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Philosophical aspects of pandemics

Throughout human history, there have been a number of pandemics. The most devastating pandemic was the plague known as the Black Death, which killed about 200 million people in the 14th century, (Philipkoski 2015) and the 1918 flu pandemic (Spanish flu). (Centers for Disease Control and Prevention and Hajmirbaba 2020) Current pandemics include COVID-19 and HIV / AIDS.

The World Health Organization (WHO) has outlined the steps for the evolution of an influenza virus into a pandemic: (National Center for Biotechnology, Information, National Library of Medicine, and National Institutes of Healt 2020)

  1. Uncertain probability of pandemic
    1. Phase 1: Animal-to-animal infection only
    2. Phase 2: Animal-to-human infection (considered a human pandemic threat)
    3. Phase 3: Sporadic or grouped human cases (no sustained outbreaks at the community level)
  2. Medium to high probability – Phase 4 (sustained community outbreaks)
  3. High to certain probability – Phase 5 (sustained in two countries in a WHO region)
  4. Ongoing pandemic – Phase 6 (sustained in another WHO regions)
  5. Post-peak
    1. Peak (levels drop below peak in most countries)
    2. Possible new wave (activity increases again in most countries)
    3. Post-pandemic (levels return to normal seasonal levels)

Notes:

  • Phases 3-6 are “sustained”, involving human-to-human transmission.
  • After phase 6: the involved “countries” are the ones with “adequate surveillance”.
  • The WHO no longer officially uses the “pandemic” category. (Nebehay 2020)

Michel Foucault, in Discipline and Punish: The Birth of the Prison (Surveillance and Punishment, the Birth of Prison), (Michel Foucault 1975) describes the measures taken in the seventeenth century in a city, on the basis of an order, against the plague pandemic (Chapter 3. Panopticism):

“First, a strict spatial partitioning: the closing of the town and its outlying districts, a prohibition to leave the town on pain of death, the killing of all stray animals; the division of the town into distinct quarters, each governed by an intendant. Each street is placed under the authority of a syndic, who keeps it under surveillance; if he leaves the street, he will be condemned to death. On the appointed day, everyone is ordered to stay indoors: it is forbidden to leave on pain of death. The syndic himself comes to lock the door of each house from the outside; he takes the key with him and hands it over to the intendant of the quarter; the intendant keeps it until the end of the quarantine. Each family will have made its own provisions; but, for bread and wine, small wooden canals are set up between the street and the interior of the houses, thus allowing each person to receive his ration without communicating with the suppliers and other residents; meat, fish and herbs will be hoisted up into the houses with pulleys and baskets. If it is absolutely necessary to leave the house, it will be done in turn, avoiding any meeting. Only the intendants, syndics and guards will move about the streets and also, between the infected houses, from one corpse to another, the “crows”, who can be left to die: these are “people of little substance who carry the sick, bury the dead, clean and do many vile and abject offices”. It is a segmented, immobile, frozen space. Each individual is fixed in his place. And, if he moves, he does so at the risk of his life, contagion or punishment.

“Inspection functions ceaselessly. The gaze is alert everywhere: “A considerable body of militia, commanded by good officers and men of substance”, guards at the gates, at the town hall and in every quarter to ensure the prompt obedience of the people and the most absolute authority of the magistrates, “as also to observe all disorder, theft and extortion”. At each of the town gates there will be an observation post; at the end of each street sentinels. Every day, the intendant visits the quarter in his charge, inquires whether the syndics have carried out their tasks, whether the inhabitants have anything to complain of; they “observe their actions”. Every day, too, the syndic goes into the street for which he is responsible; stops before each house: gets all the inhabitants to appear at the windows (those who live overlooking the courtyard will be allocated a window looking onto the street at which no one but they may show themselves); he calls each of them by name; informs himself as to the state of each and every one of them “in which respect the inhabitants will be compelled to speak the truth under pain of death”; if someone does not appear at the window, the syndic must ask why: “In this way he will find out easily enough whether dead or sick are being concealed.” Everyone locked up in his cage, everyone at his window, answering to his name and showing himself when asked — it is the great review of the living and the dead.

