Expertise and folk knowledge at a time of pandemic

This is an expanded discussion of an article that first appeared in The Sunday Independent (Ireland), 26 April 2020, p. 27.

Critiquing novelty

“Novel coronavirus”. This phrase has rapidly come to define our lives in recent weeks. Coronaviruses are an ancient family of infectious diseases composed of clusters of Ribonucleic acid (RNA), which are transmitted from animals to humans and cause respiratory infections. Their novelty in our current moment has been defined by coronavirus’s latest mutation, COVID-19 (CO-, “corona”, VI-, “virus”, D-, “disease), its newness denoted numerically by the year in which its effects were first felt in Wuhan, China. However, are there limitations of our taking COVID-19’s “novelty” as a given and, if so, what are they, how might they be pushed back, and why?

Thus far, COVID-19 has had novelty bestowed upon it by scientific expertise (based on knowledge, personnel and institutions). In one sense, this approach is completely reasonable and speaks to a technical point within scientific communities to denote a new type of disease and the challenges that its appearance poses for scientists, policy-makers and elected officials. However, the idea of novelty has also come to set much of the tone and content of our public conversations. Public discourse has largely been shaped by this notion of newness and from it a narrative has been crafted that emphasizes the “unprecedented” nature of our current experience. We might call this the key tenet of a “public-scientific” account of the disease, its significance and its effects.

Conflating novelty’s meaning across two very different contexts – technical description within science, to social, political and cultural experience without – denies, first, any agency that citizenries might have over understanding their experience of this pandemic. If you are faced with the prospect of contracting a previously unknown disease, are not an expert who might be able to attend to the problems of mediation and inoculation, and have little alternative frameworks by which to make sense of your changed circumstances, how should you proceed? The novelty – the unknown nature – of COVID-19 frightens us. At the same time, in denying our agency, we lose the opportunity to tap valuable historical and cultural resources within our communities for describing imaginable precedents to our current experience of infectious disease. In consequence, we lose out on ways of coping with the effects of dislocation, isolation and distance.

We need to identify visible and viable “folk discourses”, which will help us understand the ways in which infectious disease is more familiar to us than our established public narratives would have it. This second form of discourse is a crucial element of the information politics that have emerged in the disease’s wake, which have largely been focused on the dangers arising from the public’s consumption of misinformation about COVID-19, and substances or practices which might cure it. This has been branded its ontological sibling, an “infodemic”. The criticism levelled at purveyors of misinformation, and the actions of businesses and governments to counteract them, is, of course, valid and right. Nobody should be drinking bleach, or ingesting anti-malarial drugs, in a bid to rid or inoculate themselves from COVID-19, especially on the bogus advice of their elected (and unqualified) officials. The contributions of well-placed commentators, within medicine and politics but also from historians and sociologists who have provided valuable accounts of precedents to global pandemics, offer some counter-balance to the risks to public health arising from misinformation.

However, we still live with another type of information danger: “un-information”, or what is not spoken rather than what is spoken in error. In addition to challenging both novelty and the more pernicious problem of misinformation, there is a need, too, for individuals – regardless of their occupation or expert status – to understand their place in the social experience of COVID-19, and to share it with those around them. This is what I mean by folk discourses of infectious disease: personal narratives which originate in the experiences, both present and past, of a broad cross-section of the population.

A personal “folk discourse” of disease

In the days before she died in 1963, tuberculosis had consigned my grandmother to solitude. Restricted to a room that had been sealed off from the rest of her family’s cottage in rural county Wexford, her lungs were close to collapse, her body weakened by years of pulmonary infection. Shortly before she passed, the tape was momentarily removed from her bedroom door, so that she might see her children once more. Looking out of the window, she spied my grandfather, walking towards the house from the bottom of the field that opened out onto the Blackstairs Mountains and Mount Leinster, a large length of wood slung across his shoulders. “Mind him”, she said to my father, aged eight at the time, “he’s a good man”. She expired shortly after, leading my father to conclude that at once he had both known and not known his mother.

