Intimacy in Isolation: Podcasting, Affect, and the Pandemic

Intimacy in Isolation

podcasting, affect, and the pandemic

Molly Robson

ABSTRACT Using close interviews with podcast listeners conducted between July and September 2020, this essay explores the affective role podcasting played for listeners during the COVID-19 pandemic. For some participants trapped indoors due to COVID restrictions, podcast hosts became like friends, providing feelings of sociality in a physically distanced landscape. Furthermore, through their on-demand, converged, and idiosyncratic features, podcasts created mediated opportunities for agency for individuals bereft of their usual mobilities and freedoms, which provided a kind of affective agency that helped listeners make sense of the crisis. This essay argues that podcasting’s overriding value—both in the pandemic and contemporary life—lies not necessarily in its unifying properties, but in its individual affective impact.

On Monday, March 24, 2020, I went for a walk by myself to the waterfront of my flat’s suburb in Hataitai, Wellington, New Zealand. The Prime Minister, Jacinda Ardern, had just announced the complete lockdown of the country to slow the spread of the COVID-19 pandemic, effective at midnight the following Wednesday. Watching Ardern somberly tell the nation through a Facebook Live stream that “tens of thousands of New Zealanders could die” was a visceral experience. The worry we had all been carrying for the last week, the tangible energy on the streets and in the supermarkets, was becoming actualized in real

Victoria University of Wellington—Te Herenga Waka New Zealand. Email: molly_robson@hotmail.com.

Perspectives in Biology and Medicine, volume 64, number 3 (summer 2021): 388–407. © 2021 by Johns Hopkins University Press

time through a social media interface. During my walk, I listened to the podcast Boners of the Heart by New Zealand comedians Alice Sneddon and Rose Matafeo. Their approach is light-hearted and relaxed—an unscripted, back-and-forth chat between two friends. The episode “Boners of the Quarantine” had been released just a couple of days prior, and in it Sneddon and Matafeo—stuck in isolation together having recently fled home from the UK—chat candidly to one another about the crisis, cracking jokes about the terrifying and absurd nature of current affairs. As I walked along the harbor with my headphones on, the familiarity of their voices, accents, laughter, inside jokes, and candor offered me a feeling of welcome relief in a time of deep uncertainty. I came home feeling lighter.

This essay explores the experience of mediated affect occurring in moments like this. Affect refers to the “visceral forces beneath, alongside, or generally other than conscious knowing, vital forces insisting beyond emotion” (Gregg and Seigworth 2010, 1). In my research on podcasting, I have sought to understand the affective dimensions of the medium, and to achieve this, I conducted in-depth interviews with seven podcast listeners between April and August 2020, focusing on their personal experiences, practices, and engagement with the podcasting medium. This period of time was an unprecedented moment in history for obvious reasons, and the pandemic shaped listeners’ experience with podcasts in unique ways. This led me to consider the role that personal media technologies, such as podcasts, might play in a crisis context. How do we employ different media to feel comforted, safe, and connected during times of uncertainty?

Several participants reflected about how they used podcasts to fill the pandemic-sized hole in their everyday social lives. This article presents a critical analysis of how podcasts can be wielded as tools of self-mediation in individual efforts to negotiate emotional needs during a time of crisis. Thus, the article both helps to illuminate podcasting’s contemporary identity as a medium and offers qualitative insight into the process and function of mediated affect in a global crisis. I argue that the intimate, on-demand, and idiosyncratic dimensions of podcasting afforded listeners opportunities for dependable, free, customizable sociality in lieu of their “normal” lives.

Aural Media and Crisis

Aural media has historically played a significant role in times of crisis. According to Alex Goody (2018), in the early years of the Second World War, BBC radio drama was a crucial vehicle for articulating a sense of national unity and presenting a counternarrative against Nazi propaganda. In her article “BBC Features, Radio Voices and the Propaganda of War 1939–1941,” she argues that the blind format of the medium raised important political and moral questions in a time of national despair:

The hazards of a disembodied aural presence that could engender physical, personal emotions in listeners, generated particular issues as BBC wartime features developed and sought to dramatise contemporary events and actual people. As a result, whilst producing programmes which could bind the nation together in opposition to Nazi Germany in the opening months of the war and as British military campaigns escalated across 1940, the BBC Features Department also had to pay careful attention to what their radio voices might embody for and in their listeners. (195)

With its television service closing down at the outbreak of the war, BBC Radio was reconfigured to “adopt a new culture and outlook” that was “more powerful than ever” (BBC 2021a). As communications professor David Hendy observes, “The BBC saw one of its main wartime missions as nurturing civilian morale in the country at large” (BBC 2021b). One notable program to emerge from this shift was Desert Island Discs. In 1943, Roy Plomley invited celebrities into the bomb-damaged Maida Vale Studios, where guests would imagine they were cast away alone on a desert island and discuss the eight gramophone records they would choose to have with them: “assuming of course, that you had a gramophone and an inexhaustible supply of needles” (BBC 2021c). Though initially born of “the BBC’s effort to make life during wartime slightly more bearable,” the program achieved iconic success, and thus continues in broadcast and podcasting format today. In his New Yorker piece about the program, Hua Hsu (2020) describes the “romantic” escapism such a listening experience afforded citizens during the war: “It was a way to insure that not every waking second of life was lost to worry. The conversation was scripted and polite, and one imagines that guests were encouraged to offer selections that would make listeners feel optimistic or proud.”

The morale-building function of radio is also well documented among scholars. In 1941, James Rowland Angell located radio’s unifying potential in three key features: its ability to blend the emotional with the intellectual; the ease with which one can “tune in” and consume radio content; and the simple fact that radio’s messages are carried by the human voice. He wrote:

Again, as compared with the printed page whose meaning is taken in by the eye, radio with its transmission of the living human voice enjoys with most listeners a great psychological advantage. This is under ordinary conditions less significant in the mere communication of news, but when a great personality speaks on an issue of current moment, the effect as compared with the reading of the address at a later time is generally far greater. That the speaker is at a distance, possibly half around the world, that the voice conveys a sense of sincerity and integrity (if it does), makes an appeal that the printed page simply cannot equal in the case of most persons. (352)

This excerpt speaks to the affective and unifying power of the human voice. The importance of orality and sound is now widely acknowledged by researchers, and the recent proliferation of sound recording technologies has made it easier than ever to access and convey information through the medium of sound. However, it is important to remember that sound technologies can be equally powerful instruments in displacing bodies, as well as inspiring unification. In Sonic Warfare: Sound, Affect and the Ecology of Fear, Steve Goodman and colleagues (2009) provide a thorough historical account and analysis of what they call “sonic warfare”: “the use of force, both seductive and violent, abstract and physical, via a range of acoustic machines (biotechnical, social, cultural, artistic, conceptual) to modulate the physical, affective, and libidinal dynamics of populations, of bodies, of crowds” (10). From the sense of dread induced by low-frequency drones, to high-frequency mosquito “machines” designed to disperse teenagers in antisocial crowds, the authors offer a comprehensive map of the ways in which acoustic technologies are deployed to induce an ambience of fear.

Sound technologies can also be an instrumental tool for capturing the essence and urgency of contemporary crises. According to an article in The Outline, a new crop of sound engineers are using music and soundscapes to produce ecological knowledge and document the “mood” of modern-day environmental anxieties (Gordon 2018). For example, sound artist Anja Kanngieser explores climate justice through their work, which “encompasses oral testimony, field recording and data sonification to amplify climate justice issues, weaving a narrative around the people and soundscapes of the Pacific.” Other artists, such as Saplings, Loose Blooms, Björk, and Anohni, use soundscapes to actively engage with pressing ecological issues. More recently, British composer Pete Sollery (2021) created a “COVID-19 sound map” in an attempt to “preserve the temporary sounds of lockdown for the future, while, at the same time, “encouraging people to really listen.” His project brings together citizen-submitted sound recordings from across the world during the pandemic, including urgent loudspeaker announcements at an unusually vacant Barcelona airport, vibrant birdsong in populated urban areas, and the grain of digitized voices reciting the Lord’s Prayer via the video-conferencing platform Zoom. Sollery encourages us to “listen to the sounds around us” and “enrich our lives in a post-lockdown world—by seeking out these sounds which brought us comfort and by keeping our ears open to experience fully the soundscapes we live in.”

These accounts of sound technologies and crisis provide evidence of the rich function that sound and auditory technologies serve in times of upheaval, thereby challenging what Bull (2003) describes as “assumed supremacy of the ‘visual’ in accounts of the social” (3). They also provide helpful context for considering the role that podcasts have served in the contemporary pandemic. Podcasting can be characterized as the latest, most significant development in auditory technology, or as Llinares, Fox, and Berry (2018) describe it: “a medium that has now reached

a watershed moment” (6). Podcasting’s internet-born identity shapes its uses in the pandemic in ways that illuminate the dominant desires underpinning media use more widely. Using past studies on aural media, crisis, and affect to contextualize my participants’ responses, I argue that podcasting supported individuals both affectively and ideologically in their efforts to manage and succeed under the crisis. For most participants, podcast hosts became like “friends” to listeners suddenly trapped in lockdowns, performing a compensatory social function in a time of collective chaos. Furthermore, through their on-demand, converged, and idiosyncratic features, podcasts created mediated opportunities for agency for individuals bereft of their usual mobilities and freedoms. This provided a kind of affective agency that helped listeners make sense of the crisis via the conversations of distant, yet familiar, others.

Media Use in Social Isolation

Data for this study was attained through a series of in-depth interviews with seven regular podcast listeners. Interviews were conducted in the months between June and August 2020, at the height of the pandemic’s outbreak. Participants were recruited through two closed Facebook groups: The Bobo & Flex Show and the RNZ Podcast Discussion Group. These groups are online spaces to discuss podcasting content and debate relevant topics. While the Bobo & Flex Show group is mainly limited to the audience of that podcast show specifically (with approximately 17,000 members), the RNZ Podcast Discussion Group hosts conversations on all sorts of programs, although it is significantly smaller in size (2,400 active members) and sees less activity day-to-day. Selected participants reflected a young sample group, with most participants in their mid-to-late 20s, except for one participant who was in their 50s. At the time of the interviews, five participants were living in New Zealand, one in England, and one in Australia. Collectively, the sample reflected a range of ethnicities and gender identities. All participants considered themselves moderate-to-heavy consumers of podcasts and were motivated to participate by an intrinsic interest in the topic of the research. Interviews were conducted over Zoom—or in person, where possible—and lasted between 45 minutes to 1.5 hours. I have created pseudonyms to protect the identities of participants, but relevant details pertaining to their demographic, occupation, and media consumption practices are the same.

At the time of our meetings, all interviewees had experienced some form of lockdown over the recent weeks and were subject to varying degrees of social restrictions in their area at the time of the interview. When I asked participants to describe what they had been experiencing since the pandemic began, key themes to emerge were feelings of uncertainty and anxiety over the effects of long-term social deprivation caused by lockdowns and quarantines. Participants’ personal devices became a key tool for negotiating these challenges, and the majority of

participants reported a significant increase in their general media consumption since the pandemic started. One participant, Cassie, described the fear of “not knowing” when restrictions would be lifted in Melbourne:

There’s just been absolutely no indication whatsoever of when this lockdown’s gonna be lifted. We’ve just been hearing rumours that it’s probably going to be extended, or like, we’re not going to lift restrictions until we’re down to like zero cases, which is going to take a while. I think there’s a lot of uncertainty in that realm. And I do think that podcasts, but also like all the media that I’ve consumed in general, has been, like, soothing.

