The current Ebola epidemic has presented challenges both medical and ethical. Although we have known epidemics of untreatable diseases in the past, this particular one may be unique in the intensity and rapidity of its spread, as well as ethical challenges that it has created, exacerbated by its geographic location. We will look at the infectious agent and the epidemic it is causing, in order to understand the ethical problems that have arisen.

As COVID-19 drags on and new vaccines promise widespread immunity, the world's attention has turned to predicting how the present pandemic will end. How do societies know when an epidemic is over and normal life can resume? What criteria and markers indicate such an end? Who has the insight, authority, and credibility to decipher these signs? Detailed research on past epidemics has demonstrated that they do not end suddenly; indeed, only rarely do the diseases in question actually end. This (...) article examines the ways in which scholars have identified and described the end stages of previous epidemics, pointing out that significantly less attention has been paid to these periods than to origins and climaxes. Analysis of the ends of epidemics illustrates that epidemics are as much social, political, and economic events as they are biological; the “end,” therefore, is as much a process of social and political negotiation as it is biomedical. Equally important, epidemics end at different times for different groups, both within one society and across regions. Multidisciplinary research into how epidemics end reveals how the end of an epidemic shifts according to perspective, whether temporal, geographic, or methodological. A multidisciplinary analysis of how epidemics end suggests that epidemics should therefore be framed not as linear narratives—from outbreak to intervention to termination—but within cycles of disease and with a multiplicity of endings. (shrink)

In 2000, US Secretary of Health and Human Services Secretary Tommy Thompson mobilized the US public health infrastructure to deal with escalating trends of excess body weight. A cornerstone of this effort was a report entitled The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. The report stimulated a great deal of public discussion by utilizing the distinctive public health terminology of an epidemic to describe the growing prevalence of obesity in the US population. We (...) suggest that the ensuing controversy was fueled in part by the report's ambiguous usage of the evocative term “epidemic.” In some passages, the report seems to use “epidemic” in a literal sense, suggesting that rising prevalence of excess body weight should be defined technically as a disease outbreak. Other passages of the report present the same key term metaphorically, leaving readers with the impression that the epidemic language is invoked primarily for rhetorical effect. Here, we explore dynamics and implications of both interpretations. This analysis sheds light on the ongoing public argument about the appropriate societal response to steadily increasing body sizes in the US population; likewise, it capitalizes on the accumulated knowledge that the field of public health has garnered from combating diverse historic epidemics. Our interdisciplinary approach deploys critical tools from the fields of rhetoric, sociology and epidemiology. In particular, we draw from metaphor theory and public address scholarship to elucidate how the Call to Action frames public deliberation on obesity. We turn to the applied public health literature to develop a reading of the report that suggests a novel approach to the problem—application of the Epidemic Investigation protocol to streamline the public health response and reframe the public argument about obesity. (shrink)

Many epidemics consist in individuals spreading infection to others. From the population perspective, they also have population characteristics important in modeling, explaining, and intervening in epidemics. I analyze epidemiology’s contemporary population perspective through the example of epidemics by examining two central principles attributed to Geoffrey Rose: a distinction between the causes of cases and the causes of incidence, and between “high-risk” and “population” strategies of prevention. Both principles require revision or clarification to capture the sense in which they describe distinct (...) perspectives on the same phenomenon, each perspective capturing a different level of contrastive analysis. (shrink)

Modern scholarship has drawn hasty and numerous parallels between the Yellow Peril discourses of the 19th- and 20th-century plagues and the recent racialization of infectious disease in the 21st-century. While highlighting these similarities is politically useful against Sinophobic epidemic narratives, Michel Foucault argues that truly understanding the past’s continuity in the present requires a more rigorous genealogical approach. Employing this premise in a comparative analysis, this work demonstrates a critical discontinuity in the epidemic imaginary that framed the Chinese (...) as pathogenic. Consequently, those seeking to prevent future disease racialization must understand modern Sinophobia as fundamentally distinct from that of the past. (shrink)

The aim of the present study was to investigate relationships among epidemic risk perception, perceived stress, mental health, future time perspective, and confidence in society during the novel coronavirus disease pandemic in China. Especially, we wonder that whether perceived stress mediates associations between epidemic risk perception and mental health and that whether future time perspective and confidence in society moderate the link between perceived stress and mental health. This cross-sectional study was conducted among 693 Chinese adults aged 18–60 (...) years. The results showed that epidemic risk perception was positively related to perceived stress, depression, and anxiety. The correlations between epidemic risk perception and depression and anxiety were reduced when perceived stress was included, suggesting that perceived stress mediated these relationships. Moreover, the boundary conditions for the associations among perceived stress, depression, and anxiety were found in the study. Specifically, positive future time perspective could buffer the negative effects of perceived stress on depression, and confidence in society could weaken the negative effects of perceived stress on anxiety. Based on these findings, practical guidance and theoretical implications are provided for the public to maintain mental health during COVID-19 pandemic. Limitations and future directions are also discussed. (shrink)

