COVID-19: the first 100 days

I have begun work on my new book to be published by Routledge, entitled COVID Societies: Theorising the Coronavirus Crisis. Part of the Introduction chapter will present an overview of the emergence of the COVID-19 pandemic over its first one hundred days. Things moved very quickly over that time. Here is an except from this chapter outlining key events during this period.

Sign outside an Australian shop, April 2020

The time elapsing from the first reporting of a cluster of cases of a new respiratory disease that was later to be named ‘COVID-19’ to the first million confirmed cases worldwide was slightly less than one hundred days. The World Health Organization (WHO) has published a timeline of how events unfolded from the very beginning of the first observation of a cluster of unusual cases of atypical pneumonia in the Chinese city of Wuhan, Hubei province (World Health Organization, 2020). The Independent Panel for Pandemic Preparedness & Response (2021) also put together a chronological account of the events unfolding between late 2019 and the end of March 2020, by which time the virus had spread extensively around the world. The Panel concluded that these months were characterised by some evidence of early and rapid action by nations and global health authorities. However, delay, hesitation to act decisively and denial of the threat were also prevalent in their responses. The events and developments outlined below in these first one hundred days of the COVID crisis are synthesised from these two valuable chronologies.

On 30 December 2019, the first cases of ‘atypical viral pneumonia of unknown cause’ who had been admitted to hospitals in Wuhan were reported in two urgent notices to hospital networks in the city by officials from the Wuhan Municipal Health Commission. Wuhan clinicians noted that several of these atypical pneumonia patients had visited the same ‘wet market’ in the city selling live sea creatures and other animals for human consumption, suggesting it was a key source of transmission. On 31 December, a Chinese business publication published a report about one of these notices, which in turn was picked up by several disease surveillance systems operating in the region. WHO’s Headquarters office in Geneva was alerted to the report. Later that day, the Wuhan Municipal Health Commission sent out a bulletin for public notice, reporting that 27 cases of this disease had been identified. By the end of December, it seemed likely from the epidemiology of these Wuhan cases that human-to-human transmission of this as yet un-identified and unnamed pathogen was likely.

The WHO Country Office in China requested further information from the Wuhan officials on 1 January 2020, activating its Incident Management Support Team as part of its emergency response framework. By 2 January, the Wuhan Institute of Virology had sequenced almost the entire genome of the novel virus. There were 44 reported cases by 3 January. WHO released a tweet about this Wuhan pneumonia cluster (which had not yet caused any deaths) on 4 January, noting the investigations to determine the cause were underway. It released its first Disease Outbreak News report on 5 January about these cases. All countries were warned to take precautions against the spread of this new virus. On 9 January, Chinese authorities had determined that the pathogen was a novel coronavirus, similar to a previous virus (SARS-CoV) that had caused SARS disease (Severe Acute Respiratory Syndrome) in a previous outbreak between 2003 and 2007. Chinese scientists had developed a first test for the virus by 10 January.

The first death from infection with the novel coronavirus was reported by the China media on 11 January. The first case outside China was reported in Thailand on 13 January and a second case in Japan on 16 January: both cases had travelled from Wuhan. Chinese health experts publicly confirmed on 20 January that the virus was transmissible between humans and that healthcare workers had become infected. Wuhan officials had instituted a city-wide lockdown on 23 January in the attempt to control the spread. At this point in the outbreak, 830 cases and 25 deaths had been reported. The first case outside Asia was recorded in the USA on 21 January and the first European cases (a total of three) were reported by France on 24 January.

WHO’s first mission to Wuhan to investigate the outbreak took place on 20-21 January. It declared a ‘public health emergency of international concern’ on 30 January, its highest level of alarm. At this point in the outbreak, the novel coronavirus had begun to spread quickly around the world. A total of 98 cases had been detected in 18 countries. By 4 February, over 20 000 confirmed cases and 425 deaths had been reported in China, and 176 cases in 24 other countries. On 11 February, WHO announced that the novel coronavirus would be named SARS-CoV-2 and the disease it caused as COVID-19 (a contraction of ‘coronavirus disease 2019’). This naming followed best practice, which avoids linking titles of new microbes or diseases to specific regions, nationalities, individuals or animals because of the possibility of inaccuracy or stigma.

By 7 March, over 100 000 confirmed cases of COVID-19 had been reported globally. The outbreak was officially declared as a pandemic by WHO on 11 March 2020, when reported cases globally had reached over 118 000 across 114 countries. By 13 March, Europe had become the epicentre of the pandemic, with more reported cases and deaths than the rest of the world combined, apart from China. By 4 April, almost 100 days after the first Wuhan cases having been reported, WHO reported that over 1 million confirmed cases had been reported worldwide, with the pace of infection rapidly increasing.