“This surveillance is based on a system of permanent registration: reports from the syndics to the intendants, from the intendants to the magistrates or mayor At the beginning of the “lock up”, the role of each of the inhabitants present in the town is laid down, one by one; this document bears “the name, age, sex of everyone, notwithstanding his condition”: a copy is sent to the intendant of the quarter, another to the office of the town hall, another to enable the syndic to make his daily roll call. Everything that may be observed during the course of the visits — deaths, illnesses, complaints, irregularities is noted down and transmitted to the intendants and magistrates. The magistrates have complete control over medical treatment; they have appointed a physician in charge; no other practitioner may treat, no apothecary prepare medicine, no confessor visit a sick person without having received from him a written note “to prevent anyone from concealing and dealing with those sick of the contagion, unknown to the magistrates”. The registration of the pathological must be constantly centralized. The relation of each individual to his disease and to his death passes through the representatives of power, the registration they make of it, the decisions they take on it.

“Five or six days after the beginning of the quarantine, the process of purifying the houses one by one is begun. All the inhabitants are made to leave; in each room “the furniture and goods” are raised from the ground or suspended from the air; perfume is poured around the room; after carefully sealing the windows, doors and even the keyholes with wax, the perfume is set alight. Finally, the entire house is closed while the perfume is consumed; those who have carried out the work are searched, as they were on entry, “in the presence of the residents of the house, to see that they did not have something on their persons as they left that they did not have on entering”. Four hours later, the residents are allowed to re-enter their homes.” (Michel Foucault 1975) (M. Foucault, Agamben, and Benvenuto 2020)

Michel Foucault highlights the strict monitoring of the city’s inhabitants, with a power of the authorities exercised without discrimination. A well-developed model of the disciplinary mechanism. It is established by order for each individual his place, his illness and death, his well-being. A spectacle of the absurd that changes people’s identities, allowing a completely different truth to appear. The plague, as a form, both real and imaginary, of disorder and disorder, is opposed by the correlative medical and political discipline. A discipline considered by the authorities as ideal for the control of rebellions, crimes, vagrancy, desertions, and in general of people who appear and disappear, live and die in disorder. (M. Foucault, Agamben, and Benvenuto 2020)

Unlike leprosy, which gave rise to exclusionary rituals, the plague gave rise to disciplinary projects. Instead of dividing people as in the case of leprosy, the disciplinary mechanism in the case of the plague called for surveillance and control, an intensification and refinement of power. Tactical compartments were used instead of exile. Separation (marked) against segmentation (analyzed and distributed). Exile against arrest, with different political ideals. The first is that of a pure community, the second that of a disciplined society, the utopia of the perfectly governed city. (M. Foucault, Agamben, and Benvenuto 2020)

Major epidemics and pandemics have always been significant social and cultural events. In Madness and Civilization: A History of Insanity in the Age of Reason (Folie et Déraison: Histoire de la folie à l’âge classique), (Michel Foucault 2001) Michael Foucault describes the Great Confinement, which was based on the leprosy colony model, a ” game of exclusion ” that for centuries dominated exclusion structures where the role of the leper was replaced by the poor, vagrants, prisoners and those considered “crazy”. (Peters, Jandrić, and McLaren 2020) Foucault writes:

“In the Middle ages, exclusion hit the leper, the heretic. Classical culture excluded by means of the General Hospital, the Zuchthaus, the Workhouse, all institutions which were derived from the leper colony. I wanted to describe the modification of a structure of exclusion. (Foucault, 1996, p. 8) Once leprosy had gone, and the figure of the leper was no more than a distant memory, these structures still remained. The game of exclusion would be played again, often in these same places, in an oddly similar fashion two or three centuries later. The role of the leper was to be played by the poor by the vagrant, by prisoners and by the ‘alienated’, and the sort of salvation at stake for both parties in this game of exclusion is the matter of this study. The forms this exclusion took would continue, in a radically different culture and with a new meaning, but remaining essentially the major form of a rigorous division, at the same time social exclusion and spiritual reintegration. ” (Michel Foucault 2001, 6) (Peters, Jandrić, and McLaren 2020)