The politics of epidemics in Chinese history not only involves competing interpretations about the meanings of disease, but also includes dynamic tensions between socio-political factors and the participants involved in emergency responses. This article examines three cases-the plague epidemic of 1949, the cholera epidemic of 1961-1965, and the meningitis epidemic of 1966-1967-to reveal the entangling political, technological, and epidemiological factors involved in ending epidemics in the People's Republic of China, while also illustrating the difficulty of charting the (...) end of an epidemic when data on disease prevalence and disease control are collected, reported, framed, and archived by political authorities. (shrink)

This article explores the enterprising act of socially constructing fatness, or overweight and obesity, as an individual and collective problem. We argue that this process is complex and hence draw liberally on and extend an eclectic range of scholarship (e.g. the sociology of the body, moral panic theory, critical weight studies) when presenting a typology of obesity epidemic entrepreneurs, that is, those who actively make fatness into a correctable health problem. Using a variety of data, we consider six main (...) ideal typical entrepreneurs: creators, amplifiers/moralizers, legitimators, supporters, enforcers/administrators and the entrepreneurial self. We conclude with a critique of obesity epidemic entrepreneurship and underscore the broader salience of our work for the sociology of the body/embodiment. The relevance of social studies of the body for the obesity debate and critical weight studies is also highlighted. (shrink)

In this paper, we claim that we can only seek to eradicate the stigma associated with the contemporary opioid overdose epidemic when we understand how opioid stigma and the epidemic have co-evolved. Rather than conceptualizing stigma as a parallel social process alongside the epidemiologically and physiologically defined harms of the epidemic, we argue that the stigmatized history of opioids and their use defines the epidemic. We conclude by offering recommendations for disrupting the burden of opioid stigma.

Modern philosophy continues to grapple with the idea of subjectivity--and, as the concept of subjectivity has consequently been repeatedly refined and redefined, the struggle has spread to the ways we conceive of sovereignty, collectivity, nationality, and identity as a result. Yet, in the absence of an authoritative account of these central philosophical concepts, exciting new ways of thinking have emerged which continue to develop and evolve. Epidemic Subjects--Radical Ontology brings together a renowned team of contributors, including Eric Alliez, Levi (...) Bryant, Maurizio Lazzarato, Patricia McCormack, Angela Melitopoulos, Peter Sloterdijk, and Susan Stryker, who together forge a radically inclusive definition of subjectivity. Drawing on Gilles Deleuze and Félix Guattari's concept of the "girl" as a heuristic device for examining modern society and its foundations, they tie together recent trends in philosophy and offer a concrete way forward from the conception of the "thing" or "object" privileged by new materialism, speculative realism, and other theories of subjectivity. (shrink)

Over 60% of all epidemics have a zoonotic origin, that is, they result from the transmission of infectious diseases from animals to humans. The spill-over of diseases often happens because humans exploit and use animals. In this article, I outline the four most common interfaces that favour the emergence and spread of zoonotic infectious diseases: wildlife hunting, small-scale farming, industrialised farming practices and live animal markets. I analyse which practices serve human food security – and thus have a non-trivial purpose (...) – and which predominantly have an economic purpose or serve as a symbol of wealth. I conclude that many practices that increase the risk for zoonotic infectious disease outbreaks actually do not contribute to the survival and food security of humans. I make two arguments in turn. First, I argue that in cases where the consumption and use of animal products does not contribute to the food security of a population, then this population has a duty to abstain from them, since they impose a grave and avoidable risk to themselves as well as to innocent third-parties. However, some communities must sometimes rely on practices that increase the risk of emergence and transmission of zoonotic infectious diseases, because they have no healthy alternatives. That is, the food security of the local population depends on the consumption and use of risky animal products. The second argument I advance is that, in such scenarios, the international community has a duty to provide the communities concerned with alternative food options, as well as economic and educational opportunities and technologies, in order to reduce the spill-over risk of infectious diseases. Given that abstention from such practices contributes signifcantly to the public good and benefits the international community, the latter has a corresponding duty to provide local communities which abandon such practices with alternatives. (shrink)

