It is well understood, cross-contextually, that environment shapes human experience. The ongoing COVID-19 pandemic has been characterized in some contexts as a global collective experience: one of shared fear, fight, control, and unity over a novel infectious disease (Stanley et al., 2021). The notion of a collective experience can, however, subsume individual experience, such that an individual’s experience is largely assumed to be identical to that of a collective group (Stanley et al., 2021). It is thus important to consider that other factors, including political unrest, religious cultural influence, or prolonged conflict, can influence an individual’s, and a population’s, experience of a pandemic event.
On February 24th, 2022, Russia began its full-scale invasion of Ukraine. This coincided with a high global prevalence of cases of the COVID-19 Omicron variant, which pushed many countries to increase testing and sanitation measures (Daria & Islam, 2022; Furuse, 2022). In Ukraine, however, the emergence of full-scale war created a shift in priorities, and these health measures were all but stopped, even though modeling suggests that new cases would total approximately 30,000 per day (Chumachenko & Chumachenko, 2022). Several factors impacted this reality, including a lack of access to medical care, a shutdown of many laboratory facilities, and the impossibility of enforcing anti-epidemic measures (Chumachenko & Chumachenko, 2022). The registration of new cases and contact tracing require reliable access to electronic systems, and with the targeted destruction of Ukrainian electrical infrastructure, these methods were no longer viable. Furthermore, when civilians were taking shelter from air-raids, or being evacuated, social distancing, masking, and general sanitation practices could no longer be enforced. Exacerbating this, children under 12 years of age, a demographic that was prioritized for shelter and evacuation, were not yet eligible for vaccination in Ukraine (Chumachenko & Chumachenko, 2022). Those of us who are removed from the immediate situation can see that infection should be granted equal importance to other possible causes of death in one’s environment. To those facing immediate consequences, however, when there is the threat of a virus that may kill you if it enters your home, compared to the threat of a bombing that will kill you if it enters your home, the hierarchy is clear. The COVID-19 pandemic is not over in Ukraine, but the way Ukrainians experience the pandemic as part of our global collective is.
These experiences are not isolated to the present moment. In 1918, the world experienced the deadliest pandemic in modern history. Influenza infected over 500 million people and killed at least 50 million individuals (Morens & Fauci, 2007; Nickol & Kindrachuk, 2019). Emerging at the end of World War I, influenza wreaked havoc on soldiers and local communities, causing more casualties than the entirety of the war (Morens & Fauci, 2007). Despite this, minimal media and scientific attention were given during the time to efforts to combat the disease (Pal, 2019). Events of the war consistently had priority over the public and the media’s attention. Because of this, not much about the pandemic was known by the general population in the geopolitical Western world outside of personal experience within local areas. Public health measures were disjointed with no accurate systematic reporting of cases and deaths (Beach et al., 2020). Further, the war impacted peoples’ experiences of the deaths of loved ones from influenza. It has been recorded that many individuals felt guilty mourning those who lost their lives to influenza because of those who were willingly fighting and dying heroically for their country at war (Pal, 2019). Deaths from influenza were overshadowed by the mortalities of war, and thus, more emphasis and public focus centred on the political conflict over pandemic control.
The COVID-19 and 1918 influenza pandemics engender reflection on both individual and collective experiences of plague during times of war. Though COVID-19 has impacted all nations, the individual and collective experiences within and between nations cannot be generalized to a single unifying experience. Likewise, the political landscape in 1918 impacted individual and collective experiences of the global influenza pandemic. Due to the nature of information dissemination during the period, public health measures and views of pandemic-related death were influenced by the ongoing world war, impacting how those connected to the war experienced the pandemic (Nickol & Kindrachuk, 2019; Pal, 2019).
First recorded in 1981, what we now know as human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) has spread globally (Sharp & Hahn, 2011). The HIV/AIDS pandemic has been political since its start, first being called ‘gay-related immunodeficiency disease’ and associated with groups engaging in behaviours deemed ‘immoral,’ such as people who used injection drugs (Logie, 2020; Smith, 2004). As of 2021, over 40 million people have died of HIV/AIDS, and over 38 million people are living with HIV (UNAIDS, 2022). Since the development and dispersion of medications such as antiretroviral therapies and preventative treatments such as pre-exposure prophylaxis (PrEP), the death and global infection rates of the pandemic have significantly decreased; however, these treatments are not universally available, and knowledge and education about HIV/AIDS remains unevenly accessible (Sharp & Hahn, 2011). Of those living with HIV, approximately 10 million do not have access to lifesaving antiretroviral therapy (UNAIDS, 2022).
The distribution of HIV cases is also not equal; over two-thirds of global HIV cases, and over 90% of HIV-positive children, reside in sub-Saharan Africa (UNAIDS, 2022). This disease burden coincides with a region that has long suffered the effects of European colonization, the fallout of which exacerbates health-related events. For example, the post-colonial infrastructural development in many sub-Saharan countries is still in progress, and health infrastructure often lacks resources to prevent instances of malnutrition, or diseases such as malaria or schistosomiasis, leaving many individuals with weakened immune systems, thus more susceptible to infections such as HIV (Premkumar & Tebandeke, 2011). Furthermore, in countries experiencing post-independence political instability, such as Guinea-Bissau, Nigeria, or Uganda, HIV/AIDS can be highly stigmatized due to its social association with homosexual behaviour, leading to individuals not seeking testing, or having pandemic measures be underfunded in favour of political priorities being allocated elsewhere (Galjour et al., 2021; Premkumar & Tebandeke, 2011; Smith, 2004). This stigmatization is exacerbated by the involvement of institutions such as the Pentecostal Church in government and education systems (Fichtmüller, 2022; Gusman, 2009; Smith 2010). Their involvement integrates values held by the Church, for example, the view of LGBTQ+ individuals as immoral or sinful, into the national social and political structures (Fichtmüller, 2022). The idea of the pandemic’s urgency then shifts: LGBTQ+ individuals, with or without HIV, may avoid seeking education or treatment even if it is available, since their safety (i.e., not being identified as LGBTQ+) takes precedence over knowing their HIV status. This parallels a Ukrainian wartime experience of the COVID-19 pandemic; the priority becomes safety from what will certainly endanger you over what could potentially endanger you.
Through these examples of infectious disease events coinciding with political instability, it is clear that despite public health measures and global urgency to control a pandemic, the importance and ability to follow infection control measures necessarily changes. The matter of greater urgency – surviving through consequences of political conflict in one’s environment – takes precedence. This shift in prioritization affects how individuals perceive, process, and respond to the fears and consequences associated with a pandemic event. By acknowledging individuality within collective experience, we can seek to fully understand the human experience of pandemic events, and the effects of political conflict on the applicability and prioritization of pandemic control measures during times of unrest.
Works Cited
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Cover image: Lewin Bormann from Aachen, Berlin protests against Ukraine War, Wikimedia Commons.