In Abnormal: Lectures at the Collège de France, 1974-1975 (Les Anormaux. Cours au Collège de France, 1974-1975), (Michel Foucault 2004) Foucault shows that the solution adopted for the plague was quarantine, which divided the cities into controlled sections: a pyramidal form of administrative control, where surveillance functioned. keep going. As Foucault explains

” It is not exclusion but quarantine. It is not a question of driving out individuals but rather of establishing and fixing them, of giving them their own place, of assigning places and of defining presences and subdivided presences. Not rejection but inclusion. You can see that there is no longer a kind of global division between two types or groups of population…one that has leprosy and one that does not…There is a close and meticulous observation…[a] constant examination of a field of regularity within which each individual is constantly assessed in order to determine whether he conforms to the rule, to the defined norm of health.” (Michel Foucault 2004, 45–47) (Peters, Jandrić, and McLaren 2020)

As Elden observes, in treating plague cities

“the ‘emergency plan’ [plan d’urgence] for epidemic disease comprised the following measures:

  1. All people must remain at home in order to be isolated in a particular place, even in a single room;

  2. The town is divided into distinct sectors or regions, inspectors patrol the streets, and a system of generalised surveillance is used to compartmentalise and control;

  3. To accompany the detailed reports that come from these sectors, there will be a centralised information system;

  4. People who do not show themselves for the inspectors at their windows will undoubtedly have contracted the plague, and therefore must be transported to a special infirmary, outside the town. Statistics can be derived from the reports that follow;

  5. Houses need to be disinfected and sterilised … ” (Elden 2003, 243) (Peters, Jandrić, and McLaren 2020)

 

The WHO published, in 1999, with revisions in 2005 and 2009, a guide to pandemic situations. (World Health Organization 2010) (World Health Organization 2011) All versions of this document refer to influenza. Pandemic severity measures were based on the mortality rate, (Centers for Disease Control and Prevention 2007) although this is not considered by some specialists as an appropriate measure of the severity of the pandemic. (Reed et al. 2013)

The basic steps in controlling an outbreak are limitation (through monitoring, isolation and therapy, including vaccination) (Threats 2007) and mitigation (after controlling the spread of the disease), but these steps can also be addressed simultaneously. (Baird 2020) Reducing the epidemic peak (“flattening the epidemic curve”) reduces the risk of overcrowding in health services and provides time for the development of vaccines and treatments. (Anderson et al. 2020) (Stawicki et al. 2020) Non-pharmaceutical measures (Stawicki et al. 2020) such as hand hygiene, wearing masks, self-quarantine, and social distancing are also used. (Qualls et al. 2017)

Foucault’s analysis is found today in public health management strategies for the treatment of coronavirus.

During a pandemic, certain forms of philosophical investigations are always emphasized. The most common approach in these situations is existentialism, which explores the nature of existence by emphasizing the experience of the human subject, (MacQuarrie 1973) starting from “existential anxiety” or a feeling of disorientation, confusion or anxiety in the face of a meaningless reality, or a seemingly absurd world. (Solomon 1776) Søren Kierkegaard is considered the first existentialist philosopher, (Crowell 2020) although he did not use the term existentialism. (Kierkegaard 1992) According to Kierkegaard, every individual – not society or religion – is solely responsible for giving meaning to life and living it with passion and sincerity, or “authentic.” (Watts 2003) The predominant value of existentialist thinking is freedom, its main virtue being authenticity.

The notion of the absurd contains the idea that there is no meaning in the world beyond the one we give it. This also includes the amorality or “injustice” of the world. Existentialism is generally understood in two fundamental ways. According to Albert Camus, the world or the human being is not in itself absurd. The absurdity appears by juxtaposing the two due to the incompatibility between them. (Wartenberg 2008) The other interpretation, by Søren Kierkegaard, states that the absurd is limited to the actions and choices of human beings. These are considered absurd because they come from human freedom, undermining their foundation outside of them. According to Camus, the supreme hero of the absurd lives meaninglessly and faces suicide without giving in. (Michelman 2010)

“Existential anxiety” is considered a negative feeling that results from the experience of human freedom and responsibility. Despair is also a feeling specific to existentialism, (The Free Dictionary 2020) being defined as a loss of hope.