Most other participants reported listening to more podcasts since being in lockdown, too. Taylor, a London-based trust-officer in her early 20s, described podcasts as serving a “comforting” function in her life in social isolation: “they’ve been very soothing, comforting, and allowed you to just continue listening to dialogue in your life.” She characterized the beginnings of the pandemic and subsequent quarantine as “incredibly bleak,” and admits that she struggled to grasp the full severity of the pandemic for a couple of months. It wasn’t until they were in the thick of the lockdown that she realized “I needed to do stuff to actually help myself, during this time, otherwise I will go insane.” She started getting into “all the lockdown activities, like yoga and baking,” and developed a weekly routine around podcasts to help find a sense of normalcy in her days:

I definitely have started listening to more podcasts than before, and yeah, I have some sort of routine, I have podcasts that I listen to every week when they come out in the morning. So yeah, my listening habits have definitely changed, and gone up massively. Before I definitely did love a podcast, but I didn’t really listen to them as much as I do now, and yeah, I think it comes from us being stuck indoors and not really having too much to talk about. . . . Obviously, with lockdown happening, not having friends around, not seeing people as much, you’ve been yearning for that conversation, and that dialogue between people. So that routine definitely came out of quarantine, my listening has gone up since then. And I’d say that’s because I just miss my friends, and I miss that conversation as well.

Similar themes were evident in other participants’ responses. In Olive’s interview, she described the lockdown experience as “tedious” and “long,” having spent the period living in her parents’ house, completing her university semester from a laptop. Podcasts offered her respite from using screens all day for her assignments, as well as an opportunity to hear the voices of others outside of her immediate domestic context:

With podcasts, I was definitely listening to more [during lockdown], ’cuz I kind of realised I wasn’t having many conversations with people, I was kind of being

exposed to new ideas, or at least new thoughts. Like, you can kind of just like listen to what other people are thinking . . . . There was definitely a craving for, like, hearing people that weren’t my family. I think that definitely fulfilled that sort of desire for like, fresh perspectives, and with my family it kind of just became: “how’s your day going?” and because we’re in the same room, it just became tedious. So yeah, I think it definitely filled that sort of desire, like “I need to hear—and not necessarily have interactions—but at least hear other people having interactions.” And even like, saying words I haven’t heard today, I felt like I was getting into a really weird pattern and cycle of articulation, so it was cool to have something that shifted me out of that. It’s like a form of escapism.

These responses speak to the vital social role podcasting played for them in the pandemic, serving as a kind of compensatory tool for isolated individuals in lieu of their face-to-face networks. Statistics about global podcast listening during the pandemic support this finding. Studies have revealed that though audiences initially veered away from podcasts at the onset of the coronavirus outbreak, listening has largely increased in the months since (Amburgey 2020). Voxnest reported a 42% increase in global podcast listening since March 2020, and in an October survey by Trailer Park in collaboration with Variety Intelligence Platform, 52% of respondents said they were listening to podcasts “much more” or “a little more” since the pandemic began (Amburgey 2020). Spotify has also reported a steady growth in podcast listening on their platform, but due to changing commuting practices, noticed a shift in temporal trends of listening:

It’s clear from our data that morning routines have changed significantly. Every day now looks like the weekend. This trend was seen more significantly in Podcasts than in Music, likely due to the fact that Car and Commute use cases have changed quite dramatically. However, listening time around activities like cooking, doing chores, family time, and relaxing at home have each been up double digits over the past few weeks. Audio has also taken on a greater role in managing the stress and anxiety many are feeling in today’s unprecedented environment. (Spotify Investors 2020)

It stands to reason that populations under stressful conditions might turn to media to cope with their feelings of loneliness, anxiety or isolation. As Horton and Wohl stated in 1956: “nothing could be more reasonable or natural than that people who are isolated and lonely should seek sociability and love wherever they think they can find it” (223). Podcasting’s well-established properties of “intimacy” imbue the medium with an especially attractive social function in this new landscape. In the following analysis, I explore how the unique properties of podcasting made it a valuable tool through which participants negotiated these changes in their social worlds.

Parasocial Phenomena and Podcasts

Emerging literature is already beginning to explore the role that digital media has played in the lives of populations enduring long-term lockdowns from COVID-19, with increasing interest turning to the correlation between parasocial phenomena and mass social-isolation (Jarzyna 2020). Theories of parasocial phenomena offer a valuable lens through which to analyze how podcasts have assisted listeners during quarantines and lockdowns. According to Tilo Hartmann (2016), parasocial interaction “deals with users’ immediate illusionary feeling of being in a real social interaction with a media character, despite knowing that they are not” (131). Similarly, a parasocial relationship is when users, through repeated exposure, “develop a long-lasting social bond and sense of intimacy and proximity towards [media personalities], almost as if they were real friends” (131).

Hartmann’s definitions are startlingly consistent with the ways in which participants in my interviews described their own relationships with their favorite podcast hosts. For example, in Olive’s interview, she laughed about how she had recently caught herself accidentally referring to her favorite podcast hosts as “friends” in conversation, despite knowing it was not an accurate assessment of the relationship:

And then I was like, no no, he’s not like my friend, but he’s just someone that’s kind of entered the fold of my life—[air quotes] “to me”—in such a way that feels like a familiar face. Like, it really feels like someone who is really trying to engage with me, and trying to explain things clearly and lucidly.

Olive’s response here fits neatly within Hartmann’s definition of a parasocial interaction: “users intuitively feel addressed by the other . . . [feeling] a sense of mutual awareness, attention and behavioural adaptation towards the other—although these reciprocal qualities do not actually exist” (131–32). Other participants I spoke to were keenly aware of the fact that the feeling of mutual friendship was largely illusory, but enjoyed the fantasy nonetheless. Rosie, a 22-year-old linguistics student from Wellington, expressed similar feelings in our interview. When I asked if she felt familiar with the podcast hosts that she listens to regularly, she replied: “Yeah, heaps . . . I’m in my room, by myself, and I listen to the girls from I Said What I Said [podcast], and I’m like: ‘Ah, yes, my friends!’ It definitely has that familiarity, and also, comfort, I guess?” Taylor spoke with equal affection towards her favorite podcast hosts. Through repeated exposure to the same voices, and the continual self-disclosure evolving from such conversations, she felt that she had come to “know” her favorite podcast hosts intimately and that she nurtured an ongoing, dependable (albeit unrequited) bond with them:

You start to build a relationship. Especially with Bobo and Flex, that kind of conversation. You really get to know them, and you get to understand why

they say or do certain things and the reasoning behind them, and they talk about that as well . . . it’s getting to know someone without them knowing you, and them giving you access to so much of themselves.

According to Perks and Turner (2019), the kind of self-disclosure that Taylor describes is central to parasocial phenomena. It is worth noting how the conversational structure of many podcasts fosters heightened emotional intimacy. Unlike other audio formats such as radio, podcasting hosts know that their audience has actively chosen to tune in, and they therefore might feel more liberated to express their vulnerabilities with their audience. According to podcasting scholar Mikhaela Nadora (2019), when media personalities disclose personal admissions to their listeners, it “enhances their feelings of connectedness, and their ability to identify and cultivate intimacy with them” (10). In a similar vein, Cassie described the bond she formed with Bobo from The Bobo and Flex Show, after listening to an episode she resonated with deeply: “Now it kind of feels like . . . like I know we’re not actually friends, but it does feel like I have new ‘friends,’ or just people in my life that I can talk about these subjects with. And so that feeling was really moving to me.”

These responses show some strong consistencies between parasocial phenomena and podcasting practices, both in format and consumption. The question, then, is how might the newly restricted social landscape of the pandemic have shaped these practices? A valuable perspective is offered by the “compensation hypothesis” in parasocial studies, which asserts that parasocial relationships may compensate for a lack of social benefits usually acquired in real-world relationships. Numerous studies on parasocial phenomena strongly support this hypothesis. For example, Greenwood and Long (2009) have found that “the experience of solitude as the ‘absence of valued others’ particularly predicted parasocial intensity” (cited in Hartmann 2016, 136). Baek, Bae, and Jang (2013) found that loneliness was a strong indicator of the number of parasocial bonds formed with celebrities on social networking sites. Furthermore, social-psychological studies have examined whether parasocial bonds can in fact bolster against the effects of social isolation or loneliness, concluding that such mediated bonds “can provide social support . . . and shield against or diminish the effects of social exclusion and loneliness,” and thus appear to be at least partially successful in compensating one’s “thwarted need to belong” (Hartmann 2016, 137). These studies help to elucidate the recurring themes of affection, friendship, and familiarity that arose in my interviews. Looking at participants’ responses within these parasocial frameworks helps us to understand more clearly the intensity of the bonds listeners felt with their favorite podcast hosts.

Autonomy, Identification, and Wellbeing

Having established podcasting’s potential as a vehicle of parasociality, it is important to understand how precisely such relationships take shape through this aural medium. What are the characteristics of podcasting that make it socially gratifying? What distinguishes it from other media in this pursuit? And in what ways do these features support listeners in their efforts to manage under pandemic conditions? One participant I interviewed, Gen, offered up a short anecdote that I think speaks to podcasting’s widespread appeal in the COVID-19 era. Gen grew up listening to the “crackling radio” in her parents’ car on long road trips. Now 53 and a self-identified “podcast fanatic,” she appreciates the personal sense of freedom podcasts provide:

My parents were big radio listeners, musical people. And so we either had music blaring away, or news bulletins. And I remember that as a child, the crackling radio with the car and the aerial, and in those days it wasn’t electric aerial. . . . With the radio, you couldn’t really capture it, unless you went to the trouble of recording something with a cassette player to set up, you couldn’t hear it again. It was once. And there was no replay . . . so radio was real time. Podcasts are brilliant because you know what you’ve got, and you can listen to it when it suits you, so like “10pm: listen to a podcast.” You can plan your day and incorporate podcasts. Whereas when I was little, you had to base things—and your family had to base things—around something on the radio. So, radio is a moment in time, and the podcast is something to take along for the ride. I really like the podcast for that.

This contribution from Gen gets to the core of podcasting’s appeal as an “empowered” medium, which allows the consumer to define and enact their own agency freely, whether through the “time-shifting” playback features of the streaming platform itself or the huge swathes of content available on increasingly niche topics (Sullivan 2018, 38). As Gen notes, contrary to the linear, scheduled programming of radio, the portable, idiosyncratic properties of podcasting facilitate unparalleled “autonomy and agency over one’s mediated self” (Llinares, Fox, and Berry 2018, 3). These affordances fit into a burgeoning trend in digital media at large, which grants the user increasing control over their own consumption experience.