Even at that stage, many countries’ governments worldwide had not yet taken decisive action to contain the spread of the virus. WHO’s declaration on 30 January of a ‘public health emergency of international concern’ was largely ignored. Only a minority of countries began comprehensive prevention and response strategies. Many countries did very little throughout the month of February, even while cases were rapidly spreading and climbing globally. Most governments either did not appreciate the seriousness of the threat posed by COVID-19 or wanted to take a ‘wait-and-see’ approach rather than implement significant action. Due to their previous experiences with the SARS pandemic, several eastern and south-eastern Asian countries were among the earlier responders, while African countries who had been through the Ebola threat also learned from this and put measures into place quickly. Many other countries did not spring into action until they noted the exponential rise in cases and rapid spread of the virus. Serious actions that could have contained such a huge expansion in cases and deaths were implemented too late.

References

The Independent Panel for Pandemic Preparedness & Response. (2021). COVID-19: Make It The Last Pandemic. https://theindependentpanel.org/wp-content/uploads/2021/05/COVID-19-Make-it-the-Last-Pandemic_final.pdf

World Health Organization. (2020). Timeline: WHO’s COVID-19 response. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline?gclid=CjwKCAiA17P9BRB2EiwAMvwNyGWSa7LCiCAgb9r1TIgGmjmcYnZzOj7_zVA80ZeeVZyUsfqM35BvrhoCofQQAvD_BwE#event-7

COVID society – some resources I have put together for social researchers

 

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Over the past fortnight, I’ve put together a few open-access resources concerning what an initial agenda for COVID-related social research could be and research methods for conducting fieldwork in the COVID world.

Links are below:

Doing Fieldwork in a Pandemic (Google Doc crowd-sourced resource)

Social Research for a COVID and post-COVID World: An Initial Agenda (blog post)

Conducting Qualitative Fieldwork During COVID-19 (PowerPoint slides) (Webinar presentation with voice and slides)

 

Photo credit: Daniel Tafjord on Unsplash

 

Call for abstracts – special section on ‘Sociology and the Coronavirus (COVID-19) Pandemic’

For those people who feel they might like to contribute their expertise and insights, please see this call for papers for a special section of Health Sociology Review I am editing on sociology and the coronavirus. This is a fast-tracked process designed to get important insights out as quickly as possible.

Health Sociology Review Special Section – Sociology and the Coronavirus (COVID-19) Pandemic

Call for abstracts

The current pandemic is unprecedented in modern times. In view of this, Health Sociology Review (HSR) (Q1 journal) has asked Professor Deborah Lupton to guest edit a special section of a forthcoming issue of the journal on Sociology and the Coronavirus (COVID-19) Pandemic. The emergence of this new virus and its rapid transformation from an epidemic localised to the Chinese city of Wuhan late in 2019 to a pandemic affecting the rest of the world by March 2020 has caused massive disruptions affecting everyday lives, freedom of movement, workplaces, educational institutions, leisure activities and other aspects of social relations across the globe. Many societies have been suddenly faced with the challenge of limiting the spread of the virus to prevent over-load on the healthcare system, often involving significant societal changes such as social isolation measures and travel bans.

In response to these widespread and dramatic changes, HSR will provide a forum for sociological commentary, with a rapid paper submission and review process to ensure that papers are available as quickly as possible. Submissions to this special section are invited. All intending contributors will need to submit an abstract to Professor Lupton to be considered. If they are given the go-ahead, contributors will need to meet the timeline for submission. All full submissions will be peer-reviewed via the usual reviewing processes of the journal and submission does not guarantee publication.

Length and style of submissions and timeframes for this special section have been designed to facilitate rapid review and publication. All accepted pieces will be published online first as soon as they are finalised for publication and then collected in the special section in an issue of HSR, accompanied by a short introduction authored by Lupton.

Pieces need not be standard sociological articles reporting on empirical findings. They can take a range of formats, including commentaries, theoretical/conceptual analyses, media or policy document analysis and autoethnographies.

All submissions must fit the following guidelines:

  • Must be no longer than 4,500 words in length (including abstract, references, tables, figures and endnotes).
  • Must address the social, cultural or political dimensions of the coronavirus pandemic, extending conceptual understanding of this crisis in health sociology.
  • Must make a clear contribution to sociological inquiry relevant to health, but may be informed by conceptual and empirical debates from a broader range of health and social sciences. All submissions must demonstrate methodological rigour, adherence to ethical research principles, and potential for contribution to knowledge in health, health care and wellbeing.
  • Must use the HSR citation style (TF-Standard APA).

To be considered for submission and review for this special section, please email an abstract of 250-300 words to Professor Lupton (d.lupton@unsw.edu.au) by 9 April.

