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Lay constructions of risk impact upon public health activities and underpin social reactions to experiences and understandings of infectious diseases. In this article, we explore the social construction of COVID-19 risk and responsibility by citizens of Jakarta and the Greater Jakarta Area, Indonesia. We draw upon digital diaries produced each week by 37 participants across a 5-week period from April to June 2020, a time of substantial policy flux in Indonesia. Key findings reflect the everyday construction of risk within the context of changing government restrictions regarding physical distancing. In the context of perceived confusion around government activity, the participants narrated individualised accounts of risk production, as they reflected upon the transmission of COVID-19. Our findings indicate the emergence of the concept of the 'ignorant imagined other' as underpinning how lay persons locate risks in unknowledgeable others and see themselves as socially protected through their own perceived knowledgeability of COVID-19. Our findings contribute to the literature on the social perception of infectious disease through the examination of the understudied context of urban Indonesia and by demonstrating the social location of risk in relation to a generalised imagined other, within a wider context of public health governance. [ABSTRACT FROM AUTHOR]

This study draws upon interviews of medical staff working in the city of Minamisoma, Japan, following the 2011 Triple Disaster. It investigates staff responses to the disruption of material resources as a consequence of the disaster and its management. The disruption of spaces, and the loss of oxygen supplies, food, and medications impacted upon staff experience and the ability of institutions to care for patients. This resulted in a restructuring of spaces and materials as workers made efforts to reconfigure and reestablish healthcare functions. This is one of the few qualitative studies which draws upon the experience and perspectives of health workers in understanding material disruption following disaster. This is particularly important since this case did not involve the breakdown of lifeline infrastructure, but rather, brought to attention the way everyday material objects shape social experience. In highlighting these effects, the paper makes the case for the social scientific investigation of the impact of disasters on healthcare, shedding light on an area of research currently dominated by disaster medicine. [ABSTRACT FROM AUTHOR]

Contemporary risks are often understood as fundamentally uncertain. This uncertain status can be mobilized within political debates surrounding risks. Such a challenge serves to destabilize scientific claims. The World Health Organization’s (WHO) management of the 2009/10 spread of the H1N1 virus became a site of one such contestation. Debate within the Council of Europe particularly served to criticize the action of the WHO. This resulted in a definitional and policy contestation between the two institutions. The WHO accounted for its actions through allusions to (seemingly stable) scientific facts, using epidemiological evidence of influenza and its management based on normal science. In contrast, in criticizing public expenditure and panic, the Council of Europe critics problematized the stability of the science employed by the WHO. This included fundamental aspects of scientific knowledge such as the measurability of morbidity and mortality caused by H1N1 and the effect of vaccination against influenza viruses. This criticism relied upon the ability to destabilize the WHO’s scientific knowledge, a process made possible through understandings of the uncertain nature of the science of risk (post-normal science). The case study illustrates that potential for previous-established and seemingly stable scientific facts to become destabilized and problematized during contestations of risk management. [ABSTRACT FROM PUBLISHER]

Within public health, and increasingly other areas of social policy, there are widespread calls to increase or improve the use of evidence for policy-making. Often these calls rest on an assumption that increased evidence utilisation will be a more efficient or effective means of achieving social goals. Yet a clear elucidation of what can be considered “good evidence” for policy is rarely articulated. Many of the current discussions of best practise in the health policy sector derive from the evidence-based medicine (EBM) movement, embracing the “hierarchy of evidence” that places experimental trials as pre-eminent in terms of methodological quality. However, a number of problems arise if these hierarchies are used to rank or prioritise policy relevance. Challenges in applying evidence hierarchies to policy questions arise from the fact that the EBM hierarchies rank evidence of intervention effect on a specified and limited number of outcomes. Previous authors have noted that evidence forms at the top of such hierarchies typically serve the needs and realities of clinical medicine, but not necessarily public policy. We build on past insights by applying three disciplinary perspectives from political science, the philosophy of science and the sociology of knowledge to illustrate the limitations of a single evidence hierarchy to guide health policy choices, while simultaneously providing new conceptualisations suited to achieve health sector goals. In doing so, we provide an alternative approach that re-frames “good” evidence for health policy as a question of appropriateness. Rather than adhering to a single hierarchy of evidence to judge what constitutes “good” evidence for policy, it is more useful to examine evidence through the lens ofappropriateness. The form of evidence, the determination of relevant categories and variables, and the weight given to any piece of evidence, must suit the policy needs at hand. A more robust and critical examination of relevant and appropriate evidence can ensure that the best possible evidence of various forms is used to achieve health policy goals. [ABSTRACT FROM PUBLISHER]

As well as a site of politics and public health action, the outbreak of Ebola in West Africa has been a focus of media representations. This paper examines print media narratives around border control in relation to Ebola in the UK, the USA and Australia from the start of the epidemic to May 2015. It shows that Ebola became mobilised as a frame through which domestic politics could be discussed. The disease was transformed from a problem for West Africa to a problem for the West. The context of West Africa and affected populations was homogenised and hidden. The focus of reporting centred upon domestic political actions and more local sources of threat. [ABSTRACT FROM AUTHOR]

Scientific uncertainty is fundamental to the management of contemporary global risks. In 2009, the World Health Organization (WHO) declared the start of the H1N1 Influenza Pandemic. This declaration signified the risk posed by the spread of the H1N1 virus, and in turn precipitated a range of actions by global public health actors. This article analyzes the WHO's public representation of risk and examines the centrality of scientific uncertainty in the case of H1N1. It argues that the WHO's risk narrative reflected the context of scientific uncertainty in which it was working. The WHO argued that it was attempting to remain faithful to the scientific evidence, and the uncertain nature of the threat. However, as a result, the WHO's public risk narrative was neither consistent nor socially robust, leading to the eventual contestation of the WHO's position by other global public health actors, most notably the Council of Europe. This illustrates both the significance of scientific uncertainty in the investigation of risk, and the difficulty for risk managing institutions in effectively acting in the face of this uncertainty. [ABSTRACT FROM PUBLISHER]