However, even when considering examples of other consumer-driven programming, like Netflix, freedom of choice is still bound by the commercial purchases of that platform, and users must pay a monthly fee to maintain their subscriptions. By contrast, as Nadora (2019) describes, the autonomy offered through podcasting is a “defining advantage” of the medium at large, on both ends of the communication process: in the amateur-friendly production culture and in the autonomy listeners are given to curate their personal listening diets for no mandatory cost, and at their own will (7). Nadora explains:

Curation is an essential trait when closely interacting with podcasts and utilizing the autonomy offered by them. Without it, listeners may lose interest and concentration and tune out. Curation is a personalized experience. Because listeners want to choose how and what to spend their time on, their feed is self-scheduled and self-selected. (6)

These affordances, I argue, take on a renewed function in a pandemic context. “In crisis,” Berlant (2017) writes, “we improvise like crazy, where ‘like crazy’ is a little too non-metaphorical. Plus, when a crisis is ordinary, flailing—throwing language and gesture and policy and interpretations at a thing to make it stop— can be fabulously unimaginative, a litany of lists of things to do, to pay attention to, say, to stop saying, to discipline and sanction.” In other words, during times of deep uncertainty, humans will reach for varied demonstrations of self-autonomy and self-determination to sustain fantasies of control and security. For participants, podcasting offered a safe, dependable, free, and instant means of exercising such control.

For several participants, this freedom allowed them to construct a sense of “cultural safety” in their media consumption, a concept defined by Williams (1999) as “an environment, which is safe for people; where there is no assault, challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience, of learning together with dignity, and truly listening” (213). For my study participants, this was revealed to be an important value in deciding what to listen to. Participants would often select podcast hosts with whom they could identify and relate—people they could imagine befriending in social reality. For example, Taylor told me she listens to a range of genres but tends to “take the women and female-led podcasts more seriously.” Similarly, Cassie told me a part of the reason she started listening to programs like Bobo and Flex was because she “wanted to listen to more podcasts hosted by women.” As an American woman living in Australia, she was recommended the podcast by a friend, and immediately found herself obsessively bingeing the episodes: “[she] was like, ‘Have you heard of Bobo and Flex? One lives in America and one lives in Australia.’ And I was like, ‘Oh, that’s so cool, I’ll probably resonate with some of the things they say.’ And I’m obsessed with it now, so yeah.” Moreover, Bobo and Flex spoke from a lens of experience that Cassie found affirming to her own identity as a woman of color: “Bobo and Flex talk about very personal topics that a lot of people can just relate to, especially like if you’re a woman or a person of colour, or both.” Rosie told me that she didn’t feel her podcast consumption had challenged much of her preexisting views, laughing: “I already came to the podcast being a feminist, being a little leftist hippie, so I don’t know.”

Answers from other participants revealed that despite sometimes feeling challenged by the hosts or the content itself, this self-reflexivity helped to affirm their personal identities as progressive, critical thinkers. For example, Leo explained

that as a White person, they used podcasts as a way to gain insight into the experiences of marginalized communities and evaluate their own identity in the process: “I do my best to be, you know, a progressive person who understands from others perspectives, and I guess that’s the point . . . to kind of have your own perspectives challenged, and decide whether it’s something you want to learn from, adapt and kind of integrate into your own. So, [my podcasting diet] fits my political compass by challenging it.” Similarly, Olive explained that the podcasts she listens to have helped her to be more self-reflexive and challenge personal biases: “the podcasts that I’ve listened to have put me in spaces, like audio spaces, that I wouldn’t have been in otherwise . . . you kind of do feel like a fly on the wall and a part of a conversation . . . . It can definitely expose you to scenarios and conversations that you wouldn’t necessarily be in otherwise, or questions that are maybe really hard to ask people, that could be quite invasive.” Such responses speak to the self-reflexivity underpinning much podcast consumption. Even when a listener does not share the personal experiences of the host or subject in question, the feeling of being involved (albeit passively) in the conversation can serve as an affirmation of one’s existence, beliefs, and worldview. As Olive later told me: “It is a privilege to listen to those frank and candid interactions, especially between two people like them who gel so well in conversation. There’s a lot of chemistry, which is really cool to listen to.”

Correspondingly, many studies of parasocial relationships have found identification to be a key indicator in predicting the intensity of parasocial phenomena. Horton and Wohl (1956) argued that the strength of a parasocial interaction is positively related to their ability to identify with them. Tian and Hoffner (2010) similarly found a “significant positive predictor of both identification and parasocial interaction, and identification was associated with higher levels of parasocial interaction” (250). Perks and Turner’s (2019) study on uses and gratifications of podcasts found similarities with hosts to be a defining theme of parasocial development: “commonalities between host and listener can present invitations for intimacy” (110). Additionally, they found that parasocial connections were often powerful enough to keep some listeners consuming the content, even if the substance of the topic was not interesting to them. This last finding helps to elucidate the soothing properties of podcasting that many participants reported in my interviews. Listening to voices that one registers as familiar serves a therapeutic function, allowing users to “remain unaffected in changeable, stressful, and distracting environments” (Hagood 2019, 3). This feeling alone can be more enjoyable than the content itself, a claim that is demonstrated in one of Rosie’s answers: “You’re used to the voices. I find the first couple of episodes always take a bit of getting used to, and navigating the voices. But once you’re familiar with them, it’s really nice.”

With podcasting, feelings of identification are amplified for additional reasons. Producing a podcast is often an independent venture, with minimal barriers to

entry compared with other top-down industries such as radio, television, or film. Podcasting’s relatively “open, accessible and democratising internet distribution” means that everyday people from a variety of cultural perspectives flood the production sphere, imbuing the medium with a “powerful ethos of authenticity” (Heeremans 2018, 58–59). This affordance might partially explain the safety participants reported feeling while listening to their favorite programs. As Llinares, Fox, and Berry (2018) put it: “No matter how deep or obscure your interests are, there is a podcast for you, or there is (relatively) little stopping you making your own” (2). The widely touted “‘radical subjectivity” of the medium extends such freedoms not only to content (topics, genres, interests, style, fandoms, style) but to subjective experience itself. As past studies on radio and crisis have demonstrated, the amplified voice is aurally coded by a range of identity signifiers: it serves as an unscripted transcript of human experience that has the capacity to “powerfully pull us backward and forward through our own memories, thoughts and feelings” (Copeland 2018, 212). The aural delivery of podcasts is important here, setting it apart from visual media. As Stacey Copeland (2018) reminds us: “the sound of one’s voice carries with it traces of age, sex, gender, sexuality, culture and many more facets of collective and individual identity” (209). Furthermore, the spoken word is itself a powerful vessel of intimacy and closeness. One of my participants, Leo, explained this point in their answer: the podcasting voice helps to humanize abstract experiences, because “it carries the emotional weight of the person delivering it.”

Further support for the therapeutic role that podcasting played for participants in the pandemic can be found in “belongingness theory,” which asserts that the need to belong—the “need for frequent, nonaversive interactions within an ongoing relational bond”—is one of the strongest and most fundamental human drives (Hartmann 2016, 497). Psychological researchers have found that this need is so urgent that social isolation or lack of satisfying relationships can be a significant risk factor for mortality (House et al. 1988). Accordingly, the need to belong is intricately tied to wellbeing. According to Hartmann (2016), a wholly satisfied “need to belong” depends upon two criteria:

First, the social interactions an individual engages in should ideally be pleasant, but should definitely be devoid of conflict or negative affect. Second, these social interactions should take place in a relational context, characterized by an existing interpersonal bond or relationship with the other that is marked by stability, [mutual] affective concern, and continuation into the foreseeable future. (131)

Hartmann argues that these desires can be partially fulfilled through parasocial relationships with “mediated others” and can become stronger when particular conditions limit the possibility of face-to-face socialization. Several factors render podcasts an especially successful medium in satisfying this desire, factors that can

become amplified in a crisis like COVID-19. First, as I have established, podcasting expands opportunities for identification for increasingly niche and diverse subjectivities, meaning no matter how physically isolated one is, it is relatively easy to find voices in the podcasting sphere with which one shares experiences, values, or worldviews. Second, the serialized format of podcast distribution means that listeners frequently return to the same programs over extended periods of time, deepening the illusion of a mutual relationship. As Nadora (2019) notes: “sharing hosts’ lives through an ongoing narrative in serialised instalments furthers the parasocial bond—as if the listener is checking in on friends” (9). This trend was confirmed in my interviews, with all participants emphasizing their loyalty and affection for their “favorite” programs or hosts.

Finally, the autonomy that I described earlier applies not only to curation of the content and personalities one listens to, but also the playback controls of the podcast interface itself. Morris and Patterson (2015) conceptualize the development of these features as “sonic interactivity,” which they argue intensifies the “hyper-personalised” nature of the medium. The personal control afforded through such features enhances the capacity for non-averse, non-threatening, and pleasurable sonic experiences. If listeners don’t like the content, section, or even voices of a podcast—in other words, if they experience affective displeasure—they can simply turn it off and choose another one. This autonomy can be inherently comforting precisely because it allows even deeper control of “how we allow ourselves to resonate, especially where the vibrations of others are concerned” (Hagood 2019, 4). As Gen put it in our interview: “I take responsibility for my own good time when it comes to podcasts. If I listen to something and I don’t like it, I turn it off, and I’ll go into something else. . . . I’m selective.” She highlighted this advantage by comparing podcasts to “normal” social interaction with a good friend:

There’s nothing better than talking to a friend and you’re both in the right direction with the subject, it’s like a mound. And you just keep adding cool things, and then the next person says something cool, and so on and so forth. And before you know it, it’s like, “Gosh, we can take on the world at this rate.” And I think podcasts are that too. However, you can’t talk to them. You can’t engage with them. Equally though, a friend can really piss you off—excuse my language—but often, they say something that you don’t agree with. And so, it’s almost like you don’t have to have any conflict if you listen to podcasts. Zero conflict. If you don’t like what someone is saying on a podcast, you say bye and then you go and find another one. You know, you don’t have to invest.

Gen later explained that the fulfilment gained from podcasts actually replaced her need for some real-world support networks during the pandemic. She considered herself an extrovert until lockdown arrived, during which she was pleasantly sur-

prised at how much she enjoyed deciding the terms of her interactions: “COVID gave me a chance to enjoy podcasts in the comfort of my own home, so that was really nice. I quite like spending time on my own, and interacting with people when I want to.” Later in our interview, she elaborated on this point by offering up another anecdote:

Years ago I played in this netball, social netball team and the group of us are still friends. We get together only probably about two or three times a year. And then the lockdown came and some of the girls and old team became so nervous about things that they wanted to do a Zoom, pretty much every couple of weeks. . . . And I thought that was a really cool idea but I didn’t want to take part, because I thought, why don’t you contact everyone every couple of weeks when we don’t have a lockdown? I thought “wow, that just isn’t me at all.” And now, this netball team that I’ve grown away from, I’ve replaced all those players with podcasts.

Gen’s reflection here gives insight into the vital role that social connection plays in wellbeing, and how new media practices like podcasting have expanded opportunities in this pursuit. Her preference for podcasting relationships over real friendships in this particular example emphasizes the unique role that parasocial phenomena play as instruments of sociality. Support for this claim can be found in Schmid and Klimmt’s (2011) conclusions about the social value of parasocial relationships (PSRs):

Their unique role is rooted in their instrumental value: media users can decide autonomously whether they want to establish, continue, or break up a PSR; they do not have to accept rules and obligations that are inevitably implied in real-life relationships; and PSRs are typically less dynamic than real-life relationships, as most media characters display very stable characteristics and cannot respond individually to the social behaviours of media users like, for example, friends or neighbours do. Therefore, PSRs enable simulated or vicarious social experiences that people may find entertaining without demanding much effort or imposing obligations and responsibilities like real-life relationships. (254)

In other words, in contrast to the real social networks available to her, podcasts allowed Gen to literally and figuratively “hear” what she wanted. As Hartmann (2016) reminds us, a satisfied need to belong relies upon interactions that should “ideally be pleasant, but should definitely be devoid of conflict or negative affect” (133). Podcasts allowed Gen to filter her environment to her own personal desire, essentially suppressing the unstable, unpredictable, or unfavorable elements of social interaction while enjoying those that give her pleasure.