HIV-related state laws are being created transnationally though the use of omnibus model laws. In 2004, the US Agency for International Development funded the creation of one such guidance text known as the USAID/Action for West Africa Region Model Law, or N'Djamena Model Law, which led to the rapid spread of HIV/AIDS laws, including the criminalisation of HIV transmission, across much of West and Central Africa . In this article, I explicate how an epidemic of highly problematic legislation spread (...) across the region as a result of a text-mediated work process enabled through model laws. I theorise the textual genre of model laws arguing that these texts are best understood as ‘preoperative documents’ which, when activated, can lead to swift legislative reform in and beyond the field of HIV/AIDS governance. The legislative process being investigated was made visible through participant observation, archival research, textual analysis and informant interviews with national and international stakeholders . This involved ethnographic research in Canada, the USA, Switzerland, Austria, South Africa and Senegal . The untold policy processes and narratives explored in this article make evident how the work of contesting problematic HIV/AIDS model laws and newly drafted state laws involves both creating new texts and contesting the legitimacy and efficacy of others. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:An Epidemic of Difficult PatientsKeva SouthwellAs the opioid epidemic marches on, we have all become familiar with a particular breed of "difficult patient," the intravenous drug user. Most teams try to get through these admissions with as few interactions as possible. Nurses will tell you how much they hate caring for these patients, often citing "they did this to themselves" as they experience prolonged admissions due to (...) infections resulting from Intravenous Drug Use (IVDU). Most services try to get out of admitting these patients, saying they are more appropriate with infectious disease, cardiology, or "anywhere but with me." These patients often use drugs in the hospital, threaten to leave AMA, and are dangerous, liable to assault or abuse the very staff trying to help them. The general consensus is that taking care of these patients is a dirty job … why do I have to do it?That's where I come in. It's a dirty job … and that's exactly why I do it. I run a unique service, where my preferred patients are those admitted for 6–8 weeks of IV antibiotics to treat their endocarditis. Some of these patients survive after discharge, but most don't. I know this. But it's my job to help them anyway. It just turns out that in these cases, help doesn't always look the way you think it will.In a perfect world, having a life-threatening infection would be the rock bottom these young people need to embrace a new way of life. Unfortunately, this world is far from perfect. Just as having diabetes doesn't make you stop wanting junk food, having endocarditis does not make you stop wanting drugs. In fact, it can be the opposite. [End Page 26] Drugs are often the coping tool these patients turn to. Happy? Use drugs. Sad? Use drugs. Scared? Use drugs. That's why it's hard. Addiction defies logic; it can be cunning, baffling, and powerful. Until you understand addiction, you'll never really find a way to treat these patients, let alone a way to enjoy treating them.We all have patients who change things for us. They shift our perspective, make us view our practice, our patients, and ourselves differently; patients who teach us the lessons not learned in school. I will never forget Jack, one of those "difficult patients." He taught me how to care for people who really can't be medically helped. It's a lesson that can take years to learn: You've got to let go of the outcome, and some solutions don't look the way you think they should. In this way, he helped me continue in this difficult work.I was a nearly new hospitalist, having just moved into this work from outpatient addiction care. Jack was a young man, 32 years old. He had presented to our hospital with endocarditis of the aortic and tricuspid valves secondary to IVDU. He was referred to my service when he was ineligible for valve replacement due to septic emboli in his brain and subsequent micro hemorrhage. The surgery team wanted him to recover from these events before considering surgical treatment.Jack was a big guy, over 6'2", with a weight to match. He was covered in tattoos—his back, arms, chest, and neck—not an inch was bare. His physical presence might be considered intimidating. Jack was a man of few words: he complained of very little, was often asleep during medical visits, never really left his room, and had no visitors. About four days after his arrival, nursing became concerned about illicit drug use. Despite the fact he had no orders for narcotics or other sedating meds, he was sleeping all the time. His drug screens were negative. Despite the lack of specific evidence, I was asked to take measures to ensure he was not using illicit drugs, which included placing him on a contract and ordering 1:1 observation.His fatigue was concerning, though not for drug use. A repeat ECHO showed that his aortic insufficiency was worsening. His tricuspid insufficiency was very bad from the start. His belly began to swell, followed by his... (shrink)

Despite their common core in statistics, insurance and epidemiology propel two different forms of solidarity. In insurance, the collective is a source of protection, thanks to the pooling of risks; in epidemics by contrast, the group remains the source of danger for the individual. The aim of this paper is to highlight the conceptions of community and solidarity at play in epidemics in contradistinction to insurance, with a focus on the shift introduced by big data and algorithms. Paradoxically, while the (...) new technologies and epidemiology share a common view on the relation between the individual and the collective, tracing apps were not widely adopted in the Covid-19 crisis. This reluctance to use current technologies for the sake of epidemic containments highlights, beyond legitimate interrogations, a confusion between two imaginaries of the social: insurance solidarity where the interdependence is a source of rights, and epidemic solidarity that imposes duties. (shrink)

