Public Health, Pandemics, and Intellectualization of Violence

This elitist narrative diminishes the perceived impact of the social violence being wrought by COVID-19 by portraying it as mild, less dangerous, and endemic in an attempt to lower the public’s expectations of governmental action and thereby raising social acceptability of daily mass death.

“The obviousness of disaster becomes an asset to its apologists — what everyone knows no one need say — and under the cover of silence is to proceed unopposed. Assent is given to what has been drummed into people’s heads by philosophy of every hue: that whatever has the persistent momentum of existence on its side is thereby proved right. One need only be disconnected to be at once suspect of a world reformer.”

— Theodor W. Adorno, Can One Live After Auschwitz?: A Philosophical Reader

Persistently Raging Pandemic

The United States reported 3700 plus COVID-19 deaths in late January 2022 — a number similar to the beginning of the pandemic in 2020 and 2021, without any vaccination or other mitigation efforts. This number highlights that the COVID-19 pandemic continues to wreak unchecked havoc in the US, where the disease has killed 870,000 plus people and caused over 72 million cases, with record-breaking hospitalizations, amounting to an American dying every 44 seconds due to COVID-19. Embedded in these numbers, likely an undercount of true death and morbidity, is the unfortunate overrepresentation of historically marginalized and socially vulnerable communities. Does this mass death also serve as a proxy metric for governmental neglect or a public health policy leadership failure of those leading the COVID-19 response? Despite the extended duration of the pandemic, resulting collective trauma, and mental fatigue, the majority of Americans continue to support, with geographic variations, aggressive, upstream public health policies, including ventilation, social distancing, and travel restrictions to control the pandemic. Despite overwhelming support, these policies have not been fully adopted or implemented by the Biden Administration in the name of saving the economy.

Tale of Governance Failure and Unaccountability

The government and its public health leadership, some of whom are clinicians with MDs or other basic sciences training and limited public health training and without a deeper conceptual awareness of upstream public health policies, have sought to place the blame on those who are unvaccinated. Instead of taking responsibility, President Biden shifted the burden of his failed leadership by declaring, “This is a pandemic of the unvaccinated,” and essentially admitted his administration’s lack of vision by communicating “there is no federal solution.” Vilifying unvaccinated people as the root cause of the ongoing pandemic is not only unfair, but it also overlooks the many systematic barriers many Americans face including, socioeconomic status, education, misinformation, politicization, institutional mistrust, and access. This stance also relies on a violent individualism narrative that shields those with the power to engage in policy action and absolves them of any responsibility. To be abundantly clear, this is not a defense of the anti-intellectual, anti-vaccine movement with “militant ignorance.” Rather, it is an acknowledgment that the unvaccinated are an internally diverse group encapsulating some of the most historically marginalized communities. As public health scholars, we ought to question a state-sanctioned narrative in search of a scapegoat to deflect attention from governmental inaction.   

Elites and the Intellectualization of Violence

Why is it important to question this phenomenon? Public narratives are a powerful tool that define our social realities. Interestingly, there is another narrative being pushed both by the government and those in positions of power across our society — from politicians to editorial boards of mainstream media to other intellectual elites, including some public health academics. These are, overwhelmingly, people with abundant class privilege and a common disconnect from the social reality of the public. This elitist narrative diminishes the perceived impact of the social violence being wrought by COVID-19 by portraying it as mild, less dangerous, and endemic in an attempt to lower the public’s expectations of governmental action and thereby raising social acceptability of daily mass death. This normalization of mass death is a textbook example of the propaganda model, manufacturing consent: the notion that mass media and the elites push a certain narrative with a selective, curated viewpoint to gain public support for certain policies. The insistence on inevitability, mildness, and endemicity of SARS-CoV-2 is commonplace from mainstream newspapers such as The Wall Street Journal to those trusted with the nation’s health from the CDC Director to the Chief Medical Advisor to the President of United States.

Oracles of Social Murder

Examples of this sophisticated approach of intellectualizing mass death among the poorest and most socially vulnerable communities in the country as a logical and only outcome include:

More extreme opinions border on eugenics. Take, for example, Omicron Variant May End Up Saving Lives and Slow the Spread? Speeding It May Be Safer.