The details surrounding my grandmother’s death were a history unknown to me before the onset of COVID-19; I knew she had died young from tuberculosis, and left behind a husband to raise four children on his own, but I was unaware of the finer grain that clarified her story’s larger detail. They only fell from my father one morning last week after breakfast, one of many such discussions that have occurred in the weeks since I came to my parents’ house on the Loop Head peninsula in Clare to weather the pandemic’s effects. This sort of opening up, of the effects of infectious disease in our recent past, is what I mean here by folk discourse. There is knowledge of epidemic disease within our families, which has existed tacitly and unspoken for decades, and has the power, not only to connect us to our very recent social and cultural histories, but also to better understand some of our most long-standing relationships.

In this example from my own family, tuberculosis seemed to correlate with emigration, that most common of Irish experiences. Although also a function of the “usual suspects” in the emigration story – the push of local and national poverty, the lack of employment, the search for an imagined better life – all of my grandmother’s children emigrated in the years after her death, my father and his sister, like so many others, to London in their late teens. Given the endemic nature of tuberculosis in Ireland in the middle of the twentieth-century, there is not only an interesting line of historical inquiry to be interacted with here, by way of the work of historians who have traced how endemic disease restructured medical knowledge and familial relations, and drove the embodiment of stigma. To what extent was endemic disease responsible for casting out emigrants, too? There is also an opportunity for us to conceive of infectious disease, not as something unprecedented or novel, but as a long-standing determinant in the structuring of our social and cultural DNA. Furthermore, those previous experiences of infectious disease are still in living memory, through parents and grandparents. Perhaps knowing of their experiences would provide solace, or at the very least context, to those of us experiencing isolation and social distancing as measures that have induced anxiety or fear about the future. There is, I believe, value in understanding previous hardships thrown up by infectious disease, the way in which people adapted to meet their demands, and how they might compare to our experiences in the second quarter of 2020. By emphasizing the ability of our forebears to adapt to disease-induced change, we complement COVID-19’s scientific novelty with a cultural acuity for the resilience of those who have come before us.

Beyond acknowledging our cultural resources for coping with this fraught moment in our history, folk knowledge of disease can help us to deepen and strengthen our relationships among those from whom we find ourselves isolated. Nothing other than an existential crisis of some order, like the social anaesthesia induced by this global pandemic would have put me both physically and mentally in spaces where I was as attentive to my family. Whilst distanced and isolated from society at large, the global pandemic has also brought me into closer relations with my status as a son. If I surrender to poetry, perhaps the depth of my now knowing Dad corresponds to the shallowness of his knowing my grandmother, enforced as it was by tuberculosis’ regime.

I am aware, too, that my ability to isolate and distance from COVID-19 has been made easier and more tranquil by having the option to escape from the relatively densely populated town where I work, to the more sparsely populated place that I think of as home. Indeed, I could not claim in good faith to be one of the people for whom isolation has proven to be a trial; that same privilege is unobtainable for many. However, I am grateful for the opportunity that this physical making of space has afforded me to make space in a second sense: for reflection on not the novelty of our times but the continuities in our social history, and its being defined by responses to moments of epidemiological crisis. At the same time, I have been given space to reflect on one of my most substantial and cherished relationships, which I have with my father. History, which I so often study in abstraction, in the mode of an expert, has been brought into intimate contact with my role as a son. From that synergy, between expert and folk knowledge, I draw strength and comfort in a time of uncertainty.



Kieran Fitzpatrick

Dr Kieran Fitzpatrick is the current NUI post-doctoral fellow in the humanities, based at NUI Galway’s Moore Institute. Prior to arriving in Galway he completed his DPhil in the social history of medicine at St John’s College, Oxford. His work focuses on the history of expertise and professional work in nineteenth- and early-twentieth century Britain, particularly through the lens of the surgeon, Sir Peter Johnstone Freyer, whose archive is housed in the University’s Special Collections. He has a number of research articles appearing in prominent historical journals over the next six to twelve months, and is in the early phases of beginning work on his first book: a cultural history of the division of labour in medicine as viewed through the Freyer archive.