RESUMO O tema do artigo é a proliferação de más condutas na ciência que vem ocorrendo nas últimas décadas, designada ao longo do texto pelo termo "a epidemia". As más condutas são violações de normas éticas da ciência, sendo os tipos mais importantes as várias modalidades de fraude, e de falsidades autorais. O artigo divide-se em seis seções. Na primeira, apresenta-se o tema e alguns esclarecimentos terminológicos. Na segunda, são expostas as evidências que corroboram a existência da epidemia. A terceira (...) versa sobre a reação à epidemia, caracterizando sua dinâmica, marcada pelo conflito entre duas posições: a moralizadora, que aplica o tratamento moralizador no combate à epidemia; e a negacionista, que tende a negar a existência da epidemia e que resiste às medidas moralizadoras. A quarta seção versa sobre as causas da epidemia, introduz uma distinção entre produtivismo e producionismo e propõe uma análise das formas como o produtivismo fomenta as más condutas. A quinta consiste em uma crítica ao tratamento moralizador, fundamentada em suas inadequações, principalmente sua ineficácia. Na conclusão, procura-se dar uma ideia de qual seria uma alternativa satisfatória ao tratamento moralizador. ABSTRACT The article deals with the proliferation of violations of ethical norms of science, that started to develop a few decades ago. It will be referred to as "the epidemic". The most important types of these violations are varieties of fraud, and such forms of author misconduct as plagiarism, self-plagiarism, etc. The article is divided into six sections. In the first, the topic is introduced and some terminology clarified. In the second, evidence is presented which corroborates the existence of the epidemic. The third deals with the reaction to the epidemic, by characterizing its dynamics in terms of being dominated by conflict between two positions: the moralizing one - which promotes the application of the moralizing treatment to combat the epidemic; and the negationist one - which tends to deny the existence of the epidemic, and resists the moralizing measures. The fourth explores the causes of the epidemic. A distinction is introduced between productivism and productionism, and an analysis is proposed of the ways productivism fosters violations of ethical norms of science. The fifth consists of a critique of the moralizing treatment, based on its inadequacies, mainly its inefficacy. The conclusion points to an alternative to the moralizing treatment. (shrink)

To answer how epidemics end, one must ask two intersecting but separate questions: first, how particular waves of epidemics end, whether of yellow fever, cholera, plague; and second, how epidemic diseases become eradicated-either through scientific intervention, as with smallpox in the 1970s, or simply by disappearing for reasons that remain mysterious, as with the Second Plague Pandemic from ca. 1347. This article challenges two general notions on how epidemics end. First, individual waves of plagues in European municipalities or regional (...) states did not just fade into the sunset. By the late 16th century, their ends were celebrated with artistic displays, musical and poetic performances, ex-voto gifts, and bangs ranging from tambourines to military salutes. Second, the five-century Second Pandemic of plague-that is, the disease-did not end with declarations or scripted performances, but with another sort of bang. Instead of the usual assumption that epidemic diseases decline gradually over time, progressively inflicting lighter loads of virulence and mortality, the last significant plague outbreaks in most regions in Europe returned to heights of mortality not seen since the Black Death of 1347-1351. Finally, this article adds an obvious but rarely mentioned variable for understanding epidemic endings. Before widespread vaccination, the characteristics of these disappearances depended on the type of disease. (shrink)

The incidence and moral implications of cheating depend on how it is defined and measured. Research that defines and operationalizes cheating as an inventory of acts, that is, “cheating in any form,” has often fueled concern that cheating is reaching “epidemic proportions.” Such inventory measures appear, however, to conflate moral and administrative conceptions of the problem. Inasmuch as the immorality of behavior is a function of moral judgment, academic misconduct is immoral only when it is intentional, and the greatest (...) moral weight should be ascribed to violations that students judge to be the most “serious.”. (shrink)

Kendall's (1956) approach to the general epidemic is generalized by dropping the assumptions of constant infectivity and random recovery or death of ill individuals. A great deal of attention is paid to the biological background and the heuristics of the model formulation. Some new results are: (l) the derivation of Kermack's and McKendrick's integral equation from what seems to be the most general set of assumptions in section 2.2, (2) the use of Kermack's and McKendrick's final value equation to (...) arrive at a finite time version of the threshold theorem for the general case, comparable to that for the case of only one Markovian state of illness in section 2.5, (3) the analysis of the behaviour of the solutions of the integral equation when the starting infection approaches zero in section 2.7, (4) the derivation of the probability structure of a general branching process, after conditioning on extinction in section 3.6, (5) the statement of the generalized versions of Kendall's ideas in the form of precise limit conjectures in section 4, (6) the derivation of a closed expression for the limit epidemic resulting from (3) in appendix 4. (shrink)

The spread of epidemics, especially COVID-19, is having a significant impact on the world. If an epidemic is not properly controlled at the beginning, it is likely to spread rapidly and widely through the coexistence relationship between natural and social systems. A university community is a special, micro-self-organized social system that is densely populated. However, university authorities in such an environment seem to be less cautious in the defence of an epidemic. Currently, there is almost no quantitative research (...) on epidemic spreading and response strategies in universities. In this paper, a case study of a university community is considered for a simulation of an infection evolving after an epidemic outbreak based on the method of system dynamics of the three stages. The results show the following: By improving the speed of the initial emergency response, the total number of patients can be effectively controlled. A quarantine policy helps to slow down the evolution of infection. The higher the isolation ratio, the higher the cost; therefore, the isolation ratio should be optimized. It is important to make emergency plans for controlling epidemic spreading and carry out emergency drills and assessments regularly. According to the results of this study, we suggest an emergency management framework for public health events in university communities. (shrink)

