Outbreak Culture

A Choice Outstanding Academic Title of the Year ÒA critical, poignant postmortem of the epidemic.Ó ÑWashington Post ÒForceful and instructive...Sabeti and Salahi uncover competition, sabotage, fear, blame, and disorganization bordering on chaos, features that are seen in just about any lethal epidemic.Ó ÑPaul Farmer, cofounder of Partners in Health ÒThe central theme of the book...is that common threads of dysfunction run through responses to epidemics...The power of Outbreak Culture is its universality.Ó ÑNature ÒSabeti and Salahi present a wealth of evidence supporting the imperative that outbreak response must operate in a coordinated, real-time manner.Ó ÑScience As we saw with the Ebola outbreakÑand the disastrous early handling of the COVID-19 coronavirus pandemicÑa lack of preparedness, delays, and system-wide problems with the distribution of critical medical supplies can have deadly consequences. Yet after every outbreak, the systems put in place to coordinate emergency responses are generally dismantled. One of AmericaÕs top biomedical researchers, Dr. Pardis Sabeti, and her Pulitzer PrizeÐwinning collaborator, Lara Salahi, argue that these problems are built into the ecosystem of our emergency responses. With an understanding of the path of disease and insight into political psychology, they show how secrecy, competition, and poor coordination plague nearly every major public health crisis and reveal how much more could be done to safeguard the well-being of caregivers, patients, and vulnerable communities. A work of fearless integrity and unassailable authority, Outbreak Culture seeks to ensure that we make some urgently needed changes before the next pandemic.

An award-winning genetic researcher and a tenacious journalist examine each phase of the Ebola epidemic in West Africa, the largest and deadliest of its kind. Their postmortem identifies factors that kept key information from reaching doctors, complicated the government's response to the crisis, and left responders unprepared for the next outbreak.

DIVShows how narratives of contagion structure communities of belonging and how the lessons of these narratives are incorporated into sociological theories of cultural transmission and community formation./div

How should we understand the fear and fascination elicited by the accounts of communicable disease outbreaks that proliferated, following the emergence of HIV, in scientific publications and the mainstream media? The repetition of particular characters, images, and story lines—of Patients Zero and superspreaders, hot zones and tenacious microbes—produced a formulaic narrative as they circulated through the media and were amplified in popular fiction and film. The “outbreak narrative” begins with the identification of an emerging infection, follows it through the global networks of contact and contagion, and ends with the epidemiological work that contains it. Priscilla Wald argues that we need to understand the appeal and persistence of the outbreak narrative because the stories we tell about disease emergence have consequences. As they disseminate information, they affect survival rates and contagion routes. They upset economies. They promote or mitigate the stigmatizing of individuals, groups, locales, behaviors, and lifestyles. Wald traces how changing ideas about disease emergence and social interaction coalesced in the outbreak narrative. She returns to the early years of microbiology—to the identification of microbes and “Typhoid Mary,” the first known healthy human carrier of typhoid in the United States—to highlight the intertwined production of sociological theories of group formation (“social contagion”) and medical theories of bacteriological infection at the turn of the twentieth century. Following the evolution of these ideas, Wald shows how they were affected by—or reflected in—the advent of virology, Cold War ideas about “alien” infiltration, science-fiction stories of brainwashing and body snatchers, and the HIV/AIDS pandemic. Contagious is a cautionary tale about how the stories we tell circumscribe our thinking about global health and human interactions as the world imagines—or refuses to imagine—the next Great Plague.

When we were setting the theme of "infection control dilemmas and practical solutions" for this symposium, we asked ourselves a basic question: What are some of the most vexing problems and situations facing the hospital microbiologist epidemiologist team in today's world of opportunistic and new infectious diseases unheard of as common pathogenic occurrences 10 years ago? One of the areas which we immediately focused upon was the tremendous amount of time, energy, and financial resources that are presently being expended to satisfy the requirements mandated by the recognition of the danger of spread of blood-borne pathogens in the hospital environment. With the advent of Universal Precautions, primarily in response to HIV infection and the AIDS crisis, but certainly augmented by the increased incidence of hepatitis in its various forms, a significant effort has been required to meet the standards rec ommended and/or required by OSHA and the CDC. With this in mind we brought together experts in the field of infectious diseases to address the problems engendered by the threat of nosocomial spread of selected pathogens. Further, we devoted several sessions to discussing the investi gation and resolution of institutional outbreaks of disease, particularly with reference to methicillin-resistant Staphylo coccus aureus (MRSA). Special problems of dental offices and clinical teaching as well as extended care facilities were also selected for attention, particularly with relation to blood borne pathogens.

In 2005, American experts sent out urgent warnings throughout the country: a devastating flu pandemic was fast approaching. Influenza was a serious disease, not a seasonal nuisance; it could kill millions of people. If urgent steps were not taken immediately, the pandemic could shut down the economy and “trigger a reaction that will change the world overnight.” The Pandemic Perhaps explores how American experts framed a catastrophe that never occurred. The urgent threat that was presented to the public produced a profound sense of insecurity, prompting a systematic effort to prepare the population for the coming plague. But when that plague did not arrive, the race to avert it carried on. Paradoxically, it was the absence of disease that made preparedness a permanent project. The Pandemic Perhaps tells the story of what happened when nothing really happened. Drawing on fieldwork among scientists and public health professionals in New York City, the book is an investigation of how actors and institutions produced a scene of extreme expectation through the circulation of dramatic plague visions. It argues that experts deployed these visions to draw attention to the possibility of a pandemic, frame the disease as a catastrophic event, and make it meaningful to the nation. Today, when we talk about pandemic influenza, we must always say “perhaps.” What, then, does it mean to engage a disease in the modality of the maybe?

This book centers on negotiations around cultural, governmental, and individual constructions of COVID-19. It considers how the coronavirus pandemic has been negotiated in different cultures and countries, with the final part of the volume focusing on South Asia and Pakistan in particular. The chapters include auto-ethnographic accounts and ethnographic explorations that reflect upon experiences of living with the pandemic and its implications for all areas of life. The book explicates people’s dealings with COVID-19 at various levels, situates the spread of rumors, conspiracy theories, and new social rituals within micro- and/or macro-contexts, and describes the interplay between the virus and various institutionalized forms of inequalities and structural vulnerabilities. Bringing together a variety of perspectives, the volume relates to the past, describes the Covidian present, and offers futuristic implications. It enlists distinct imaginaries based on current understandings of an extraordinary challenge that holds significant importance for our human future.