Abstracts will be reviewed and by 17 April, a limited number will be selected to go forward for peer review for the special section. If selected to go forward, contributors must undertake to submit their piece for peer review by 15 May.

 

Digitised quarantine: a new form of health dataveillance

isolation

Most social analyses of the use of personal health data for dataveillance (watching and monitoring people using information gathered about them) have largely focused on people who engage in voluntary self-tracking to promote or manage their health and fitness. With the outbreak of COVID-19 (novel coronavirus), a new form of health dataveillance has emerged. I call it ‘digitised quarantine’.

Traditional quarantine measures, involving the physical isolation of people deemed to be infected with a contagious illness or those who have had close contact with infected people, have been employed for centuries as a disease control measure. Histories of medicine and public health outline that quarantine (from the Italian for ’40 days’ – often the length of the isolation period) was practised as early as the 14th century as a way of protecting people living in European coastal cities from the plague brought by visiting ships.

With the advent of COVID-19, quarantine has been actively used in many of the locations that have experienced large numbers of cases. Millions of people have already been placed in isolation. Quarantine measures have included self-isolation, involving people keeping themselves at home for the required 14-day period, as well as imposed isolation, such as requiring people to stay in dedicated quarantine stations, and large-scale travel bans and lock-downs of whole large cities. Quarantine began with lock-downs of Wuhan and nearby cities in the Chinese province of Hubei. At the time of writing, cases have been discovered in many other countries, often with identified hot-spots of contagion around identifiable places and regions, including a South Korean church, a north Italian region and a cruise ship docked in Japan.

Side-by-side with these centuries-old measures, in some locations, digital technologies and digital data analytics have been taken up as ways of monitoring people, identifying those who are infected and tracking their movements to ensure that they adhere to self-isolation restrictions for the length of the quarantine period. In China, people were prevented from leaving their homes if they had been identified as infected with COVID-19 by a digitised rating system on a phone app that coded them ‘red’. Chinese government agencies also released a ‘close contact detector’ app that alerted people if they had been in close proximity to someone infected with the virus. In some Chinese cities, local government authorities have brought in monitoring measures using facial recognition data and smartphone data tracking combined with information derived by requesting people to enter details about their health and travel history into online forms when visiting public places.

It is not only Chinese authorities who are experimenting with digitised forms of identifying infection risk and enforcing isolation. In the Australian city of Adelaide, two people identified as having COVID-19 were placed under voluntary home isolation, their movements monitored by the police using their smartphone metadata. It is notable that the police emphasised that this is the same dataveillance system used for tracking offenders in criminal investigations. As is the case with traditional quarantine measures, the freedoms and autonomy of those deemed to be infected or at risk of infection are in tension with public health goals to control epidemics.  The types of digitised monitoring of people’s movements using their smartphones or enforced notifications to complete online questionnaires are redolent of the measures that are used in the criminal justice system, where employing electronic monitoring technologies such as digital tracking bands has been a feature of controlling offenders’ movements once released from a custodial sentence.

These resonances with law enforcement should perhaps not be surprising, given that public health acts in many countries allow for the enforced isolation or even imposing significant fines or incarceration of people deemed to pose a risk to others because they are infectious or identified as being in a high-risk category of transmitting disease. There is a recent history of countries such as Singapore using technologies such as surveillance cameras and electronic tags for controlling the spread of SARS in 2003. These practices have been called into question by scholars interested in investigating the implications for human rights.

Since then, the opportunities to conduct close monitoring of people using their smartphones and online interactions have vastly expanded. The use of detailed data sets generated from diverse sources in these novel digitised quarantine measures leads to a range of new human rights challenges. Such monitoring may be viewed as a ‘soft’ form of policing infection, in which physical isolation measures are combined with dataveillance. However, underlying the apparent convenience offered by digitised quarantine are significant failures. One difficulty is the potential for the data sets and algorithmic processing used to calculate COVID-19 infection risk to be inaccurate, unfairly confining people to isolation and allowing them no opportunity to challenge the decision made by the app. Examples of such inaccuracies have already been reported by Chinese citizens subjected to these measures.  As one man claimed: “I felt I was at the mercy of big data,” … “I couldn’t go anywhere. There’s no one I could turn to for help, except answer bots.”

At a broader level, another problem raised by digitised quarantine measures is the ever-expanding reach into people’s private lives and movements by health authorities and other government agencies that they portend. This function creep requires sustained examination for its implications for human rights. The data-utopian visions promoted by those seeking to impose digitised quarantine may well lead to data hubris when their inaccuracies, biases and injustices are exposed.

Acknowledgement: Thanks to Trent Yarby for alerting me to two of the news stories upon which I drew for this post.