Conclusions, Critiques, and Future Areas of Inquiry

While listeners felt affectively and ideologically safe with their favorite podcast hosts, the private, customizable, individual, and idiosyncratic practices underpinning podcasting ultimately did little to challenge the ideological or material conditions of isolation from others. More importantly, this was never the goal to begin with. Instead, podcasts, like most new media during this time, helped listeners to navigate and manage these challenges privately. As Gen’s reflection shows, sometimes podcasts—and digital media at large—made it easier to completely sever traditional social ties.

Looking at most podcasting and radio literature to date, one might be forgiven for assuming that podcasting would have been a unifying and moralizing force in the pandemic, something that could have brought our varied networks closer together. To quote Llinares and colleagues (2018): “podcasting seems to possess the advantages of the internet while expelling some of the pitfalls” (2). However, my analysis reveals that, somewhat paradoxically, participants’ engagement with podcasts during the pandemic represented both a mediated antidote to social isolation and a fortification of its core dynamics.

This is not to undermine the serious affective value and power that podcasting serves in a contemporary context. As I have demonstrated, for many, podcasts offered a vital means of sensory self-care, which provided easy comfort amid widespread uncertainty. Podcasts fostered feelings of safety, understanding, companionship, and intimacy for listeners suddenly bereft of those fundamental human needs. To conclude my analysis, I offer a critique of podcasting’s identity as an “empowered” medium, one that hopefully helps us to reach a richer understanding of podcasting’s value and its limitations in times of crisis.

Podcasts, like many digital media technologies, can be theorized as one of the latest manifestations of what Jodi Dean (2009) calls communicative capitalism: “the materialization of ideals of inclusion and participation in information, entertainment, and communication technologies in ways that capture resistance and intensify global capitalism” (2). Under communicative capitalism, Dean argues, “messages are contributions to circulating content—not actions to elicit responses” (26). Perhaps no medium better embodies this critique than podcasting. First, podcasting’s ultimate value lies in its ambient dimensions: the content of the message matters less than the affective experiences it offers users, which is often constituted by and through the people voicing them (and what they represent). Second, the podcasting sphere is saturated by voices from laypeople, fandoms, producers, and professionals, reflecting perfectly what Dean conceptualizes as the “fantasy of abundance,” which begins with the observation that “more people than ever before can make their opinions known” (25). She elaborates on this concept in the first chapter of her book:

Uncoupled from contexts of action and application—as on the Web or in print and broadcast media—the message is simply part of a circulating data stream. Its particular content is irrelevant. Who sent it is irrelevant. Who receives it is irrelevant. That it need be responded to is irrelevant. The only thing that is relevant is circulation, the addition to the pool. Any particular contribution remains secondary to the fact of circulation. The value of any particular contribution is likewise inversely proportionate to the openness, inclusiveness, or extent of a circulating data stream: the more opinions or comments that are out there, the less of an impact any given one might make (and the more shocking, spectacular, and new a contribution must be in order to register or have an impact). In sum, communication functions symptomatically to produce its own negation. (26)

According to Dean, the risk of this fantasy is that massive streams of content erode the specificity of messages, creating an overwhelming din of voices that foreclose opportunities for action and application: “any given message is a contribution to this ever-circulating content, a drop in the ocean of cultural and political stuff engulfing us” (26). Similarly, the hyper-personalization of the podcasting medium provides great comfort for individual listeners, but ultimately does little to resolve increasing concerns about digital echo chambers, online polarities, and radicalization in an increasingly virtual social landscape (Hagood 2019).

Thus, a key risk associated with the personal autonomy offered by media tools like podcasts is an ever-increasing desire to “hear what you want,” which presents a challenge to idealistic discourses about podcasting’s identity as a community-driven medium. However, as Hagood (2019) notes, “new media’s din of mediated voices—diverse and democratic, yet overwhelming and often hateful—makes guarded listening a necessity for sensory and emotional self-care” (6). Perhaps then, instead of theorizing podcasting in a binary of “progressive” versus “regressive” media, it is more helpful for us to consider what podcasting’s popularity in this context illustrates about our sociopolitical landscape. Zizi Papacharissi (2014) argues that to understand the civic utility of technologies, “we need not interpret them as forces that bring about change, do activism, or enact impact. They are networked infrastructures that present people with environments of a social nature, supporting interactions that are aligned with the particular cultural ethos deriving from historical or geographic context” (6). Through neoliberal logics of freedom and choice, podcasts offer listeners an escape from the fraught realities of the pandemic, while at the same time they reflect the same dynamics of isolation, closed networks, and individualism that have defined our response to that pandemic. Podcasts thus occupy a liminal space in the pandemic: they are both inclusive and exclusive; social and solitary; democratic and hegemonic.

“The psychological effects of losing all but our closest ties can be profound” writes Amanda Mull (2021) in an Atlantic article on the pandemic’s social impact. “Peripheral connections tether us to the world at large; without them, people

sink into the compounding sameness of closed networks.” As we retreat into our “bubbles” to prevent the spread of the virus, we creatively employ the media tools at our disposal to soothe our loneliness, anxiety, and worries. However, as I have demonstrated, the core appeal of technologies like podcasting often derives from the suppression of difference and discomfort: podcasting gives us the ability to hear what we want, when we want, how we want. While listening to your favorite podcast can sustain a powerful illusion of personal friendship and affection, more often than not the podcast host has, at most, only a vague idea of your existence, and you no idea of fellow audience members’. Instead, as my analysis on parasocial phenomena demonstrates, the medium’s defining appeal lies in its stable, consistent, uncomplicated one-sidedness. It is a medium, primarily, about contribution to the conversation, and the feeling of being a part of something. In Papacharissi’s words, “affective attachments to media cannot produce communities, but they may produce ‘feelings of community’” (4). While this might seem like a despondent perspective, personal affect-management plays an important role in crisis. Affective safety is central to survival and wellbeing in a fundamentally unstable world: a compromised solution to uncontrollable circumstances. To quote Lauren Berlant (2010): “shifts in affective atmosphere are not equal to changing the world. They are, here, only pieces of an argument about the centrality of optimistic fantasy to surviving in zones of compromised ordinariness” (116). Podcasting’s overriding value in the pandemic thus lies not in its unifying potential, but instead in its individual affective impact.

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Victors, Victims, and Vectors

Rebecca E. Olson,* Adil M. Khan,* Dylan Flaws,† Deborah L. Harris,‡ Hasan Shohag,§ May Villanueva,¶ and Marc Ziegenfuss**

ABSTRACT COVID-19 has plunged us into times of loss—loss of friends and family, loss of purpose, and loss of a sense of certainty about the immediate future. As we traverse this time of anomie and loss between pre- and post-COVID-19 times, through pandemic surges that threaten to exhaust our resources and seemingly endless troughs of calm, we need to care for each other. Care provided to those in need of hospitalization due to COVID-19 should undoubtedly be prioritized, but we should not forget to care for those who are physically well but suffering, by recognizing the fear and sorrow that flavor changed experiences due to COVID-19. Narratives that reveal challenges and triumphs are central to this kind of care. Frank (2007) argues that care is about “helping people find their stories.” We find comfort in telling these stories and in hearing them; recognizing ourselves in another’s tale allows us to find meaning in our own suffering. This paper tells the narratives of three health professionals on the COVID-19 frontline.

*School of Social Science, University of Queensland, St. Lucia, Australia. †Department of Mental Health, Royal Brisbane and Women’s Hospital, Herston, Queensland; Critical Care Research Group, The Prince Charles Hospital, Chermside, Queensland; and School of Clinical Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia. ‡School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, New Zealand. §Internal Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia. ¶Auckland City Hospital, New Zealand. **Adult Intensive Care Service, The Prince Charles Hospital, Chermside, Queensland, Australia.

Correspondence: Rebecca E. Olson, School of Social Science, University of Queensland, St. Lucia, Queensland, Australia.

Email: r.olson@uq.edu.au.

Perspectives in Biology and Medicine, volume 64, number 3 (summer 2021): 408–419. © 2021 by Johns Hopkins University Press

The Story of Medicine

The well-established story of medicine in the 20th century is one of discovery and intervention: perseverance and conquest over the unknown leading to great achievements. Improvements in medical knowledge (along with advances in wealth, nutrition, and public health), from the discovery of penicillin to a vaccine for polio, saw substantial improvements in life expectancy (Szreter 2002). Documentaries such as the New England Journal of Medicine’s Getting Better: 200 Years of Medicine tell the familiar tale of the victors of medical research, from Dr. Sidney Farber’s advances in treating childhood leukemia in 1948 to advances in personalized medicine and the terror, turmoil, and triumphs of the HIV/AIDs epidemic (Porter, Dietz, and Johnson 2012). There is comfort—from the vantage point of the present—in the linear progress trajectory of medicine that such stories reinforce.

COVID-19—as a novel and potentially life-threatening disease—suspends this humanistic narrative, thrusting medicine into uncertain terrain and the world into a period of stasis. The emotional and economic burden from COVID-19 is heavy, and it is not yet clear how long we will need to bear it. Yet uncertainty has long been central to medicine. Uncertainty comes not just from personal but also professional limits of knowledge (Fox 1957). New York Times medical columnist and physician Dr. Lisa Sanders (2014), for example, recounts her first day of medical school, when the faculty dean announced that “half of what we teach you these next four years will be wrong. Unfortunately, we don’t know which half” (219). Further disturbing the narrative of certainty, and the security that it brings, are uncertainties stemming from treatment and client responses (Light 1979). Variations in human bodies and the complexity of interactions between the social, psychological, environmental, and physical realms mean medicine isn’t always an exact science; sometimes it’s a process of trial and error (Hodges 2010).

COVID-19 lays bare the (un)certain tension in medicine’s narrative. To varying extents, governments around the world have entrusted medical officers with direct responses to the pandemic, making judgments about border closures, social distancing, mask wearing, and work-from-home restrictions. But when medical officials have made mistakes or changed guidelines following the release of new information, we have seen frustration with this vacillation experienced as a betrayal in our trust in medicine to secure our futures (Martin et al. 2020; Piotrowski 2020).

In addition to disrupting medicine’s narrative, COVID-19 has prompted suffering through many other forms of loss. Drawing on Tate and Pearlman’s (2019) relational conceptualization of self and suffering, COVID-19 has threatened who we are. Lockdown undermines our relationships while uncertainty and change threaten the socially informed roles that are central to what it means to be ourselves. This is true for many, but perhaps particularly for health-care professionals

working on the frontline, isolated from family and friends and facing reimagined roles in hospitals, clinics, and communities.

