purpose of which is to lighten the work-related mental load. (Participant 3)

Major theme: Adaptable EMS operations

There were several different resources that clarified mission activities. The amount of protective and cleaning equipment was ramped up, and the treatment equipment was quickly updated to meet the demands brought about by the pandemic and to enable safety distances for the EMS personnel. In addition, various guidelines were amended to reduce exposure. For example, personnel on the dedicated COVID-19 ambulances were separated to work without physical contact with others, and field supervisors joined the EMS missions less often than before. Moreover, people at the scene were contacted by phone in advance to ensure that there would be no exposure risk, which also allowed other occupational safety risks to be identified. New practices resulted from the pandemic, such as cleaning communication equipment during shift changes and regularly using PPE with infected patients. All of these were seen as positive resources for efficient work.

At the end of each shift , all keys , telephones , etc., were cleaned and handed over to the next shift. This practice was not previously established in our area , but this will become a permanent practice in the future and is perceived by everyone in our work community as a positive thing. (Participant 10)

Some stated that access to PPE was sufficient, especially in areas where the number of COVID-19 infections was low. PPE was upgraded to make it easier to wear. Further, organizations acquired a variety of cleaning equipment to speed up the disinfection of ambulances.

Organizations hired more employees to enable leave and the operation of dedicated COVID-19 ambulances. The overall number of ambulances was also increased. Non-urgent missions were handled through enhanced phone services, reducing the unnecessary exposure of EMS personnel to COVID-19.

Five extra holiday substitutes were hired for EMS so that the employer could guarantee the success of agreed leave , even if the Emergency Preparedness Act had given them opportunities to cancel or postpone it. (Participant 12)

Minor theme: Encouraging atmosphere

Peer support from colleagues, a positive, comfortable, pleasant work environment, and open discussion, as well as smooth cooperation with other healthcare employees were felt to be resources for work well-being by reducing the heavy workload experienced. Due to the pandemic, the appreciation of healthcare was felt to increase slightly, which was identified as a resource.

One factor affecting resilience in the healthcare sector is certainly that in exceptional circumstances , visibility and appreciation have somewhat increased. (Participant 23)

This study examined, according to the experiences and observations of paramedics, (1) what kinds of emotions the Emergency Medical Service (EMS) personnel experienced in their new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic. Each research question was answered with three themes.

Previous studies have shown that the pandemic increased the workload of paramedics, prompting changes in their operating models and the function of EMS to align with new pandemic-related requirements [ 9 , 27 ]. Initially, the paramedics in the current study described facing unclear and deficient guidelines and feeling obligated to follow instructions without adequate support to internalize them. Constantly changing instructions were linked to negative emotions in various ways. Moreover, the overwhelming flood of information was heavily connected to this, although the information flow was also perceived as a resource, especially when it was timely and well-structured. The study by Sangal et al. [ 15 ] has raised similar observations and points out the importance of paying special attention to the personnel working in the frontline, as in EMS, who might be more heavily impacted by too much information and anxiety about it. They also discovered that three factors are crucial for addressing the challenges of information overload and anxiety: consolidating information before distributing it, maintaining consistent communication, and ensuring communication is two-way. McAlearney et al. [ 11 ] found that first responders, including EMS personnel, reported frustration regarding COVID-19 information because of inconsistencies between sources, misinformation on social media, and the impact of politics. A Finnish study also recognized that health systems were not sufficiently prepared for the flood of information in the current media environment [ 12 ]. Based on these previous results and our findings, it can be concluded that proper implementation of crisis communication should be an integral part of organizations’ preparedness in the future, ensuring that communication effectively supports employee actions in real-life situations. Secondly, this topic highlights the need for precise guidelines and their implementation. With better preparedness, similar chaos could be avoided in the future [ 17 ].