The outbreak and impact of COVID-19 alert humans to the fragility of life and interpersonal bonds. The pandemic and its aftermath bring us not only disease and death but fear and suspicion. Enforced lockdown, quarantine, and isolation worldwide hampered and slowed down human interaction. However, epidemics also prompt us to rediscover valuable qualities inherent in our everyday lives despite the many problems. The retrieval of love in Maugham’s The Painted Veil (1925) is a case in point. By reading Maugham’s The (...) Painted Veil via the lens of epidemics and their impact on humanity, this paper discusses how disease can precipitate rather than impede human interaction. The discussion will help shed light on the meanings and implications of love during and after epidemics. (shrink)

Viral modernity is a concept based upon the nature of viruses, the ancient and critical role they play in evolution and culture, and the basic application to understanding the role of information and forms of bioinformation in the social world. The concept draws a close association between viral biology on the one hand, and information science on the other – it is an illustration and prime example of bioinformationalism that brings together two of the most powerful forces that now drive (...) cultural evolution. The concept of viral modernity applies to viral technologies, codes and ecosystems in information, publishing, education and emerging knowledge systems. This paper traces the relationship between epidemics, quarantine, and public health management and outlines elements of viral-digital philosophy based on the fusion of living and technological systems. We discuss Covid-19 as a ‘bioinformationalist’ response that represents historically unprecedented level of sharing information from the sequencing of the genome to testing for a vaccination. Finally, we look at the US response to Covid-19 through the lens of infodemics and post-truth. The paper is followed by three open reviews, which further refine its conclusions as they relate to philosophy and the notion of the virus as Pharmakon. (shrink)

This paper provides an overview of recent literature on the history of epidemics in East Asia, with a primary focus on modern and contemporary China, but including some discussion of the scholarship in English on epidemics in Korea and Japan. Key research strands are identified within the field: local and regional histories, disease biographies, histories of public health campaigns, global connections, and cultural representations. The paper argues that studies of epidemic disease have been central to debates about East Asian (...) modernity, transformations of the state, the formation of a post-imperial citizenry, postcolonial science and technology studies, and East Asia’s role in globalizing processes. The paper concludes by reflecting on the COVID-19 pandemic and the issues it raises for future research. (shrink)

Institute for Biomedical Ethics, Geneva University Medical School * Corresponding author: Médecins Sans Frontières (OCG), rue de Lausanne 78, CH-1211 Geneva 21, Switzerland. Tel.: +41 (0)22 849 89 29; Fax: +41 (0)22 849 84 88; Email: philippe_calain{at}hotmail.com ' + u + '@' + d + ' '//--> Abstract Outbreaks of filovirus (Ebola and Marburg) hemorrhagic fevers in Africa are typically the theater of rescue activities involving international experts and agencies tasked with reinforcing national authorities in clinical management, biological diagnosis, sanitation, (...) public health surveillance and coordination. These outbreaks can be seen as a paradigm for ethical issues posed by epidemic emergencies, through the convergence of such themes as: isolation and quarantine, privacy and confidentiality and the interpretation of ethical norms across different ethnocultural settings. With an emphasis on the boundaries between public health investigations and research, this article reviews specific challenges, past practices and current normative documents relevant to the application of ethical standards in the course of outbreaks of filovirus hemorrhagic fevers. Aside from commonly identified issues of informed consent and institutional review processes, we argue for more clarity over the specification of which communities are expected to share benefits, and we advocate for the use of collective definitions of duty to care and standard of care. We propose new elaborations around existing normative instruments, and we suggest some pathways toward more comprehensive approaches to the ethics of research in outbreak situations. CiteULike Connotea Del.icio.us What's this? (shrink)

“An epidemic has a dramaturgic form,” wrote Charles Rosenberg in 1989, “Epidemics start at a moment in time, proceed on a stage limited in space and duration, following a plot line of increasing and revelatory tension, move to a crisis of individual and collective character, then drift towards closure.” Rosenberg's dramaturgic description has become an important starting point for critical studies of epidemic endings (Vargha, 2016; Greene & Vargha, 2020; Charters & Heitman, 2021) that, rightly, criticize this structure (...) for its neatness and its linearity. In this article, I want to nuance these criticisms by distinguishing between the term Rosenberg uses, “closure,” and its implicature, “ending.” I aim to show how many of the complications ensuing between the different forms of ending imagined may well be resolved by assessing whether they bring closure or not. (shrink)

The ethics of conducting research in epidemic situations have yet to account fully for differences in the proportion and acuteness of epidemics, among other factors. While epidemics most often arise from infectious diseases, not all infectious diseases are of epidemic proportions, and not all epidemics occur acutely. These and other variations constrain the generalization of ethical decision-making and impose ethical demands on the individual researcher in a way not previously highlighted. This paper discusses a number of such constraints (...) and impositions. It applies the ethical principles enunciated by Emmanuel et al.1 to the controversial Pfizer study in Nigeria in order to highlight the particular ethical concerns of acute epidemic research, and suggest ways of meeting such challenges. The paper recommends that research during epidemics should be partly evaluated on its own merits in order to determine its ethical appropriateness to the specific situation. Snap decisions to conduct research during acute epidemics should be resisted. Community engagement, public notification and good information management are needed to promote the ethics of conducting research during acute epidemics. Individual consent is most at risk of being compromised, and every effort should be made to ensure that it is maintained and valid. Use of data safety management boards should be routine. Acute epidemics also present opportunities to enhance the social value of research and maximize its benefits to communities. Ethical research is possible in acute epidemics, if the potential challenges are thought of ahead of time and appropriate precautions taken. (shrink)