Suffering in the context of uncertainty and powerlessness is not new for medicine. During the HIV epidemic, it took nearly two decades to make anti-retroviral medications widely available to people living with HIV/AIDS—and they are still not universally accessible (Barré-Sinoussi, Ross, and Delfraissy 2013). The years between emergence and pharmaceutical treatment saw millions of people infected, their taken-for-granted linear trajectories suspended (Ezzy 2000). During the height of the HIV epidemic, medicine was valued not so much for its (delayed) ability to treat those facing a life-threatening illness, but for its capacity to bear witness to suffering and provide care (Frank 2002). Not eventual treatment, but care. This aligns with the 15th-century aphorism offering a timeless assessment of medicine’s role: “to cure sometimes, relieve often, comfort always” (Shaw 2009, 955). During the height of the HIV/AIDs epidemic, medicine offered care and comfort by recognizing and acknowledging other’s’ suffering and helping patients and carers to make sense of their loss: lost physical capabilities, lost capacities to work, lost friends, lost plans, lost capacity to plan for the future (Frank 2007; Olson 2011; Tate and Pearlman 2019). Narratives are central to this kind of care.

Words, more specifically stories, are therapeutic. They have the power to assuage and make people feel cared for. Through the validation and empathy that they foster, stories can even alleviate physical symptoms of pain (Tate and Pearlman 2019). In short, if we feel cared for, we do better physiologically—we feel less fatigued and less pain; our bodies focus on repair rather than defensive response (Brody 2016; Marchant 2016). Narratives also help us to understand what to do and who to be.

Listening to stories teaches us what it means to live and live well. From Aesop’s fables to the stories of First Nation Peoples, narratives provide important lessons about the world and how to be in it (Wachowich and Scobie 2010). Stories “show how to live” and “bring everyone to life, by allowing us to see ourselves in the lives of others” (Frank 2007, 393, 394). Telling our own stories allows us to contain and distance ourselves from what is threatening us, find meaning in suffering and—most importantly—find ourselves (Thomas 2010). Although narratives can feel very personal, they are also social. As Andrews and colleagues (2004) explain, narratives are “the cornerstone of our identities,” but they “are not and can never be wholly personal” (100). Stories work both on and through people, helping us to find our roles and “become a self” (Frank 2007, 391). They are how we form (and reform) our identities within groups, how we articulate ourselves through social means—especially in times of uncertainty and change, such as illness.

Arthur Frank (1993, 2003, 2007, 2008) argues that when serious illness threatens one’s sense of self, life purpose, and linear trajectory, narratives can be central

to reimagining and reasserting one’s identity. Stories are useful in helping patients to find, and find meaning in, their new roles—to articulate the grief for lost plans and recognize frustration with life’s fragility (Bury 2001). As Frank (2007) explains: “The universal aspiration expressed in personal narratives of illness is to learn what it is to play the part of being ill, to reach a decisive moment in which one shows that one can play this part well, and to teach others something of their parts and what counts as playing them well. This last aspiration, to teach, is when private trouble crosses into public plight, and illness crystallizes the problem of how to live” (380–81). In contexts where cure is not an option, care can be more about “helping people find their stories” (390). The role of health professionals in the patient’s unfolding drama is to recognize that “they are playing parts in the ill person’s plight” and to help, rather than stifle, the patient’s narrative journey (380). The power of stories to care and alleviate suffering, however, is not limited to patients. Health-care professionals can also benefit.

Medicine’s New Story

With lockdown measures and border closures, everyone has experienced fear and loss: lost roles, lost connections, lost purpose, and, importantly, a lost sense of certainty about the future. For the story of medicine in particular, COVID-19 has posed a disruption. Beside the fear of close contact with COVID-19 patients, health-care professionals have experienced a sense of loss as the traditional role of hero or victor has been challenged by this novel disease, prompting uncertainty for some about who and how to be. Like HIV in the 1980s and 1990s, COVID-19 has displaced medicine’s discovery and conquest narrative with a more complex tale that includes fear of the unknown.

How do health professionals learn to play their parts in this more complex drama? How can they support themselves and each other? Narratives can help. Narratives help us show care for each other and learn what it means to play our new parts. Recognizing ourselves in another’s tale can allow us to find meaning in and relief from our own suffering. This is because, when we become storytellers, “fear and loss become actors in [our] drama,” and we become “capable of directing that drama” rather than the reverse. In this way, stories take care of us, allowing us to take control of our emotions and share them (Frank 2007, 389).

Shifting beyond medical sociology’s long fascination with patient’s narratives and medicine’s usual practice of emotional concealment (Frank 1993, 2007; McNaughton 2013; Thomas 2010), this essay reflexively examines the narratives of three health professionals on the COVID-19 frontline. Specifically, it draws on narrative interviews with coauthor health professionals from New Zealand and Australia, facilitated as part of an international webinar on COVID-19 frontline responders’ experiences, to explore what it means to be a health professional

and to live well in this new era (Frank 2008; Khan and Olson 2020). 1 Inspired by ethical convictions from participatory research and narrative approaches to valuing experiential data (Bernard 2000; Thomas 2010), first and second authors Olson and Khan invited five health professionals, representing different frontline responder experiences in logistics, mental health, internal medicine, contract tracing, and nursing, to collaborate with us on the project as participants, co-researchers, and webinar speakers. Prior to the webinar we asked collaborating health professionals to reflect in written format on a list of questions inspired by narrative approaches to inquiry (Labov 1997). Questions attended to health professionals’ knowledge, actions, feelings, and reflections: When did you first hear about COVID-19? When was your first engagement with a COVID-19 patient? How did you feel? How did you respond? How were you treated in the community after you returned from work? Should we see COVID-19 or another pandemic reemerge, what should we do differently? During the recorded international webinar, we invited frontline responders to speak to their written narratives and respond to questions. In this essay, we draw on our abductive analysis of the recorded narratives—obtained in written and audiovisual format (in quotes)—of three coauthors with direct patient contact experience (Dey 1993; Frank 2007). We merge these narratives into one story (below), drawing on media reports for context.

References to well-known images and tales of danger, loss and uncertainty are woven into health professionals’ stories to make them more familiar and aid in the search for security, predictability, and triumph amongst the dangers and upheaval of COVID-19. The metaphors are familiar—some might even say cliché—but useful, helping us to make sense of and attune our emotions to previous experiences of the unknown, the tumultuous, and the fear-inducing. The collective story articulated across health professionals’ narratives is divided into three chapters, aligned with Frank’s (2007) analysis of typical story emplotment, which begins with genesis, follows through to a form of reckoning, and ends with a resolution.

Chapter 1. Confronting the Unknown

Our story begins with Dr. Hasan Shohag, Staff Specialist in Internal Medicine at the Gold Coast University Hospital in Queensland, Australia. Hasan tells a genesis story: the start of the “conflict between forces” with patients, health-care professionals, and the community caught in the surge of COVID-19’s tidal wave.

1A summary of the discussions included in the webinar can be found at https://cgs-bd.com/article/971/ COVID-19-and-frontline-responders—Health-professional-perspectives. The webinar, jointly organized by the Faculty of Humanities and Social Science and the School of Social Science, University of Queensland, Australia, and the Centre for Governance Studies, Dhaka, Bangladesh, brought together COVID-19 frontline health responders from five South Asian countries and Australia and New Zealand to exchange experiences and learn from each other.

For Hasan, the story begins in January 2020. He learned that a doctor from China’s Wuhan province found a new strain of coronavirus. Subsequently, Wuhan went into lockdown and a temporary hospital was formed to treat coronavirus patients in the area. Invoking Hokusai’s famous painting, The Great Wave of Kanagawa, the news in China was like a tidal wave visible in the far distance, building strength before reaching our shores.

By March the waves came crashing down before us, in Australia. Hundreds of cruise ship passengers disembarked in Sydney’s Circular Quay, spreading coronavirus through Australia’s second most densely populated urban area (ABS 2020). International arrivals quietly flooded capital cities with the infection. In Queensland, some of the first patients to be treated were Hollywood actors Tom Hanks and Rita Wilson, who started to feel unwell while working on a Baz Luhrmann movie about Elvis (ABC News 2020). Hasan describes the actors as “whistle blowers,” awakening Australia and the Gold Coast University Hospital, where he works, from their paralytic fear of the COVID tidal wave and prompting a swift call to action.

Consequently, our infectious diseases team established COVID-wards. Hospital governance came up with a multi-tier action plan. Appropriate working groups were appointed in advance. To reduce the pressure on doctors and nurses, shift duties were put in place, minimizing burnout. Daily briefings and multidisciplinary meetings were in place to evaluate the progress and find fault in the system. Review of new emerging evidence in treatment was discussed daily.

The “fear of the unknown” deterred some coworkers, but Hasan saw COVID as “a once in a life-time event.” He volunteered to be a leader of the COVID response team and began directly treating COVID-19 positive patients at the end of March. Because the hospital was “well-equipped” with the necessary personal protective equipment (PPE), Hasan “never felt any risk.” But this feeling was not shared by the community:

In hospital, a strict hygiene protocol was maintained daily. It included changing into hospital scrubs and wearing PPE prior to entering COVID-wards, taking a shower and changing back to casual clothing upon leaving the COVID-ward and following a strict handwashing protocol. All the COVID patients were kept in tight isolation in their single rooms with negative pressure ventilation and a two-stage entry system to visit them. Unfortunately, despite all this, I was seen by others in my community as a potential threat of COVID infection. I was asked to stay in hospital indefinitely. My family was seen by neighbours as a possible source of infection too.

As the first wave progressed, reports of health professionals in the community— in Australia and abroad—being scorned had become commonplace in the media

(Bagcchi 2020; Ralph et al. 2020). Hasan began to share the sense of vulnerability and fear projected by neighbors. None of his patients died, but a close friend in the UK contracted the disease and died. Subsequently, “the fear of getting COVID and transmitting the infection to others became stronger.”

A niggling sense of helplessness started seeping in. “The stress of your patient deteriorating in front of your eyes and you are unable to do anything, is the worst fear for a doctor.” This sense of powerlessness was undergirded by widespread uncertainty. “There was no treatment. We knew too little about COVID at that stage. . . . We only knew Hydroxychloroquine may have some benefit as it showed inhibition of COVID-19 in vitro.” So, Hasan prescribed hydroxychloroquine for several COVID patients, but, as studies would eventually confirm (WHO 2020), he was “not convinced” of its efficacy in treating COVID-19.

In Hasan’s genesis story, we hear his excitement at rising to the challenge, along with his sorrow for the loss of a close friend. We bear witness to the rising sense of fear and helplessness that goes with confronting a novel disease. We get a glimmer of the uncertainty swimming below medicine’s shining surface.

The plot twist in the call to action of this early chapter in COVID-19 frontline responders’ story is that the victors, victims, and vectors are one: health professionals at risk of infection, nonetheless acting to treat and protect the public from COVID. The villain takes many shapes: it is found in the disease, the community, and possibly even in oneself as a potential source of infection.

In the next chapter, we learn what it means to play the part of the duty-bound health professional, acting and enduring to help those struggling.

Chapter 2. Reckoning with COVID-19

New Zealand Nurse May Villanueva’s story is one of reckoning. It is a story of “self-reconstruction and renewal,” where the hero is “forced . . . by necessity . . . to recognize, first, what they truly value and desire, and second, the fullest extent of their capacity to act in order to achieve what is valued and desired” (Frank 2007, 392).

