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)

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)

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.

Data indicate the ubiquity and rapid increase of depression wherever war, want and social upheaval are found. The goal of this paper is to clarify such claims and draw conceptual distinctions separating the depressive states that are pathological from those that are normal and normative responses to misfortune. I do so by appeal to early modern writing on melancholy by Robert Burton, where the inchoate and boundless nature of melancholy symptoms are emphasized; universal suffering is separated from the disease states (...) known as melancholy or melancholia, and normal temperamental variation is placed in contrast to such disease states. In Burton's time these distinctions and characterizations could be secured by the anchoring tenets of humoral theory. Without such anchoring, and in light of the findings and assumptions of today's biological diagnostic psychiatry, we must re-visit each of them. My goals here are to show the need for analytic foundations when claims are made about depression such as those cited above, and to draw attention to some contemporary attempts that may help provide those foundations, particularly, attempts to define disorder or disease. With adjustments, one of these (Cooper 2002) is shown to take us some way toward that goal. (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)

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.

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)

Irrational responses to patient with AIDS, particularly in regards to the transmissibility of HIV are examined from an historical and psychosocial perspective. Although these responses are similar to those reported from past epidemics such as plague and leprosy, they are in direct conflict with our current level of understanding regarding the transmission of this virus. Their genesis may relate to the human penchant to react to illness metaphorically. In order to allay effectively public concern about the transmissibility of AIDS, it (...) is essential to recognize the metaphor associated with venereal disease in general and AIDS in particular. (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)

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)

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)

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)

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)

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)

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)

Review of S. Nadler and L. Shapiro, When Bad Thinking Happens to Good People: How Philosophy Can Save Us from Ourselves.

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)

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)

Monrad JT. Ethical considerations for epidemic vaccine trials. J Med Ethics 2020;46:465–9. doi:10.1136/medethics-2020-106235 This ….

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)

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)

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)

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)

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)

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)

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)

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)

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)

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.

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)

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)

BackgroundRapid data sharing can maximize the utility of data. In epidemics and pandemics like Zika, Ebola, and COVID-19, the case for such practices seems especially urgent and warranted. Yet rapidly sharing data widely has previously generated significant concerns related to equity. The continued lack of understanding and guidance on equitable data sharing raises the following questions: Should data sharing in epidemics and pandemics primarily advance utility, or should it advance equity as well? If so, what norms comprise equitable data sharing (...) in epidemics and pandemics? Do these norms address the equity-related concerns raised by researchers, data providers, and other stakeholders? What tensions must be balanced between equity and other values?MethodsTo explore these questions, we undertook a systematic scoping review of the literature on data sharing in epidemics and pandemics and thematically analyzed identified literature for its discussion of ethical values, norms, concerns, and tensions, with a particular emphasis on equity. We wanted to both understand how equity in data sharing is being conceptualized and draw out other important values and norms for data sharing in epidemics and pandemics.ResultsWe found that values of utility, equity, solidarity, and reciprocity were described, and we report their associated norms, including researcher recognition; rapid, real-time sharing; capacity development; and fair benefits to data generators, data providers, and source countries. The value of utility and its associated norms were discussed substantially more than others. Tensions between utility norms and equity norms were raised.ConclusionsThis study found support for equity being advanced by data sharing in epidemics and pandemics. However, norms for equitable data sharing in epidemics and pandemics require further development, particularly in relation to power sharing and participatory approaches prioritizing inclusion. Addressing structural inequities in the wider global health landscape is also needed to achieve equitable data sharing in epidemics and pandemics. (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)

Die populäre Vorstellung, exzessiver Drogenkonsum sei in der Weimarer Republik ein gesellschaftlich weit verbreitetes Phänomen gewesen, hält einer empirischen Überprüfung nicht stand. Obwohl Mediziner die Öffentlichkeit und die Politik vor einer „Kokainwelle“ warnten, die die „Volksgesundheit“ bedrohe, existieren keine Belege, die auf eine signifikante Zunahme des Kokainkonsums in den Zwanziger Jahren hindeuten. Die entscheidende Ursache für diese moralische Panik lag vielmehr im Krankheitsbild des Kokainismus begründet. Die Sucht trug das Gepräge einer Infektionskrankheit und sollte den Körper, den Willen und die (...) bürgerliche Existenz der Betroffenen vernichten. Gemäß der medizinischen Lehrmeinung erzeugte chronischer Kokainkonsum die Neigung zu abweichenden Sexualpraktiken und kriminellen Handlungen. Daher wurde der Gebrauch der Substanz vor allem mit ohnehin als deviant markierten sozialen Milieus wie der sogenannten Bohème und Halbwelt verknüpft. Tatsächlich zeigen historische Quellen jedoch, das es sich hierbei primär um ein Problem der medizinischen Berufe handelte. Vor dem Hintergrund der desolaten politischen, sozialen und ökonomischen Lage Deutschlands nach dem Ersten Weltkrieg betrachteten viele Mediziner Suchtkrankheiten wie Kokainismus und Morphinismus als Bedrohung für den erhofften politischen und biologischen Wiederaufstieg der Nation. (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)

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)

Loneliness is one of the most neglected aspects of emotion history, despite claims that the 21st century is the loneliest ever. This article argues against the widespread belief that modern-day loneliness is inevitable, negative, and universal. Looking at its language and etymology, it suggests that loneliness needs to be understood firstly as an “emotion cluster” composed of a variety of affective states, and secondly as a relatively recent invention, dating from around 1800. Loneliness can be positive, and as much a (...) part of the body as the mind. Using a longue durée approach, I argue that we cannot understand loneliness as a “modern epidemic” without considering its history, its meanings, its practice, and its links with the body. (shrink)