In this paper, we propose a nonlinear coupled model to study the two interacting processes of awareness diffusion and epidemic spreading on the same individual who is affected by different neighbor behavior status on multiplex networks. We achieve this topology scenario by two kinds of factors, one is the perception factor that can change interplay between different layers of networks and the other is the neighbors’ behavior status that can change the infection rate in each layer. According to the (...) microscopic Markov chain approach, we analyze the dynamical evolution of the system and derive the theoretical epidemic threshold on uncorrelated heterogeneous networks, and then, we validate the analysis by numerical simulation and discuss the final size of awareness diffusion and epidemic spreading on a scale-free network. With the outbreak of COVID-19, the spread of epidemic in China prompted drastic measures for transmission containment. We examine the effects of these interventions based on modeling of the awareness-epidemic and the COVID-19 epidemic case. The results further demonstrate that the epidemic spreading can be affected by the effective transmission rate of the awareness and neighbors’ behavior status. (shrink)

For Albert Camus, plague was both a fact of life and a powerful metaphor for the human condition. Camus engaged most explicitly and extensively with the subject of plague in his 1947 novel, The Plague (La peste), which chronicles an outbreak of what is presumably cholera in the French-Algerian city of Oran. I often thought of this novel—and what it might teach us—during the recent COVID-19 pandemic. In this article, I discuss seven important insights from The Plague about epidemics, public (...) health and morality. (shrink)

Vaccines are a powerful measure to protect the health of individuals and to combat outbreaks such as the COVID-19 pandemic. An ethical dilemma arises when one effective vaccine has been successfully developed against an epidemic disease and researchers seek to test the efficacy of another vaccine for the same pathogen in clinical trials involving human subjects. On the one hand, there are compelling reasons why it would be unethical to trial a novel vaccine when an effective product exists already. (...) First, it is a firm principle of medical ethics that an effective treatment or vaccine should not be withheld from patients if their life may depend on it. Second, since epidemic outbreaks often emerge in settings with less-resourced health systems, there is a pronounced risk that any trial withholding an effective vaccine would disproportionately affect the vulnerable populations that historically have been exploited for biomedical research. Third, clinical trials for novel vaccines may be at odds with efforts to control active outbreaks. On the other hand, it may be justified to conduct a trial for a candidate vaccine if it is expected to have certain advantages compared with the existing product. This essay discusses key factors for comparing vaccines against epidemic pathogens, including immunological, logistical and economic considerations. Alongside a case study of the development of vaccines for Ebola, the essay seeks to establish a general framework that should be expanded and populated by immunologists, epidemiologists, economists and bioethicists, and ultimately could be applied to the case of COVID-19 vaccines. (shrink)

This article offers a series of critical theorizations on the biopolitical dimensions of methicillin-resistant Staphylococcus aureus (MRSA), with specific attention to what has recently been referred to in the United States as the ‘MRSA Epidemic’. In particular, we reflect on the proliferation of biomedical discourses around the ‘spread’, and the pathogenic potentialities, of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). We turn to the work of Roberto Esposito and Jean-Luc Nancy to better make sense of how, during this immunological crisis, the (...) individualized fleshy and fluid body is articulated to dimensions of community and corporeal proximity; the body is thus conceived in popular biopolitical framings as a site of transmission, inoculation, and isolation – as a living ecological and pathological vessel. We give emphasis to the spatial relations of flesh, namely in how biomedical ‘experts’ have sought to (bio-)technologize spaces of heightened communal bodily contact (such as playgrounds or gymnasia). (shrink)

Accurate prediction of epidemic evolution faces challenges such as understanding disease dynamics and inadequate epidemiological data. A recent approach faced these issues by modeling susceptible-infectious-susceptible (SIS) dynamics based on the first two statistical moments. Here, we improve this approach by including finite-size populations and analyzing the stability of the resulting model. Results underscore the influence of uncertainties and population size in the natural history of the epidemic.

This paper applies models of the onset of adolescent sexual intercourse using national data from Denmark and the USA. The model gave excellent fits to data on Danish Whites and a good fit to American Whites, but the model-fits for American Blacks and Hispanics were not as good. The weakness of the latter model fits may reflect either real processes that the model does not capture or problems in the reliability of adolescent sexuality data.