May’s story starts in late February. New Zealand has its first COVID-19 patient, an international arrival from Iran, who is being treated at Auckland City Hospital (France-Presse 2020). “I heard on the news that the hospital was treating the first COVID patient. Because I work in a Respiratory Ward, I had assumed the patient would be treated in another ward. So, I was surprised when the patient was in our ward—moreover, when I learned that I would be the nurse taking care of him that shift.”

Her initial inclination was to run. “There was a lot of fear and anxiety every time we heard the world and local news about the number of COVID cases increasing day by day. I felt like quitting. I had just joined the hospital for a threemonth contract. But I said to myself, I was called to be a Nurse to serve the sick

regardless of the sickness and the situation. So, I stood firm and am doing my best to serve my patients and protect myself and my family at home too.”

Protecting her family meant weeks without physical contact with her spouse or children. “Practicing social distancing at home was hard—setting guidelines, having separate utensils, no other stuff in the toilet and shower room. Each person had their own basket for toiletries. For two months, not sleeping in the same room with my spouse and not being able to kiss and hug my kids. It was also the time that my children were at home doing distance learning with my spouse.”

Sorrow and longing tinged with inert compassion are evident in how May describes life while working on the COVID ward. She compares her sense of loss to staying on the COVID ward. “I felt for my patients wanting to have their family see them, being sick and away in the hospital. They wanted their own books and belongings. They felt bored and sicker being in a lonely room, but their belongings were restricted. They had phones with dead batteries, as nothing was allowed to enter their hospital rooms unless it was significant for their care—not even phone chargers.”

May’s sense of loneliness was only interrupted by her feelings of camaraderie with the others working on the COVID ward. “Our Ward was our bubble during COVID-19.” They were alone together, as “the hospital responded by isolating the COVID ward—including restrooms, equipment, cleaners, kitchens—from all other wards in the hospital. . . . All doors were locked. No other Ward had access to ours.” A buddy system, where each nurse worked with one other nurse over the course of a shift, meant she did not feel alone when caring for patients on the COVID ward. The other nurse was there to share in caring for the patient, assist in maintaining infectious disease control measures, and break up the oppressiveness of isolation.

From May’s story of reckoning, we learn what it means to live well—to embody a sense of duty, to endure isolation and manage emotionally and relationally. May’s story allows us to bear witness to her fear, suffering, and vigilance as a health professional working on the frontline and caring for the sick while protecting herself, her family, and the public. From May, we also gain insight into the sense of loss that is magnified for frontline health workers: lost certainty about the future, lost contact with family, and lost taken-for-granted sense of infection security. The sorrow that imbues her tale is interrupted only briefly by empathy for her patients, for whom isolation is even more extreme, and by solidarity with colleagues whose shared sense of camaraderie offers temporary respite.

May’s narrative offers insight into her suffering as a COVID nurse, giving this suffering scale and purpose. The final chapter of our COVID narrative culminates in a path forward, not just for health professionals working on the frontline, but for the broader public.

Chapter 3. Road to Resolution

Nurse Practitioner and Lecturer Dr. Deborah Harris’s chapter offers an ending to our frontline responders’ tale: a path to follow in responding to COVID-19.

Deborah was called on in mid-March 2020 to set up New Zealand’s National Close Contact Service (NCCS). With a team of five other nurses, she worked to establish this government-supported response to COVID-19. The NCCS was responsible for identifying and calling by phone close and casual contacts of those infected with COVID-19, and instructing them to isolate:

I was responsible for confirming that people had COVID-19, calling close contacts and informing people that self-isolation (or more correctly that quarantine) was required for 14 days. I also fielded phone calls from nurses and people in the community who were unwell. As more and more callers were recruited to the NCCS, our small group of 5 nurses became more responsible for pastoral care. There were tears, feelings of fear of the unknown. As the COVID-19 outbreak continued, anxiety increased. However, our leadership was calm and clear, and we had a capability style (we have got this—if we do this).

The NCCS was New Zealand’s mechanism for breaking through the fear and uncertainty to develop a defense plan. This plan called on the public to trust in leaders, rally support, and reinstate a sense of confidence in the “now normal.” “I am troubled by the number of people who have died internationally because of poor leadership. The virus has one goal—to infect the host (us). Our job is to stop that from happening and the only way to do that is to listen to the science and public health advice: self-isolate.” As Auckland saw a second wave of COVID-19 in August—albeit much smaller—the defensive plan was tested again. But they were “more prepared” this time. Through the NCCS, they now have “end-toend data collection which is accessible to all healthcare providers who need it. We can call up to 10,000 people a day.”

As Frank (2007) explains, dramatic stories typically involve: “conflict between forces; certain actors are caught among those forces and have limited capacities to affect the forces that affect them; the action moves forward toward a decisive moment in which an individual actor or a collective of actors does something” (380). In Hasan and May’s stories, we see Australia and New Zealand rendered powerless to COVID-19, without a cure and unable to foster the usual affect-rich, relational caring environment to which patients and practitioners are accustomed. Through their stories, we hear the familiar tales of fear and loneliness, helping us to recognize and give meaning to our own feelings of loss, frustration and helplessness.

Deborah’s chapter offers us a path out of the turmoil: a decision about how to respond as health professionals and as humans. Even without a vaccine, her story tells us that the challenges of COVID-19 can be endured and staved off through

strong leadership and the tried-and-tested techniques of quarantine and contact tracing. Rather than a resolution—as might be found in a happily-ever-after tale—Deborah’s story offers a road paved with strategic thinking and prevention. As Bruner (2002) explains, some stories are about finding meaning in “the road rather than about the inn to which it leads” (cited in Frank 2007, 389). Once we know what road we are walking down, we can then (re)discover who we are and what we are to do.

Conclusion

As we travel between the pre-COVID and post-COVID worlds—or, more accurately, as we move into a world where COVID-19 becomes one of many seasonal viruses to which we have some immunity in the community—we need to take care of ourselves and each other. Stories are central to providing this care. “Fears multiply in silence,” Frank warns us (2007, 388). By allowing us to name and contain our fears and uncertainties—especially in acknowledging that challenges are daunting, but triumph is also possible—stories provide a mechanism for reflecting on who and how to be.

Narratives provide a rich means of exploring human action as embodied and emotionally rich. They offer a way to appreciate the centrality of meaning, emotion, and identity at the intersection between individual behavior and social circumstances. Besides forming the “fabric of everyday life,” narratives mend and reinstate meanings (Bury 2001, 264). Much research has attended to how illness narratives enable individuals to respond to an identity disrupted by illness or stigma by helping reconcile their relationship between body, self, and surroundings (Bury 2001; Hydén 1997). Yet stories may be useful to all of us—sick or not—as we confront the existential challenges that come with COVID-19. Narratives may be particularly valuable to health-care professionals, whose overarching medical narrative, roles, and sense of self are challenged by the suffering, uncertainty, and loss of COVID-19. The story offered here not only articulates these challenges, but normalizes and contains them, allowing space for health professionals to find reassurance and (re)direction. Furthermore, the narratives reflected upon here also serve as an important reminder that, despite ongoing isolation, we are not walking this road alone.

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Unpacking

We move in two weeks before lockdown. The house is full of spiders. At first, we release them, then invite them to stay. We feed feral kittens abandoned beneath the house in those first quiet days, leave food and water for birds and hedgehogs. We trust in routine, but love what flickers in or out.

Michael McLane

Michael McLane is an editor with the journals saltfront and Sugar House Review. His work has appeared in numerous journals, including Western Humanities Review, Denver Quarterly, Colorado Review, and South Dakota Review. He is a PhD candidate in the International Institute for Modern Letters at Victoria University of Wellington.

Perspectives in Biology and Medicine, volume 64, number 3 (summer 2021): 420. © 2021 by Johns Hopkins University Press

Uses of History During the First Nine Months of COVID

Merle Eisenberg

ABSTRACT During the first year of the COVID-19 pandemic, historians of medicine, disease, and health became frequent guests in academic talks and even in national media. These historians’ expertise suddenly appeared relevant, particularly those who worked on two previous pandemics, the 14th-century Black Death and the 1918 influenza pandemic. This article examines how history was searched for possible insights and predictions about the present-day pandemic. The article then traces why assumptions about what COVID would do based on the past, such as COVID leading to a leveling of inequality, were faulty: these supposed lessons from the past flattened pandemics into one-size-fits-all approaches, which existed in neither the past nor the present. To understand the possibilities and limits of what pandemics do, we must ground the differing experiences of a pandemic in their specific times and places. In particular, framing pandemic responses in terms of resilience serves to center the market and the state, rather than individuals. The article concludes with thoughts on how to make changes during a pandemic that center people, not states or profits.

By fall of 2020, the COVID-19 pandemic had passed through two rough stages of historical commentary and reflection. The first attempted to use lessons

National Socio-Environmental Synthesis Center (SESYNC), University of Maryland–College Park.

Email: meisenberg@sesync.org.

The author would like to thank Robert Alpert, Andrew Edwards, and the anonymous reviewers for their comments. This work was completed at the National Socio-Environmental Synthesis Center, which is supported by funding received from the NSF DBI 1639145.

Perspectives in Biology and Medicine, volume 64, number 3 (summer 2021): 421–435. © 2021 by Johns Hopkins University Press

from historical pandemics as tools to help the public understand and mitigate the spread of the virus. The second asked what past pandemics could tell us about what comes next. One group of early historical op-eds offered comparisons with the Black Death (c. 1346–1353 CE) and its global spread. COVID and the Black Death both passed along trade and transport routes from China to the Middle East and then to Europe, offering plenty of comparative material, and journalists and producers asked historians to contextualize this information (Marcus 2020). In other cases, historians drew on analogies from the 1918 influenza pandemic in policy discussions of how to minimize the impact of subsequent waves of COVID (Petras and Gelles 2020). There was a view early on that we in the 21st century could take lessons from the past about what had worked and what had failed, to ensure we would do better. But by late 2020, at least in the United States, that seemed a vain hope. Historical reflection on the spread of pandemics all but disappeared. Historical knowledge had proved ineffective. It became increasingly clear that despite the profession’s best efforts, few in the US had learned anything from history (Chandra, Christensen, and Likhtman 2020).1 In fact, policymakers seem to have chosen to make disastrous choices despite knowing what had previously occurred. Presentist exceptionalism had triumphed.

