Understanding COVID-19 as a ‘Disaster’: A Sociological Perspective

Disasters are defined as severe disruptions in the routine functioning of society due to adverse events which cause serious harm to lives and livelihoods, economy, environment, and social and cultural resources. Based on this definition, the novel coronavirus disease or COVID-19 qualifies as a ‘disaster.’ Though COVID 19 has not caused damage to property or infrastructure, it has claimed many lives and created a serious disruption in the functioning of the society, thereby affecting almost everyone across the world. It has overwhelmed organizations established to address emergencies and disasters and has led to the closure of borders and cancellation of arts, sports, and other social events. Thus, COVID-19, though a public health emergency, qualifies as a ‘disaster’.

Considering COVID-19 as a ‘disaster,’ however, calls for an interpretation of COVID-19 from the perspective of disaster studies. This article focuses on understanding COVID-19 as a ‘disaster’ utilising theories and concepts developed in the sociological studies of disasters and what this implies for the management of COVID-19. This nuanced understanding, different from a medical or epidemiological perspective, is essential to identify alternative strategies and approaches to reduce the risk and ‘disastrous’ impact of pandemics in the future.

COVID-19 hazard, exposure, vulnerability, and risk

Disaster theorists unanimously agree that disasters only occur when vulnerable individuals, communities or environments are exposed to hazardous processes or events. [1] Reflecting on COVID-19 from this perspective implies that COVID-19 is not a simple manifestation of a virus that can affect anyone anywhere. Its The virus’s risk and impact are shaped by socio-economic and institutional processes. The hazard in the case of COVID-19 is the virus, which is neutral and can affect anyone. Exposure and vulnerability to the hazard, however, are determined by pre-existing conditions in the society that are not related to the biological threat of the virus but are influenced by structural factors.

Exposure implies a situation where people or property are located in a hazard-prone area. In the case of COVID-19, exposure means that an individual comes in contact with or close to a person who is affected by COVID-19. Marginalized people are predisposed to work under conditions which disproportionately expose them to the virus. For example, an individual residing in an urban slum working in the service industry travelling in public transport is more exposed to COVID-19 than a privileged individual.

Vulnerability, on the other hand, implies the susceptibility of an individual to be affected by a hazard. Marginalised groups (in terms of gender, caste, ethnicity, age, economic status, and other demographic factors) are more likely to suffer from chronic medical conditions and have weak immunity to diseases. [2] In the absence of a robust public health care system, such groups are more likely to have poor access to health care facilities and medical attention. The public health strategies implemented to manage pandemics in the form of social isolation and lockdown also disproportionately affect marginalised people. In India, the migrant workers were massively affected after the announcement of a nationwide lockdown. Additionally, the ‘social’ distancing and hygiene norms prescribed in the management of COVID-19 risk are hard to implement even in regular scenarios. According to the 2011 census, almost 65.5 million people live in slums in India, where maintaining a ‘social’ distance is not feasible. [3] Only 46.6% of the Indian population avail drinking water within the premises, which implies that a large section of our population is compelled to utilise communal drinking facilities. [4] Additionally, large parts of India face acute water scarcity in summer months, which raises serious questions on the feasibility of handwashing practice. These pre-existing socio-economic disparities and institutional shortcomings create additional layers of vulnerability for the disadvantaged sections of the population.

The socio-economic dimensions of COVID-19 risk and impact become evident if we look at the mortality and morbidity rates of the disease, which have not been uniform across different population groups. In most cases, the impact has been devastating in marginalised groups. For example, in the United States, the pandemic has disproportionately affected communities in the Navajo nation and African Americans who are already considered marginalised and vulnerable. [5, 6] Thus, the pandemic is far from a ‘leveller’ that it is touted to be and rather is largely socio-economic and political in nature.

What this means for management of pandemic risks

This approach to understanding COVID-19 is not without limitations. Firstly, the pandemic and its impact are still evolving, and hence our understanding is also transitional. Secondly, this approach to study a pandemic necessitates understanding a hazard of biological origin through concepts and theories developed to study the hazards of natural or technological background. Reflecting on COVID-19 as a disaster brings forth perspectives that can prove crucial in the management of pandemics in the future.