Various forms of research are essential in emergency, disaster and disease outbreak situations, but challenges exist including the long length of time it takes to get research proposals approved. Consequently, it would be very advantageous to have an acceptable model for efficient coordination and communication between and among research ethics committees/IRBs and ministries of health, and templates for expediting ethical review of research proposals in emergency and epidemic situations to be used across the Caribbean and in other low and (...) middle income countries. This project involved a literature search and the interviewing of ministry of health officials, public health practitioners, and research ethics committee/IRB members in Jamaica and St. Lucia, to obtain suggestions for the best model for efficient coordination and communication between research ethics committees, and developed a template for expediting review of research protocols in epidemic and emergency conditions. (shrink)

Epidemics that were probably influenza have been reported throughout recorded history. There were 13 fairly severe epidemics during the 18th century and 12 during the 19th century. Probably 8 of these 25 were influenza pandemics. In the 20th century there have been 4 pandemics (1918/19, 1957/58, 1968/69 and 1977) due to the emergence of new subtypes of influenza A virus. The great pandemic of 1918/19 caused an estimated 20 million deaths. Between pandemics usually there have been epidemics of varying severity (...) at intervals of one to three years and a trickle of sporadic cases every winter. The morbidity and mortality rates have varied greatly from epidemic to epidemic and from place to place during the same epidemic. Generally the morbidity has been lowest in people over 60 years of age, but, except for 1918/19, the mortality has been predominantly in old people. The epidemic behaviour of influenza has been so erratic and difficult to understand that there are still a few scientists who consider that extraterrestrial influences operate. These views are not taken seriously by most virologists but there are puzzling aspects of influenza that are not yet understood. (shrink)

The historiography of pandemics and inequality can be characterized by two distinct but often overlapping traditions. One centers structural and political analysis, the other a race-critical approach to the production of human difference. This bibliographic essay reviews historical scholarship in these traditions spanning the past hundred years, with a focus on Anglophone literature in the history of medicine in the United States over the past half century. Early writing on the history of epidemics celebrated the conquest of disease through the (...) application of laboratory research. Insights from social history and environmental history came to inform new analyses of epidemic inequalities, drawing questions of race, class, and empire into the frame during the 1960s and 1970s. The AIDS pandemic of the 1980s further oriented scholarship toward reckoning with stigma, identity, and human experiences of inequality while also troubling the relationship between medicine and the state. In more recent decades, the scholarship on race, social inequality, and pandemics has become deep and broad, remedying longstanding biases toward elite scientific actors and the metropolitan centers of Europe and the East Coast of the United States. In expanding their vision, historians also have engaged in more nuanced analyses of racialization as a social, environmental, and ideological process of embodying difference. Further, where earlier scholarship often relied on mortality data, there has been growing awareness of how numbers shape narratives and are shaped by them in turn. In its conclusion, the essay highlights emerging themes in race and inequality with particular attention to themes that have become prominent amid the global devastation wrought by the COVID-19 pandemic. (shrink)

The obesity epidemic among children and adolescents in the United States continues to worsen. The most recent analysis of data from the National Health and Nutrition Examination Survey showed that the prevalence of overweight among children and adolescents – defined as a Body Mass Index at or above the 95th percentile on gender-specific BMI-for-age growth charts developed by the Centers for Disease Control and Prevention – increased significantly between 1999-2000 and 2003-2004. Over this period, the prevalence of overweight among (...) children and adolescents aged 2-19 increased 23% – from 13.9% to 17.1%. In 2003-2004, 18.8% of children aged 6-11 and 17.4% of adolescents aged 12-19 were overweight. Roughly comparable proportions of each age group were considered to be at risk of becoming overweight. (shrink)

Previous studies revealed that the susceptibility, contacting preference, and recovery probability markedly alter the epidemic outbreak size and threshold. The recovery probability of an infected node is closely related to its obtained resources. How to allocate limited resources to infected neighbors is extremely important for containing the epidemic spreading on complex networks. In this paper, we proposed an epidemic spreading model on complex networks, in which we assume that the node has heterogeneous susceptibility and contacting preference, and (...) susceptible nodes are willing to share their resources to neighbors. Through a developed heterogeneous mean-field theory and a large number of numerical simulations, we find that the recovered nodes provide resources uniformly to their infected neighbor nodes, and the epidemic spreading can be suppressed optimally on homogeneous and heterogeneous networks. Besides, altering the susceptibility and contacting preference does not qualitatively change the results. The susceptibility of the node decreases, which makes the outbreak threshold of epidemic spreading increase, and the outbreak size decreases. Our theory agrees well with the numerical simulations. (shrink)

In this manuscript, I analyze Slavoj Žižek’ s debate with the Canadian clinical psychologist Jordan Peterson. The terms “Venus envy” and “academic inferiority complex” are used based on classical psychoanalytic jargon. Jordan Peterson and Slavoj Žižek are interpreted as the representatives of the opposing ends of our contemporary academic postmodern spectrum. Žižek demonstrates the unchained M arxist, and Peterson embodies the persona of the capitalist educator. T his article is a gateway to shed light on the decaying core of postmodern (...) ideology in contemporary academic discourse. (shrink)