The second stage of historical analysis focused on what might come next, but the same naïve goal remained: using the past as a means of projecting beneficial outcomes to replicate. Stage one’s failures were lost, or ignored, in the process. Given the few discernible, positive effects of the 1918 influenza pandemic, the Black Death took on a more central role. Some historians speculated that the aftermath of COVID, like that of the Black Death, might result in a reduction in wealth inequality (McBride 2020). Others suggested we might experience a cultural rebirth, a 21st-century Renaissance (Wright 2020). Despite the lack of accurate historical data to support any long-term, broad-based reduction in inequality after the Black Death or any connection to the emergence of the Renaissance, hope for the future remained central to thinking about COVID (Alfani 2020). These supposed “silver linings” had no basis in the empirical reality of the Middle Ages, but hope, it seemed, was what historians had left to sell (Eisenberg and Mordechai 2020c).2

This article reflects upon the paradigmatic use of historical disease during the first nine months of the COVID pandemic. I first lay out some of the problems

1Chandra and co-authors wrote in the spring of 2020 but published in the fall. Their article reflects a sense of optimism during the early months of COVID that, by explaining the importance of seasonality and connectivity in the disease’s spread, it might be stopped. Many of the articles in the special issue of the Journal of Global History that was published in November 2020 suggest similar lessons, but this recourse to history did not stop subsequent outbreaks of COVID, which the introduction to the volume, written later, recognizes (Birn 2020). 2Increased inequality due to COVID-19, rather than a reduction, seems obvious now, with Amazon CEO Jeff Bezos’s seemingly limitless increase in wealth as the most apparent. For a discussion of numbers, see Woods 2020. Eisenberg and Mordechai 2020c offer a refutation of these Black Death myths and legends.

with how historical pandemics have been used during COVID-19, particularly the flattening of earlier pandemics into a single conceptual model. I then demonstrate that even if pandemics offer lessons or hope from the past, they are too often used to offer false comfort, assuring people that life will improve without engaging in an understanding of the present or in challenging the status quo. I next examine how we too often neglect the experience of living during pandemics, focusing on the beginnings and endings at the expense of understanding how people lived and struggled through them. We in the 21st century have assumed our moral, scientific, and humanistic superiority to peoples of the past, which our response to this pandemic in no way justifies. We have also focused on how our communities, whether local, national, or more expansive, might be resilient in the face of COVID-19, rather than acknowledging that resilience does not create social change without understanding, and that without concerted, organized effort, grit alone does little to transform the underlying structures of societies. Using lessons from the past is futile without tracing the framework through which historical societies perceived the pandemics of their time and through which they accordingly acted (or did not). Furthermore, by using a contemporary capitalist impulse to draw lessons from the past and think about future possibilities, we inevitably prioritize economics above human experience and suffering, resulting in cheapened, mechanistic accounts of social struggle. Given that COVID’s impact is disproportionately borne by those least able to do so, I argue that we should instead attempt to understand how historical peoples have thought humanistically about pandemics, and to apply those different modes of thinking towards ending our contemporary inequities.

Lessons from the Past, Hope for the Future

The first few months of the COVID-19 pandemic amplified the voices of historians of medicine, disease, and pandemics. In academic circles, various temporal, thematic, and geographic fields raced to increase programming to meet a seemingly endless demand, as historians sought to reflect upon what had happened in the past as they lived with new, daily pandemic realities. Specialist historians presented to broader public audiences as well, through digital and traditional media forms, with well-known historians, and those with timely books, engaging in a variety of commentary (Clark 2020; Eisenberg and Mordechai 2020a). The next few years will likely witness an explosion in monographs devoted to histories of disease and pandemics, just as similar booms occurred in the history of capitalism after the 2008 financial crisis (Johnson 2013; Levy 2012).

Historians first engaged in thinking about historical pandemics by directly comparing past experience with the present, often as a result of people wanting to know whether there was historical precedent for their new realities during COVID. These early forays were understandable, since most people lacked any

personal experience of living through an epidemic, let alone a pandemic. These historical analyses reflected upon the past not just as a useful source of perspective, but also for equivalencies that could be copied and pasted directly onto the present. The first months of 2020 not surprisingly witnessed an outburst of comparisons between past pandemics and COVID-19. By the time of the first European and American lockdowns of February and March 2020, this had grown into a cottage industry. As the founder of a new podcast who suddenly found himself on CNN, I should know. As commentators and the public grappled to understand what was happening first in China and then across the globe, past pandemics were a natural way to try to understand COVID’s spread. COVID, for example, appeared to follow the path of the Black Death of the mid-14th century: originating somewhere in the east, spreading through central Asia, and then into Italy (and finally, in obvious and understandable contrast to the Middle Ages, into the Americas) (Green 2020; Khanna 2020). But historical comparisons were not more useful than knowledge of 21st-century context. Current political and economic connections between China and Iran, for example, resulted in a much higher rate of initial spread of COVID in Iran. While the Black Death followed a similar transmission from central Asia to the Middle East, understanding how COVID spread did not require comparison to the Black Death (Eisenberg 2020). The second equivalency with the Black Death was the underlying fear generated from the novel coronavirus’s spread: would COVID-19 be as bad? The Black Death emerged as a point of comparison because it remains the single greatest destructive pandemic (by percentage) in human history, and because it looms large in the collective imagination. The early fears surrounding COVID-19 were amplified by its many unknowns: its virulence, its morbidity, and, perhaps most of all, how it infected people. Historians who discussed the Black Death in public-facing pieces were quick to assure readers that COVID was far less likely to kill you than the Black Death (known simply as “the plague” and caused by the bacterium Yersinia pestis), but the fear lingered (Clamp 2020; Eisenberg, Mordechai, and Alpert 2020; Newfield 2020). These fears only increased when early reports about the spread of COVID suggested that it could remain on surfaces for up to three days, which led to runs on bleach and frantic efforts to wipe down anything that entered the home. This fear mirrored early 20th-century discoveries about the role of germs; lacking precise scientific knowledge, the public adopted that earlier 20th-century model as a means of preventing COVID’s spread (Tomes 1998; van Doremalen et al. 2020). That fear only dissipated once the idea of surface spread was finally (or at least largely) shown to be highly unlikely. Finally, the Black Death was a popular point of comparison for the scapegoating and xenophobia in America and elsewhere against Asians and Asian-Americans during COVID. Segments of the population sought to (and still do) blame China—and Asians more broadly—for the spread of COVID. Indeed, the ubiquity of blaming “wet markets” as a stand-in for “strange,” foreign practices of eating, seems clear

in retrospect, given how COVID spreads via human to human, airborne contact (Liu 2020; Lynteris and Fearnley 2020). Historians, of course, responded to these persecutions and the use of racist language to remind the public of their ubiquity in past pandemics. Bigotry feeds on ignorance; the Black Death famously led to the scapegoating of Jews (Einbinder 2018; Marcus 2020).

In addition to the Black Death, commentators employed the 1918 influenza as a useful comparison. This assessment stemmed from the superficial similarities between the two: both are airborne viruses that globalized and killed—or at the time potentially might kill—millions. The 1918 influenza pandemic also appealed to commentators because it offered photographs that looked eerily prescient: images of mask-wearing Americans in 1918 were easily juxtaposed with Americans today (Solomon 2020). The influenza pandemic likewise provided evidence of what might happen during COVID, with subsequent “waves” of the pandemic over the course of several years. The first wave in early 1918, as historians have shown, was less virulent than the second wave in late 1918, which was impressed upon the public consciousness from an early date of COVID’s spread. Thus, COVID, too, could get worse in subsequent “waves.” Moreover, the 1918 influenza had been at the center for planning preparations for future pandemics during several previous US presidential administrations (Markel et al. 2006). The office overseeing those plans adopted historical data from the 1918 influenza before COVID broke out, only to be dissolved by the Trump Administration (Johnson 2020). This failure was not the case everywhere: Australia and New Zealand, among others, used 1918 planning to guide their responses to the COVID outbreak (Rice 2020).

The 1918 influenza pandemic provided mixed lessons for COVID in 2020. For example, there is little evidence of significant societal effects in the years that followed the outbreak of the 1918 pandemic. Although influenza killed tens of millions of people, there is little indication of any economic, cultural, or political impact on the 1920s in the US or anywhere else. Alfred Crosby famously framed the 1918 Influenza as “America’s Forgotten Pandemic” in the 1989 title to the reissued version of his original 1976 book. Not satisfied with this explanation, historians have speculated and sought to trace potential tangible effects through hypotheticals. What if President Woodrow Wilson had contracted the virus at the key moment of the post–World War I peace negotiations, which then supposedly changed the political trajectory of the world? This hypothetical (and many others) notwithstanding, drawing a causal connection between the 1918 influenza and events in the 1920s is uncertain, if not impossible. Disease was the dog that did not bark. If this earlier pandemic was not forgotten, as if the entire world had collective amnesia, it was perhaps most remembered at an individual level, even if it did little to shape large-scale social structures (Bristow 2012; Milne 2018).

The 1918 influenza has also had relatively little impact on contemporary thinking as a result of a changed perception of medical advancements and of technology generally. In 1918, scientists and the public assumed germs could still kill large numbers of people, which large-scale pandemics such as the “Russian Flu” had done just a few decades earlier (Honigsbaum 2010). At the same time, paradoxically, the public was beginning to believe that modern medicine and hygiene could contain, or even stop, diseases. People in 1918 had a memory of what a pandemic, and infectious diseases more generally, could do, but at the same time they were increasingly optimistic that modern science, public health, and the transformation of the norms of daily life to eliminate germs might end the scourge of disease once and for all (Hays 2009; Tomes 1998). From the 1918 pandemic through the 1970s, the public began to take less seriously the impact of diseases and particularly pandemics, even if this fear never went away entirely (Peckham 2020). The elimination narrative began to shift starting in the 1980s, during the reemergence of infectious diseases around the world, especially the HIV/AIDS epidemic (McKay 2017). Despite repeated warnings from the scientific community that a pandemic could eventually wreak havoc on the global community, expectations that a disease could disrupt individual lives or even broader society remained low until COVID (Caduff 2015; Garrett 1995; Spinney 2018).

The COVID pandemic has unfolded in an inverse context from the 1918 influenza pandemic. Due to medical advancement in the intervening century and the belief in the elimination of infectious diseases, there is now a view that we have the necessary medical knowledge (or can quickly develop the medicine) to stop a pandemic from interrupting our lives. This assumption is based significantly on technological utopianism, with an emphasis on the development of a vaccine that will stop COVID and allow us to return to our “normal” lives. This somewhat paradoxical set of contingent circumstances, complacency, and technological utopianism helps account for the significant number of infections and deaths from COVID in many Western European countries and the United States.3

Both the Black Death and the 1918 influenza pandemic, are, of course, dramatically different from COVID-19 in one obvious respect. There is a stark divide between how people live and work in 2020 versus 1918, let alone 1347. It is now possible to shut down an entire country or union of countries, while allowing white-collar sectors to continue largely unchanged through telework. Large numbers of people today can sit in their homes while meeting with colleagues on Zoom and writing reports. Commerce and capitalism can likewise continue online and arrive via delivery to your front steps.

3As of February 2021, this view seems likely to increase in the US and the UK, which have had some of the highest numbers of deaths but also some of the fastest vaccination rates.

Problematic Paradigms and the Plague Concept

Over the past century, historians and other scholars have developed, almost unwittingly, a set of assumptions about what historical pandemics must supposedly do. The paradigmatic pandemic has long been the Black Death. Our collective memory of that experience, however partial, I have argued, has resulted in the “plague concept.” We know that the Black Death killed tens of millions, and we believe it reshaped European history in a variety of ways. We then take that knowledge and apply it as a point of comparison to every subsequent pandemic, real or imagined. The plague concept has the effect of transforming any significant epidemic outbreak into an ahistorical and trans-historical event, merging all historical pandemics into a single, flat concept (Eisenberg and Mordechai 2020b). The plague concept prompts us to look for certain kinds of impacts, certain kinds of stories. Of course, the concept is itself not static: it has evolved over the past century and surely will again following COVID. Historians are constantly adding to it, subtracting from it, or altering bits and pieces. But the broader problem is the notion of sameness it fosters, the sense that disease, rather than people responding to disease in specific, contingent ways, makes history.