The common theme across much of this wishful-thinking narrative is its target audience: upper and upper-middle-class, the people least affected by the pandemic and, noteworthy, those with the most sociopolitical capital to gamble away the lives of those at the margins of society. This narrative also sanitizes itself of the structural barriers and lack of policy infrastructure needed for much of the public to return to “normal.” Additionally, it further perpetuates the dehumanizing narratives around people with disabilities and those with pre-existing conditions by passively assigning lesser value to those lives — a hallmark of eugenics thinking. The absurdity of this dangerously seductive, defeatist narrative around accepting mass death would be laughable if it was not as violent. These mendaciously crafted narratives focusing on individual risk and selling it as a public health metric readily forego the very foundational principles of public health, such as the precautionary principle. Moreover, these narratives exaggerate negligible governmental action and characterize it as an overkill, when in reality much of the governmental response has been non-population health, individualistic, reactive, and too little, too late, such as demure, sporadic, and half-baked policies of “lockdowns” and sending a few tests per household without accounting for multi-family households, and many other issues — arguably a reactive publicity stunt.

Market Fundamentalism and Public Health

This narrative also personifies American market fundamentalism and the extremism of our market society. Key outcomes of this narrative include engineering assent for policy inaction by gaslighting the public and portraying anyone demanding more evidence-based policy action as an unreasonable, radical fanatic, particularly, by creating strawmen of false dichotomies such as the impossibility of “zero COVID.” For instance, an endemic is defined as “a disease outbreak that is consistently present but limited to a particular region. This makes the disease spread and rates predictable” which is nowhere close to where we currently are or will be any time soon given the global inaction and prioritization of profits over people. Further, endemic does not imply without harm and is embedded with the normative assumption of inequitable distribution of morbidity and mortality. Similarly, there is nothing mild about this pandemic wave with deaths increasing 42% from just two weeks ago and record hospitalizations, including those of children.

These fatalist narratives in apologetics only justify thousands of preventable daily deaths. Elites have historically been on the wrong side of history from supporting American militarism leading to the destruction of entire societies in the Global South to Harvard and the likes supporting eugenics as it “attracted considerable support from progressives, reformers, and educated elites [emphasis added] as a way of using science to make a better world.”

Whose Normal? Towards a Politics of Plenty and a Way Forward

We all want the pandemic to end. However, this intentionally divisive narrative that mass death and illness from COVID are some kind of natural phenomenon or inevitable collateral damage only distracts us from holding those in power accountable. It also robs us of critical discourses on questioning the current predominantly biomedical approach to COVID-19 and implementing upstream public health policies such as universal health care, paid shelter-in-place, aggressive vaccination efforts domestically and around the globe, universal paid leave, hazard pay, ventilation requirements for employers, universal availability of masking and rests, and other health and safety protections for workers. Additionally, this narrative of normalcy for the few at the expense of the many also holds the power to lower the bar even further for the acceptability of mass death and illness. This could lead to incredibly dangerous desensitization for social murder towards the existential climate crisis. 

The public health community must resist and unequivocally reject these narratives and not concede to policy-based-evidence-making to justify inaction and tolerate mass death. We must stay vigilant, no matter the level of fatigue, and deploy a structural approach towards COVID mitigation and control while holding those in positions of power accountable, with critical intersectional power analysis of race and social class, from academia to the White House. We must interrogate whose normal? I am not naïve to think that people are not rewarded for their proximity to the powers that be, the status quo, conformity, and whiteness. To that end, those in leadership and secure positions, such as the Promised Land of tenure, should be the ones leading this charge as history will not look kindly on those who chose the status quo through silence. We must remember: our task in public health is honoring and centering the dignity of those at the margins of society without careerist political expediency supported by a violent, neo-liberal, and hyper-capitalist status quo.

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Author Profile

Ans Irfan
Ans Irfan, MD, EdD, DrPH, MPH, is a public health scholar-practitioner currently based at Harvard University where he is exploring the intersection of religion and public health policies with an emphasis on climate action. He also serves as a faculty member at George Washington University. He is a Robert Wood Johnson Foundation Health Policy Research Scholar. Recent projects include: climate innovation and information technology; climate change and farmworkers' mental health equity; intersection of theology and public health; traffic wardens and climate adaptation in Pakistan; evaluation of physicians’ training on climate change and health. He can be contacted at Twitter:@phscientist

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