The study aims at shedding light on plagues and epidemics that hit Egypt during the Mameluke period through describing the plague disease and the plagues and epidemics that hit Egypt and the social and economic impact on the Egyptian society. The study is based on some historical sources that are contemporary of the Mameluke period, especially the book "Al-Suluk li-marifatiduwal Al-muluk" by Al- Maqrizi and we reach the following conclusions through this research:- Plagues are bacterial and lethal epidemics that spread (...) fast, and have the symptoms of high temperature nausea, and severe fatigue. Most plagues that hit Egypt during the Mameluke era were very severe, and that what is usually referred to as the Great plague or Black Death, where the patient dies within one week of having the disease.- The plagues had harsh social effects on the population, where it caused the death of individuals, and damaged hundreds of Egyptian villages and cities, The conditions of the society almost came a halt, and were an impetus for the people to bind in social solidarity, and the true repentance to Allah the almighty, and the increase of worship and alms hoping that Allah the almighty will shield the people from this disease. - The plagues and epidemics led to disorder and disruption of the economic conditions of the society, where most land was left without farming and most trades and crafts were disrupted and earnings hit lows in the markets and trade was in recession in commerce and trade in general. (shrink)

The COVID-19 pandemic has created unusually challenging and dangerous workplace conditions for key workers. This has prompted calls for key workers to receive a variety of special benefits over and above their normal pay. Here, we consider whether two such benefits are justified: a no-fault compensation scheme for harm caused by an epidemic and hazard pay for the risks and burdens of working during an epidemic. Both forms of benefit are often made available to members of the armed (...) forces for the harms, risks and burdens that come with military service. We argue from analogy that these benefits also ought to be provided to key workers during an epidemic because, like the military, key workers face unavoidable harms, risks and burdens in providing essential public good. The amount of compensation should be proportional to the harm suffered and the amount of hazard pay should be proportional to the risk and burden endured. Therefore, key workers should receive the same amount of compensation and hazard pay as the military where the harms, risks and burdens are equivalent. In the UK, a form of no-fault compensation has recently been made available to the surviving families of key workers who suffer fatal COVID-19 infections. According to our argument, however, it is insufficient because it offers less to key workers than is made available to the families of armed services personnel killed on duty. (shrink)

The classical models of epidemics dynamics by Ross and McKendrick have to be revisited in order to incorporate elements coming from the demography (fecundity, mortality and migration) both of host and vector populations and from the diffusion and mutation of infectious agents. The classical approach is indeed dealing with populations supposed to be constant during the epidemic wave, but the presently observed pandemics show duration of their spread during years imposing to take into account the host and vector population (...) changes as well as the transient or permanent migration and diffusion of hosts (susceptible or infected), as well as vectors and infectious agents. Two examples are presented, one concerning the malaria in Mali and the other the plague at the middle-age. (shrink)

The national opioid epidemic is severely impacting Indian Country. In this article, we draw upon data from the Centers for Disease Control and Prevention to describe the contours of this crisis among Native Americans. While these data are subject to significant limitations, we show that Native American opioid overdose mortality rates have grown substantially over the last seventeen years. We further find that this increase appears to at least parallel increases seen among non-Hispanic whites, who are often thought to (...) be uniquely affected by this crisis. We then profile tribal medical and legal responses to the opioid epidemic, ranging from tribally-operated medication-assisted therapy to drug diversion courts rooted in traditional tribal cultures. (shrink)

This article highlights and evaluates the role of CEPI and its contribution to global equitable access to COVID-19 vaccines through its established partnerships for vaccine development. The article adds to the understanding of how and when such partnerships can work for public health, especially under emergency citations.

Obesity may be the most difficult and elusive public health problem this country has ever encountered. Unlike the classical infectious diseases and plagues that killed millions in the past, it is not caused by deadly viruses or bacteria of a kind amenable to vaccines for prevention, nor are there many promising medical treatments so far. While diabetes, heart disease, and kidney failure can be caused by obesity, it is easier to treat those conditions than one of their causes. I call (...) obesity elusive partly because of the disturbingly low success rate in treating it, but also because it requires changing the patterns, woven deeply into our social fabric, of food and beverage commerce, personal eating habits, and sedentary lifestyles. It also raises the most basic ethical and policy questions: how far can government and business go in trying to change behavior that harms health, what are the limits of market freedom for industry, and how do we look upon our bodies and judge those of others?. (shrink)

Here, an epidemiological model considering pro and anti-vaccination groups is proposed and analyzed. In this model, susceptible individuals can migrate between these two groups due to the influence of false and true news about safety and efficacy of vaccines. From this model, written as a set of three ordinary differential equations, analytical expressions for the disease-free steady state, the endemic steady state, and the basic reproduction number are derived. It is analytically shown that low vaccination rate and no influx to (...) the pro-vaccination group have similar impacts on the long-term amount of infected individuals. Numerical simulations are performed with parameter values of the COVID-19 pandemic to illustrate the analytical results. The possible relevance of this work is discussed from a public health perspective. (shrink)