A cursory observation and popular perceptions reveal a ‘fatigue’ with respect to the current trends. In plain language, people are fed-up with the unusual control on their lives and this is especially severe among young people and the children. The fatigued also include parents who have to manage the dichotomy with respect to professional and personal lives with extra efforts as children remain at home and the online or virtual social sphere takes a toll on them. Most people wonder when all these are going to end and also pose their concerns and worries regarding the post-COVID scenario. Public health and epidemiology have a fundamental responsibility to answer their concerns although there are severe limitations due to non-availability of data. In the absence of such data, a large number of control activities were based on speculations, assumptions and hypotheses. Some of them are also falsities in the name of science which would have induced panic among population.
Normally, epidemiologists will have a field day after epidemics or pandemics. They come out with various measures, graphs and figures unintelligible to many in the general public. Unfortunately or fortunately, this did not happen much and it did not happen because there was not data of any worth for their calculations except a few numbers. Even with regard to many earlier infections that struck humanity at various times, it took time for ‘scientists’ to understand the science of transmission. We should expect the same story with COVID. Given such uncertainties, expressions like ‘it is possible’, ‘it appears’, ‘it is likely’ ‘might have’ etc. have been doing the rounds in scientific and popular articles. These are inevitable when people become uncertain and helpless!
Epidemiological analysis are required in order to assess ourselves regarding where we want to invest our resources to control. In the US or in China too where the virus is believed to have originated, relevant epidemiological analyses were carried out. But most of such analyses have not contributed much to the policy process regarding control of the pandemic. It is true that some people cannot tolerate lack of rigour in health research and they think that hobnobbing with quantitative entities and playing the number game would be sufficient to take care of rigour. But in many cases as in the present too, it is not always possible to adhere to dictionary definitions of rigour such as ‘exact, scrupulously accurate, precise etc.’. In health-related research where people and their life are closely intertwined, this becomes more problematic. Ratcliffe and Gonzalez-Del-Valle presented an expanded conceptualization of rigour as research cannot be considered as mere use of data collection tools and statistical analysis but involves deliberate or even arbitrary choices made by the researcher. Such research, therefore, introduces lot of errors which are normally dismissed or white-washed with more indices and numbers. In the current scenario, such conceptualizations become evermore pertinent as uncertainties galore.
One alternate approach is based on the concept of ‘popular epidemiology’ and I have been a follower of such an epidemiology for a long time. Phil Brown, who refined the concept termed it as a form of citizen science and a type of social movement. Popular epidemiology is a lay way of knowing that is based in part on an appropriation of expert knowledge by non-experts. As a social movement and citizen science, popular epidemiology can be used to mobilize the population around health issues. It can also be used to understand people’s health problems and their struggles in grappling with them which in essence is ‘going to the people and learning from them’.
Such an epidemiology has the potential to identify local patterns with respect to the infection as well as the risk factors including socio-economic factors. It can also reveal the strengths and weakness of institutional and infrastructural capabilities in grappling with infections. I used such an approach in some of my own research as well as my students’ research and it always led to meaningful additions to knowledge regarding many important health problems affecting the society. At a larger philosophical level, I believe that the people have played and still playing an important role in shaping their own health as the political leaders only respond to the popular expressions of their needs.
Given the current scenario of data limitations and data availability, ‘popular epidemiology’ becomes extremely meaningful where the dialectical complexities with respect to the interactions between the virus and the people can be brought out. This will certainly help the process of pandemic control.
(K Rajasekharan Nayar is affiliated to Global Institute of Public Health and Santhigiri Research Foundation, Thiruvananthapuram, Kerala)