Many other factors also caused changes in work. The EMS mission profile changed [ 3 , 4 , 5 , 6 ], where paramedics in this study saw concerns. To prevent infection risk, the number of pre-arrival calls increased [ 7 ], the duration of EMS missions increased [ 8 , 9 ], and the continuous use of PPE and enhanced hygiene standards imposed additional burdens [ 9 , 10 ]. In Finland, there was no preparedness for the levels of PPE usage required in the early stages of the pandemic [ 12 ]. In this study, paramedics described that working with potentially inadequate PPE caused fear and frustration, which was increased by a lack of training, causing them to feel a great deal of responsibility for acting aseptically and caring for patients correctly. Conversely, providing adequate PPE, information and training has been found to increase the willingness to work [ 28 ] and the sense of safety in working in a pandemic situation [ 29 ], meaning that the role of precise training, operating instructions and leadership in the use of PPE is emphasized [ 30 ].

The paramedics in this study described many additional new concerns in their work, affecting their lives comprehensively. It has been similarly described that the pandemic adversely affected the overall well-being of healthcare personnel [ 31 ]. The restrictions implemented also impacted their leisure time [ 32 ], and the virus caused concerns for their own and their families’ health [ 11 , 28 ]. In line with this, the pandemic increased stress, burnout [ 10 , 33 ], and anxiety among EMS personnel and other healthcare personnel working on the frontline [ 11 , 14 , 34 , 35 ]. These kinds of results underscore the need for adequate guidance and support, a lack of which paramedics reported experiencing in the current study.

Personnel play a crucial role in the efficient operation of an organization and comprise the main identified resource in this study. Previous studies and summaries have highlighted that EMS personnel did not receive sufficient support during the COVID-19 pandemic [ 11 , 14 , 17 , 18 ]. Research has also brought to light elements of adequate support related to the pandemic, such as a review by Dickson et al. [ 16 ] that presents six tentative theories for healthful leadership, all of which are intertwined with genuine encounter, preparedness, and information use. In this current study, the results showed numerous factors related to these contexts that were identified as resources, specifically underlined by elements of caring, effective operational change, knowledge-based actions, and present leadership, similarly described in a study by Eaton-Williams & Williams [ 18 ]. Moreover, the paramedics in our study highlighted the importance of encouragement and identified peer support from colleagues as a resource, which is in line with studies in the UK and Finland [ 12 , 23 , 37 ].

In the early stages of the pandemic, it was noted that the EMS personnel lacked adequate training to manage their mental health, and there was a significant shortage of psychosocial support measures [ 14 ], although easy access to support would have been significant [ 18 ]. In the current study, some paramedics felt that mental health support was inadequate and delayed, while others observed an increase in mental health support during the pandemic, seeing it as an incentive for organizations to develop standard operating models for mental support, for example. This awakening was identified as a resource. This is consistent, as providing psychological support to personnel has been highlighted as a core aspect of crisis management in a Finnish study assessing health system resilience related to COVID-19 [ 12 ]. In a comprehensive recommendation commentary, Isakov et al. [ 17 ] suggest developing a national strategy to improve resilience by addressing the mental health consequences of COVID-19 and other occupational stressors for EMS personnel. This concept, applicable beyond the US, supports the view that EMS organizations are becoming increasingly aware of the need to prepare for and invest in this area.

A fundamental factor likely underlying all the described emotions was that changes in the job descriptions of the EMS personnel due to the pandemic were significant and, in part, mandated from above. In this study, paramedics described feelings of concern and frustration related to these many changes and uncertainties. According to Zamoum and Gorpe (2018), efficient crisis management emphasizes the importance of respecting emotions, recognizing rights, and making appropriate decisions. Restoring trust is a significant challenge in a crisis situation, one that cannot be resolved without complete transparency and open communication [ 38 ]. This perspective is crucial to consider in planning for future preparedness. Overall, the perspective of employee rights and obligations in exceptional circumstances has been relatively under-researched, but in Australia, grounding research on this perspective has been conducted with paramedics using various approaches [ 39 , 40 , 41 ]. The researchers conclude that there is a lack of clarity about the concept of professional obligation, specifically regarding its boundaries, and the issue urgently needs to be addressed by developing clear guidelines that outline the obligation to respond, both in normal day-to-day operations and during exceptional circumstances [ 39 ].