The classification of novel disease events is central to public health action surrounding them. Drawing upon the sociology of scientific classification, this article examines the role and contestation of the World Health Organization’s Pandemic Alert Phases, as applied to the spread of 2009/10 H1N1 Influenza. The analysis of World Health Organization texts, including policy documents, public statements and epidemiological documents, has been utilized to examine the Organization’s actions and public narratives around the event of H1N1. Analytically, the functional role of such classificatory schemes and the social construction of scientific classifications are examined. It is argued that in understanding the World Health Organization’s 2009/10 application of the Pandemic Alert Phases, the critical limitation of the functions served by the classificatory scheme led to the breakdown of its construction. This case study highlights the importance of classification for the successful production of scientific ‘facts’, the constructed nature of classificatory systems and the potential for contestation that arises when such classifications do not adequately fulfil their functional roles. [ABSTRACT FROM PUBLISHER]

Infectious disease threats are surrounded by scientific uncertainty. As a result, institutional structures can heavily determine the way in which such risks are managed. This is illustrated by the World Health Organisation's (WHO) management of the 2009 H1N1 pandemic. Given this, theories of path dependency, derived from the ‘new institutionalism’, are useful in analysing such events. This article examines theories of institutional and discursive path dependency in respect to the case study of the WHO's management of H1N1. It argues that the WHO's emphasis on the use of vaccines as a protective measure constitutes a path dependent reaction, based on the organisation's historical achievements with vaccines and its discourse surrounding vaccine use. Furthermore, in contrast to accounts which understand historical and institutional path dependency as exclusive theoretical models, the article argues that institutional and discursive path dependencies were mutually interacting in forming the WHO's response to H1N1. Finally, the article explores the question of institutional change within theories of path dependency. Here, using the case of the WHO, it is shown that the interference of an outside actor, the Council of Europe, caused the WHO to internally evaluate its actions, leading to institutional change. [ABSTRACT FROM AUTHOR]

This paper examines the construction of avian influenza in Australian media and federal government policy, with a focus placed on discourses of contagion, preparedness and risk. The threat of an infectious disease outbreak, such as avian influenza, on social life is surrounded by a range of collective narratives which attempt to make it explicable. These narratives socially define the disease and provide explanations for its existence. The paper demonstrates that central to these narratives are depictions of the source of the outbreak and suggestions of appropriate responses to the threat. Methodologically, a narrative analysis of print media and government documents was conducted. This showed that conceptually both government and media discourses could be understood in terms of risk, contagion and blame. Furthermore, it was found that narratives linking the risk of avian influenza with globalised interconnectedness and contagion by the developing world underpin discourses of causation and frame the reactions to and preparation for a potential outbreak. [ABSTRACT FROM AUTHOR]

Since 2003, avian influenza has recently spread around the world sparking fears of a potential pandemic. As a result of this, a range of explanations and expectations surrounding the phenomenon were generated. Such social representations of disease depict the issue under discussion and frame reactions to the event. This paper explores the social representations surrounding avian influenza in Australia. Methodologically, a textual analysis of media and government documents was conducted in order to uncover the social representations implicit in these accounts. This demonstrated a symbolic framing of avian influenza with reference to the Spanish Influenza pandemic (1918). Analytically, the study draws upon the concepts of social representations from Durkheim and of risk and symbolic risk in the work of Beck. Overall, it is argued that the framing of avian influenza as a risk, mediated through the collective memory of Spanish Influenza, characterised the nature of the social representations surrounding the phenomenon. This resulted in the production of symbolic solutions to the threat. [ABSTRACT FROM AUTHOR]

Background: Worldwide, COVID-19 has exacerbated the vulnerability of migrants, impacting many facets of their lives. Nepalese make up one of the largest groups of migrants residing in Japan. Crises, such as the ongoing COVID-19 pandemic could disproportionately affect migrants from low- and middle-income countries like Nepal, widening health and economic inequalities. An in-depth, comprehensive assessment is needed to appraise the diverse problems they encounter. Drawing upon qualitative interviews, this study aimed to identify challenges faced by Nepalese migrants in Japan as a consequence of the COVID-19 pandemic and to discuss their needs to counter these challenges.Methods: This qualitative study employed an interpretivist approach to appraise the first-hand experience of Nepalese migrants living in Japan. Fourteen participants (8 males and 6 females, aged 21 to 47 years old) were recruited to participate in semi-structured in-depth telephone interviews (45-60 min) regarding: (a) their perceived current physical and mental health, (b) problems faced as a result of the COVID-19 pandemic, and (c) perception of available and necessary support structures. Purposive and snowball sampling techniques were used to recruit the participants. Interviews were recorded, transcribed, and thematically analyzed.Results: Six themes were identified: 1) experiencing psychosomatic symptoms, 2) adoption of new healthy behaviors, 3) financial hardship, 4) family concerns, 5) reflections on discrimination and 6) reflections of existing support and expectations of support systems. The findings of our study illustrate the specific impact of COVID-19 among Nepalese migrants regarding their unstable employment conditions, perceived lack of social support, possible obligation to send money home, difficulty in accessing services due to the language barrier, and a lack of effective governmental support from Nepal. Pandemic-related adversity has negatively impacted migrants' mental well-being, exacerbating their vulnerability.Conclusions: Comprehensive and timely support should be provided to the vulnerable migrant population. Effective coordination among relevant parties in both countries, including the governments concerned, should be facilitated. [ABSTRACT FROM AUTHOR]