Sisyphus, the symbol of the absurdity of existence, painting by Franz Stuck (1920)

The Plague (La Peste) by Albert Camus, a novel published in 1947, tells the story of a plague epidemic that allegedly appeared in the French Algerian city of Oran. (Camus 1972) The Plague is considered a classic existentialist novel, (Hughes 2010) emphasizing the inability of individual characters to affect their destinies, even the power of the absurd.

Michael A. Peters, Petar Jandrić and Peter McLaren discuss, in Viral modernity? epidemics, infodemics, and the ‘bioinformational’ paradigm, the concept of viral modernity, based on the nature of viruses and their role in evolution and culture, and the concept of bioinformationalism. In this paradigm, COVID-19 can be considered a “bioinformationalist” response that ” represents historically unprecedented level of sharing information from the sequencing of the genome to testing for a vaccination.” (Peters, Jandrić, and McLaren 2020)

They state that understanding these complex forces from historical and political perspectives is essential in examining the current COVID-19 epidemic. They show how bioinformation, modernity, the concepts of virus and quarantine and post-truth politics “blend into a poisonous public stew in this case.” The authors emphasize the importance of informal education in relation to biopolitics, public health management and bioinformationalism in this case. (Peters, Jandrić, and McLaren 2020)

Petar Jandrić notes that computer viruses bring a viral modernity that “causes and disrupts the opening of a free distribution model, as well as distributed knowledge, media and learning systems”. Alterability of information allows the virus to modify and change information, providing conditions for self-replicability. ” (Peters 2012, 62)

The Gaia hypothesis, also called the Earth reaction hypothesis, (J. Lovelock 2001) formulated by James Lovelock (J. E. Lovelock 1972) and later developed by Lynn Margulis, (J. E. Lovelock and Margulis 1974) proposes the idea that living organisms interact with their inorganic environment on Earth. to form a synergistic and self-adjusting, complex system that helps maintain and perpetuate the conditions for life on the planet. The Gaia hypothesis states that this system determines the stability of the global temperature, the salinity of seawater, atmospheric oxygen levels, the maintenance of a liquid water hydrosphere, and in general the environmental variables that affect life on Earth.

According to the hypothesis, organisms co-evolve with their environment, “influence their abiotic environment, and that environment, in turn, influences the biota through the Darwinian process.” (J. Lovelock 1995)

In the twentieth century, Russian scientists introduced concepts that overlap with the Gaia hypothesis. (Lapenis 2002) The less accepted versions of the hypothesis argue that changes in the biosphere occur through the coordination of living organisms and maintain these conditions through homeostasis. In some philosophical versions, all life forms are considered part of a single living planetary being called Gaia.

The famous French philosopher Bruno Latour stated during the COVID-19 pandemic, in “The first lesson that the coronavirus taught us” (Latour 2020) that we must take care of what we have, because it is over.

“This seems to add a political limit to James Lovelock’s Gaia hypothesis, which explains how “Life” acts to protect itself. Compared to the infinity of worlds taught by science, Lovelock, together with Margulis, proved that the Earth is unique because it has life.” (Latour 2020)

Bruno Latour considers that the confirmation of the idea of the two is his greatest discovery of this period, although still not accepted by the main science. In this sense, the paradigm shift from Aristotelian cosmology to Galileo is just as important as the one from Galileo to Gaia.

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Sfetcu, Nicolae, “Philosophical aspects of pandemics”, SetThings (October 19, 2020), DOI: DOI: 10.13140/RG.2.2.34967.80801, URL = https://www.setthings.com/en/philosophical-aspects-of-pandemics/

Email: nicolae@sfetcu.com

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International. To view a copy of this license, visit http://creativecommons.org/licenses/by-nd/4.0/.

A translation of:

Sfetcu, Nicolae, “Aspecte filosofice ale pandemiilor”, SetThings (2 octombrie 2020), DOI: 10.13140/RG.2.2.31276.49284, URL = https://www.setthings.com/ro/aspecte-filosofice-ale-pandemiilor/

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