Misunderstanding a Viral Pandemic: The Social and Cultural Contexts of COVID-19

it is rare that social theory can save lives, but the conceptual framework through which viral pandemics are largely understood costs lives by failing to include key insights based in social theory. In this paper, we employ a cultural contexts of health approach to show how the ways in which viral transmission is conceptualized, and misunderstood, affect how society deals with pandemics.

As we write this in early 2020, the SARS-CoV-2 virus is spreading across the world, upending economies and lives. One-third of the world's population is under stay-at-home orders, an instance of biosocial coordination unprecedented in scope or scale. At a time when trust in many traditional institutions is at an all-time low, political leaders and the general public have placed great hope in scientific laboratory solutions, namely tests and vaccines. This is important and necessary work, but we cannot fully understand how the virus works—or combat its effects—just by looking through a microscope or sequencing the genome. Flattening the growth curve of transmission also requires a deep understanding of the social and cultural aspects of the viral pandemic. In fact, the devastation of COVID-19 results from social norms, cultural practices, and political decisions as much as from biological causes.

Let us be clear: we are not using "culture" here in the way it is often invoked in the public health literature, as a polite shorthand for stereotypes about groups of people based on age, gender, and racial or ethnic background. By culture we refer simply to shared conventional understandings of any type, including those shared by institutions and professions (Napier et al. 2014). Culture is not opposed to science. It is not just beliefs and prejudices that counter scientific facts. It refers to our often local, and sometimes global, taken-for-granted assumptions, as well as our strongly held and consciously recognized beliefs.

The idea that social and cultural contexts are key to health and well-being is not a new idea, even if it was often forgotten in the twentieth-century surge of modernist scientific and technological innovation. Studying the devastation wrought by the 1848 Silesian typhus epidemic, Rudolph Virchow concluded that promoting public health requires seeing medicine as a sociocultural, as well as a biological, science (Taylor and Rieger 1984). Following Virchow's example, we may draw several lessons from analyzing the current COVID-19 pandemic as a cultural and social phenomenon.

first, viral transmission depends almost entirely on the ways we socialize, norms of conviviality, and the requirements of making a living. The timing of the outbreak in China fatefully coincided with celebrations of the Lunar New Year, when hundreds of millions of people return to their ancestral villages for feasts and festivals with family and friends. These cultural practices led to rapid and widespread transmission. Moreover, it is commonplace activities, and not just exotic customs, that facilitate transmission. Habits of work, large family meals, social and religious gatherings, and holiday travel—everywhere the virus has spread, it has been along social and cultural pathways.

But all is not grim in this regard. Cultural norms can also protect and encourage us. Healthcare workers daily risk exposure, showing us the better sides of our common humanity. And many who are not endangered by limited periods of isolation have used time in retreat for reflection on life's purpose. Provided a certain level of trust and stability prevail, such mindfulness can engender a productive hope that insecurities will not be fueled and inflamed by inequality and that governments themselves do not excuse their own public health neglect by blaming outsiders.

second, the ways we conceptualize viruses—our cultural and mental models—affect how we are able to deal with them. Certainly, there are devastating consequences of the counterfactual narratives promoted by national leaders, including the United States' Donald Trump, Brazil's Jairo Bolsonaro, and China's Xi Jinping. In a March 2020 survey conducted by the Pew Research Center, almost 30 percent of respondents thought COVID-19 was developed in...