Complex adaptive systems (CAS) theory recognizes that in a resilient organization, different levels adapt to changing environments [ 19 , 20 ]. Barasa et al. (2018) note that planned resilience and adaptive resilience are both important [ 19 ]. Kihlström et al. (2022) note that the health system’s resilience was strengthened by a certain expectation of crisis, and they also recognized further study needs on how effectively management is responding to weak signals [ 12 ]. This could be directly related to how personnel can prepare for future changes. The results of this study revealed many negative emotions related to sudden changes, but at the same time, effective organizational adaptation was identified as a resource for the well-being of EMS personnel. Dissecting different elements of system adaptation in a crisis has been recognized as a highly necessary area for further research [ 20 ]. Kihlström et al. (2022) emphasize the importance of ensuring a healthy workforce across the entire health system. These frameworks suggest numerous potential areas for future research, which would also enhance effective preparedness [ 12 ].

Limitations of the study

In this study, we utilized essay material written in the fall of 2020, in which experienced paramedics reflected on the early stages of the COVID-19 pandemic from a work-oriented perspective. The essays were approached inductively, meaning that they were not directly written to answer our research questions, but the aim and the research questions were shaped based on the content [ 26 ]. The essays included extensive descriptions that aligned well with the aim of this study. However, it is important to remember when interpreting the results that asking specifically about this topic, for instance, in an interview, might have yielded different descriptions. It can be assessed that the study achieved a tentative descriptive level, as the detailed examination of complex phenomena such as emotions and resources would require various methods and observations.

Although the essays were mostly profound, well-thought-out, and clearly written, their credibility [ 42 ] may be affected by the fact that several months had passed between the time the essays were written and the events described. Memories may have altered, potentially influencing the content of the writings. Diary-like material from the very onset of the pandemic might have yielded more precise data, and such a data collection method could be considered in future research on exceptional circumstances.

The credibility [ 42 ] could also have been enhanced if the paramedics who wrote the essays had commented on the results and provided additional perspectives on the material and analysis through a multi-phase data collection process. This was not deemed feasible in this study, mainly because there was a 2.5-year gap between data collection and the start of the analysis. However, this also strengthened the overall trustworthiness of the study, as it allowed the first author, who had worked in prehospital emergency care during the initial phase of the pandemic, to maintain a distance from the subject, and enabled a comparison of our own findings with previously published research that investigated the same period in different contexts. The comparison was made when writing the discussion, with the analysis itself being inductive and following the thematic analysis process described by Braun & Clarke [ 26 ].

When evaluating credibility [ 42 ], it should also be noted that the participants who wrote the essays, i.e., the data for the study, were experienced paramedics but also students and one of the researchers was their principal lecturer. This could potentially limit credibility if the students, for some reason, did not want to produce truthful content for their lecturer to read. However, this risk can be considered small because the essays’ topics did not concern the students’ academic progress, the essays’ content was quite consistent, and the results aligned with other studies. As a strength, it can be considered that the students shared their experiences without holding back, as the thoughts were not for workplace use, and they could trust the data privacy statement.

To enhance transferability [ 42 ], the context of the study was described in detail, highlighting the conditions prevailing in Finnish prehospital emergency care during the early stages of the pandemic. Moreover, including a diverse range of perspectives from paramedics working in different regions of Finland (except Northern Finland) contributes to the transferability of the study, indicating that the results may be applicable and relevant to a wider context beyond a single specific region.

Dependability [ 42 ] was reinforced by the close involvement of two researchers from different backgrounds in the analysis of the material, but a limitation is that no separate analyses were conducted. However, the original data was repeatedly revisited during the analysis, which strengthened the dependability. Moreover, the first author kept detailed notes throughout the analysis process, and the last author supervised the progress while also contributing to the analysis and reporting. The research process is also reported in detail.

This study highlighted numerous, mainly negative emotions experienced by EMS personnel during the initial months of the COVID-19 pandemic due to new working circumstances. At the same time, several work-related factors were identified as resources for their well-being. The findings suggest that crisis management practices should be more attentive to personnel needs, ensuring that personnel have the necessary support, both managerial and psychological, readily available in crisis situations. Effective organizational adaptation in a crisis situation also supports personnel well-being, emphasizing the importance of effective preparedness. Future research should particularly focus on considering personnel well-being as part of organizational adaptation during exceptional circumstances and utilize these findings to enhance preparedness.