As with disasters, COVID-19 also showed how underlying factors of vulnerability like inequality, lack of access to resources, marginalization, and exclusion could exacerbate the risk and impact of pandemics. Like floods that need more than the construction of embankments to reduce the effects, pandemics also need solutions that are more than a medical cure. It calls for urgent attention to reducing socio-economic and institutional vulnerability. It is noteworthy that Phelan and Link’s Theory of Fundamental Cause to explain health disparities also recognise the association between socioeconomic status and disease mortality rates despite ‘radical changes in diseases and risk factors.’ The theory argues that health disparities can be addressed either by “reducing disparities in socioeconomic resources themselves or by developing interventions that, by their nature, are more equally distributed across socioeconomic status groups.” [7] Considering the socio-economic and political nature of the COVID-19 and its impacts, there is thus an urgent need to engage in a more significant debate on understanding how this can inform not only public health policy and pandemic management practices but also the social and political discourse in general. On a broader level, we need to reflect on whether we want to resume the same socio-economic and institutional processes and activities that created a situation of disproportionate risk or demand for a structural change and ‘build back’ a better system.

Preparing for pandemics and mitigating their impacts

From the above discussion, it is evident that socio-economic marginalisation and inequality in resource access shape the vulnerability and exposure of individuals during pandemics. Welfare policies and social security nets which ensure food security, health care, minimum wages, affordable housing, access to water, etc. are robust instruments to reduce marginalisation and are all relevant in reducing pandemic risk and impact. For example, an individual whose food security is ensured is less likely to travel to work in unsafe conditions risking exposure to the disease. Similarly, an individual who has access to adequate water is more likely to adopt behavioural interventions like hand hygiene than one who is water insecure. Thus, welfare policies and programmes, though falling outside the explicit mandate of public health systems, are intricately tied to health outcomes and need to be recognised and emphasised to reduce the risk and impact of pandemics in the future.

Secondly, there is an urgent need to remove existing barriers in healthcare access due to a lack of resources. Marginalised people are more likely to have limited savings and no medical insurance, which prohibits timely access to healthcare and recovery. In the case of pandemics, this impedes the containment of the disease. Bringing everyone under the umbrella of healthcare will enable quick detection of new emerging diseases and containment of local outbreaks, reducing the chance of undetected spread of pandemics and mitigating possible pandemic risks.

Lastly and most importantly, policies to control and manage pandemics need to be humane, with the overarching goal of developing health interventions which anyone can adopt. If this is not feasible due to practical challenges, we need to identify every section of the population who, due to resource constraints, might not be able to follow the suggested interventions and develop an alternate strategy to safeguard them. For example, recognition of the homeless population as a vulnerable group who are highly likely to fail to adopt lockdown rules and providing them with temporary shelters to stay, at least, during the lockdown. Without such a holistic approach, pandemic management strategies will fail to deliver the envisioned results.

Notes:

1. Quarantelli, E. L. (Ed.). (1998). What is a disaster?: perspectives on the question. Psychology Press.
2. Kennedy, B. M., Paeratakul, S., Ryan, D. H., & Bray, G. A. (2007). Socioeconomic status and health disparity in the United States. Journal of Human Behavior in the Social Environment, 15(2-3), 13-23.
3. Kumar, P. (2016). Slums in India: results from census, 2011. J Environ Soc Sci, 3(1), 124.
4. Kumar, A., & Das, K. C. (2014). Drinking water and sanitation facility in India and its linkages with diarrhoea among children under five: evidence from recent data. Int J Humanit Soc Sci Invent, 3(4), 50-60.
5. Tai, D. B. G., Shah, A., Doubeni, C. A., Sia, I. G., & Wieland, M. L. (2020). The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States. Clinical Infectious Diseases.
6. Van Dorn, A., Cooney, R. E., & Sabin, M. L. (2020). COVID-19 exacerbating inequalities in the US. Lancet (London, England), 395(10232), 1243.
7. Phelan, J. C., Link, B. G., & Tehranifar, P. (2010). Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. Journal of health and social behavior, 51, S28-S40.