One example of how the plague concept misleads was the initial view that COVID would act as a great leveler of inequality. This view was based upon mid-14th-century economic data showing that in the years immediately following the catastrophic loss of around 50% of the European population, some peasants in some regions received an increase in their wages, resulting in a reduction in inequality (Scheidel 2017). Elites who required peasants to farm their lands were required to redistribute their wealth (via increased pay) given this labor shortage. Of course, this happened in only certain regions, England in particular, and affected only some people (Alfani 2020). However, the notion of disease as an economic leveler entered the plague concept, thus extending this belief in the redistribution effects of a pandemic to somehow apply everywhere and across all time, wherever disease takes a devastating societal toll. (For more details, see Geltner 2020 and Haldon et al. 2020b.)

In the early months of COVID, some historians naïvely found the notion of plague as a great leveler comforting, even hopeful. They put forward the notion that this latest pandemic also might reduce economic inequality. Optimistic that this pandemic might duplicate the Black Death’s leveling, early commentators ignored contradictory examples, the significance of social context, and the reality of political struggle, and, unsurprising, were disappointed (Scheidel 2020a, 2020b). In the US in 2020, by all accounts, the income gap only increased, with white-collar workers receiving steady paychecks, significant returns in the stock market, and becoming flush with cash they were unable to spend, while “essential” workers were forced to put themselves and their families at risk in order to earn a paycheck, and were likely to suffer first when businesses or local governments experienced a cash crunch. Able to isolate safely in their homes,

elites cut back on discretionary spending (Horsley 2020), while workers whose jobless benefits were reduced or cut off in an effort to force them back to work, even as the pandemic continued to spread, found themselves increasingly unable to support themselves, even as COVID-19 devastated their communities (Badger and Parlapiano 2020). Social context matters, yet the plague concept has molded what we think should happen, supposedly based on lessons from the past, even as such projections have manifestly failed to appear.

The Pandemic Experience

Historical pandemic research should focus instead on a different source of information, which we have tended to ignore: the voices of those who have lived during past pandemics. Historical scholarship on pandemics has begun to ask about the experiences of those living through an outbreak (Bristow 2012; Milne 2018; Steere-Williams 2020). Rather than the grim mortality statistics or economic outcomes, the daily life of those living through past pandemics may offer us glimpses of different ways to think about our world today.

One experiential focus has been on the significant trauma of people who cannot bury dead relatives and friends in accordance with normal practices. Procopius of Caesarea famously wrote a firsthand account of Constantinople during the initial Justinianic Plague outbreak of 542 CE. According to him, the situation grew increasingly worse over the course of the outbreak, and while the first people to die were buried in single graves, eventually a new office (called the Referendarius) was created that was tasked with finding new ways to bury the dead. Procopius noted that “at that time all the customary rites of burial were overlooked. For the dead were not carried out escorted by a procession in the customary manner, nor were the usual chants sung over them, but it was sufficient if one carried on his shoulders the body of one of the dead to the parts of the city which bordered on the sea and flung him down.” Moreover, throwing people into the sea was not the only way to dispose of the large numbers of dead. Some, for example, were thrown into hollowed out sections of the city walls, while others were tossed into mass graves (Procopius, 2.22–23). How many people died may never be known, but the impact of the disease on the minds of the city populace, including Procopius, was profound (Mordechai et al. 2019). Similar attitudes to burial were exhibited during the 1918 influenza pandemic, in which even the (relatively) small increase in the weekly dead quickly overwhelmed the morgues, and authorities had to create temporary burial jobs in Philadelphia (Crosby 1989). COVID-19 is no different: hospitals have required temporary freezer morgues on site; infamous large mass graves of unclaimed dead were established on Hart Island off the Bronx in New York City during COVID’s height; and even those who could be buried in single graves have had funerals conducted via online platforms (Jackson and McDermid 2020; Kilgannon 2020).

A second pandemic experience appears to be flight, especially of elites from cities. During the initial outbreak of the Justinianic Plague, John of Ephesus, who was traveling through what is now Israel and Syria, remarked that entire villages were empty as people fled into the hills to avoid the plague. This was far from unusual. Paul the Deacon recorded similar empty villages in Italy during an outbreak of the plague a century later. While some entire villages fled, elites benefitted the most. They not only could afford to flee but also left with large amounts of their wealth intact and available, which is why John of Ephesus’s account is focused on the greed of elites in trying to abscond not just with their own wealth, but with their neighbors’. According to Theophanes Confessor, during one of the last outbreaks recorded in the middle of the eighth century, the Emperor Constantine V fled from the capital of Constantinople to a nearby city. While the writers of the time condemned his actions, his flight did not disrupt the workings of the government. He continued working as before, but in a new place.

COVID-19 has resulted in a similar experience. Elites with their excess capital and ability to work remotely have been able to flee urban centers, famously New York and Paris, and move to rural and suburban locations to avoid the threats and inconveniences of COVID. The focus here on how different groups—those with the power to move and those without—is a far more useful approach to understanding, and critiquing, the culture of the time, than simply noting pandemics leave a path of death and destruction (Bellafante 2020; Onishi and Méheut 2020). The Justinianic Plague example highlights the differences between how societies define “elites.” In the eighth century, the elites consisted of the emperor and his key administrators, who were both wealthy and non-wealthy individuals, while today the flight of people from cities is linked almost entirely to financial wealth. This one example reveals the inappropriateness of applying the past to the present without an understanding of that cultural past. It also demonstrates how contemporary culture hardly represents a moral improvement upon premodern people simply by virtue of modern medicine. Contemporary culture too, can react to a pandemic in altruistic or callous ways.

Resilience and Transformation

Historians of disease and other disasters (not to mention many other scientific fields) have often worked within a resilience framework. Within that framework, societies are conceived as complex adaptive systems that have structural features with significant roles for humans and their belief systems. The complex interplay of humans and structural features provides the possibility that states can resolve instances of social stress—crises—within those belief systems (Cumming and Peterson 2017; Haldon et al. 2020a). Many historical analyses of pandemics, but especially those of the distant past, have subsumed the experience of people who lived through them to questions about how the society, regardless of its size,

was resilient. The pandemic then simply becomes an autonomous actor imposing its biological power on another biological specimen—a pathogen against a human, with human society simply trying to prevent or at least limit the pathogen’s impact—and from today’s perspective, the primary reason the premodern world is unable to contain the pathogen is the absence of modern medicine. The resilience framework is inherently conservative, because the goal of resilience is defined as a return to the status quo. Death, particularly of the poor and vulnerable, is simply accepted. Additionally, the resilience framework is self-serving to those who center capitalism, and particularly the free market, because while the market may be resilient, individuals—who die in large numbers—clearly are not. In a series of separate articles with several colleagues, I have examined reactions to these moments of stress, the costs of resilience, and the intended and unintended consequences of this resilience. What appears quite clear from these historical cases—which span from the early middle ages to the early modern period—is that the costs are not shared equally and, in fact, are borne most significantly by the least powerful members of society (see, for example, Haldon et al. 2020b).

The flattening of the pandemic past into a societal resilience model misunderstands how people in the past thought about their world, how they experienced a disease at an individual level, and inappropriately uses past pandemics to conform to present needs. It is not enough to try to find silver linings during past pandemics, since doing so ignores the plight of the individuals who lived through them and suggests that past realities might simply be reused in the present. The failure to contain COVID in the US resulted not just from President Trump’s disbanding the response team that had put together a plan for addressing a pandemic such as COVID-19, but also from a collective failure to think outside the structural straitjacket of contemporary cultural norms. Arguing about whether past pandemics caused a reduction in inequality teaches us nothing, because the obsessive focus on saving “the economy” did not exist in the past: the idea of the economy as a unique sphere that should be privileged above all else is a creation of the 20th century (Mitchell 2014).

Our search for easy economic answers exists across all spheres of our lives today. Looking for answers about the future of the sports industry in a postCOVID world, for example, based on what happened in 1918, is futile. The place of sports in shaping daily life and culture was fundamentally different in 1918 than it is in 2020. Simplistic predictions, such as that COVID will reduce the number of collegiate sports, overlooks how differently people thought in the past. More importantly, it prevents us collectively from making choices that will shape a future that benefits us equitably and morally. For the past to be of use, we must first acknowledge how differently people once thought and then engage in the slow, hard work of examining ourselves today.

Conclusion

A key goal for historians should be to recognize the different ideologies that governed how cultures previously responded to pandemics in order to provide us new ways of thinking about and transforming the inequalities of the society in which we live. Resilience requires not merely survival (of the fittest) but also attempts to transform the reality in which we find ourselves. One result of the COVID-19 pandemic that already appears “obvious” is that hospitals, nursing care centers, and other high-risk locations must retain on hand significant quantities of personal protective equipment (PPE) and other supplies to prevent devastating consequences. The surplus approach seems to have helped Taiwan, for example, reduce the number of deaths and researchers, even before the pandemic suggested the US and other countries adopt the same practices (Chen et al. 2017). Yet, if the world is able to prevent another globalized pandemic for five or 10 years after COVID, hospitals and nursing centers are likely to refuse to replenish any stocks of PPE as an “onerous” business expense. As long as economics drives these kinds of decisions, we will simply be left to mourn again the enormous numbers of preventable deaths at nursing homes. Multiple waves of COVID infections were initially predicted, and this prediction resonated with the media and public, but because most people, including governments, could not be bothered to take appropriate actions, the predicted waves were allowed to occur. We will need to change our thinking in order to prevent additional deaths.

We must use different ideas from the past to change the present, aiming for better outcomes during and after the COVID-19 pandemic. At an initial level, states need their populations to unify during COVID as a way to ensure social cohesion and to prevent the deaths of their most vulnerable members. Social cohesion is necessary, for example, to ensure that everyone wears a mask in countries that are unwilling or unable to impose more coercive measures to reduce infection rates. Yet that is the bare minimum. On a broader level, we must take into account the diversity of experiences and impacts and replace an economics-centered model as the sole basis for analysis. There is no point in returning to a normalcy in which in which capital defines who lives and increasingly who dies. Nothing changes just because something—in this case, the COVID pandemic—happens: rather, change happens because of how people react to what has happened as they organize, mobilize, and march.

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Special Issue on the COVID-19 Pandemic Edited by Cherie Lacey and Annemarie Jutel

Editors’ Introduction: More Than a Virus Cherie Lacey and Annemarie Jutel The Trials of Solidarity: A Defence Rubén A. Gaztambide-Fernández

Cells in Hiding Rebecca Gray Ontological Uncertainty and Ontological Threat: COVID-19 and the UK Michael P. Kelly In Case the Sun Disappears Julia Schneider “In This Together”: Diagnosis and the Imaginary Nation Annemarie Jutel The Unexpected Perks of Flatting During Covid-19 Ruby Solomon Autopsy of the Living: Elderhood, Race, and Biocitizenship in the Time of Coronavirus Jennifer Lum You Must Change Your Life: A Journey Toward Love and Kindness Kathleen M. Kuehn

NZ COVID Diary Annemarie Jutel Intimacy in Isolation: Podcasting, Affect, and the Pandemic Molly Robson Victors, Victims, and Vectors Rebecca E. Olson, Adil M. Khan, Dylan Flaws, Deborah L. Harris, Hasan Shohag, May Villanueva, and Marc Ziegenfuss Unpacking Michael McLane

Uses of History During the First Nine Months of COVID Merle Eisenberg

Cover Illustration: Graffiti on a Wellington, New Zealand, street. Photo © Emily Greenbank. Used with permission.