Data availability

The datasets generated and analyzed during the current study are not publicly available due to the inclusion of sensitive information and the extent of the informed consent provided by the participants.

Abbreviations

Complex Adaptive Systems (theory)

Coronavirus Disease 2019

Emergency Medical Services

Personal Protective Equipment

United Kingdom

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We want to sincerely thank all the paramedics who participated in this study.

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Henna Myrskykari

Emergency Medical Services, University of Turku and Turku University Hospital, Turku, Finland

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Study design (HM, HN). Data collection (HN). Methodology (HN). Analysis (HM, HN). Writing (HM, HN). Review and editing (HM, HN). Supervision (HN). Both authors read and approved the final manuscript.

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The study followed the good scientific practice defined by the Finnish National Board on Research Integrity TENK [ 43 ]. The study was conducted in accordance with the Helsinki Declaration and applicable national guidelines. Adhering to the Finnish National Board on Research Integrity (TENK) guidelines on ethical principles of research with human participants and ethical review in the human sciences in Finland, an ethical review statement from a human sciences ethics committee was not required for this type of study. The participants consisted of adult students engaged in regular employment. Their involvement in the research was grounded on informed consent. The study did not involve concerns regarding the participants’ physical integrity, nor were they subjected to exceptionally strong stimuli. The potential for causing mental harm was not beyond what is typically encountered in everyday life, and their participation did not pose any safety risks [ 44 ].

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Myrskykari, H., Nordquist, H. Paramedics’ experiences and observations: work-related emotions and well-being resources during the initial months of the COVID-19 pandemic—a qualitative study. BMC Emerg Med 24 , 152 (2024). https://doi.org/10.1186/s12873-024-01072-0

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DOI : https://doi.org/10.1186/s12873-024-01072-0

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When Your Child Is an Animal

The charged cultural conversation about pets and children — see “Chimp Crazy,” “childless cat ladies” and more — reveals the hidden contradictions of family life.

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By Amanda Hess

Amanda Hess is a critic at large who writes about internet and pop culture.

“Monkey love is totally different than the way that you have love for your child,” Tonia Haddix, an exotic animal broker, says at the beginning of “Chimp Crazy,” the documentary HBO series investigating the world of chimpanzee ownership. “If it’s your natural born child, it’s just natural because you actually gave birth to that kid. But when you adopt a monkey, the bond is much, much deeper.”

“Chimp Crazy” arrives in a summer of cultural and political obsession about the place of animals in our family lives. When JD Vance became the Republican vice-presidential nominee, his 2021 comment about “childless cat ladies” resurfaced, positioning them as adversaries of the traditional family. New York magazine published a special issue questioning the ethics of pet ownership, featuring a polarizing essay from an anonymous mother who neglected her cat once her human baby arrived. In the background of these stories, you can hear the echoes of an internet-wide argument that pits companion animals against human children, pet and tot forced into a psychic battle for adult recognition.

These dynamics feel supercharged since 2020, the year when American family life — that insular institution that is expected to provide for all human care needs — became positively airtight. The coronavirus pandemic exaggerated a wider trend toward domestic isolation : pet owners spending more time with their animals, parents more time with their children, everyone less time with one another — except perhaps online, where our domestic scenes collide in a theater of grievance and stress.

When a cat, a dog or certainly a chimp scampers through a family story, it knocks it off-kilter, revealing its hypocrisies and its harms. In “Chimp Crazy,” Haddix emerges as the avatar for all the contradictions of the domestic ideal of private home care: She loves her chimp “babies” with such obsession that she traps them (and herself) in a miserable diorama of family life.

Haddix, a 50-something woman who describes herself as the “Dolly Parton of Chimps,” believes that God chose her to be a caretaker. She was a registered nurse before she became a live-in volunteer at a ramshackle chimp breeding facility in Missouri, where she speaks of a male chimp named Tonka as if she is his mother. Haddix also has two human children; she just loves them less, and says so on television.

As she appoints herself the parent to an imprisoned wild animal, she asserts an idealized form of mothering — one she describes as selfless, unending and pure. “Chimp Crazy” is the story of just how ruinous this idea of love can be, for the woman and the ape.

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