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Behavioural, environmental, social, and systems interventions against covid-19

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2982 (Published 28 July 2020) Cite this as: BMJ 2020;370:m2982

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Covid-19: The humanities and social sciences have much to contribute to beating this pandemic and the next

Dear Editor

Michie and West are absolutely correct.(1) The humanities and social sciences definitely have a vast amount to contribute to resolving the massive challenges arising out of the covid-19 pandemic. Indeed, that may be where the most critically important academic advances may arise, as vastly better understanding of human and societal behaviour is essential if truly effective strategies and policies to reduce viral transmission and maximise human safety are to be identified and implemented.

Indeed, when it comes to infection prevention and control at both the local and international levels, a fuller understanding of areas of study such as politics, international relations, philosophy, economics, psychology, sociology and ethics have all been suggested as meriting urgent consideration by expert researchers.(2-5)

For example, particular areas needing greater attention include the behavioural psychology around variations in different people's desire and willingness to embrace risk taking (6), the growth of the vaccine denial phenomenon (7,8) and the emerging organised "fight-back" against the wearing of face masks in locations where human beings congregate and the risk of human-to-human spread of covid-19 is thus greatest.(9,10) Beyond this, one should surely be asking what the reasons are behind the emerging claims that the covid-19 virus itself is not a serious threat, and how such assertions could best be countered. (11) Improved understanding of phenomena of these types is vital if effective progress on infection prevention and control is to be made, and the requisite improved understanding to achieve this will come from research conducted from a social sciences/humanities perspective rather than from scientific endeavour directed primarily towards areas such as vaccination, therapeutics, genomics and immunology, as undeniably important as they all are.

Teasing this out further, given that new and emergent zoonoses are among the greatest threats facing the human race, both now and quite probably forever,(12) the key drivers - some of which may be behavioural, some sociological, some economic, some arising from as yet unrecognised sources etc. - behind the international (and often illegal) trade in rare animal species which probably facilitates the emergence of at least some new zoonotic pathogens absolutely need to be understood much more completely if any action of genuine preventative value is to be formulated and implemented.

Prevention is always better than cure, and the vital assets on the public health medicine and epidemiology fronts certainly have to be properly funded (13) as should of course basic medical-scientific research, but since it is covid-19’s ability to exploit particular aspects of human behaviour that allows it to continue to spread from person-to-person at an unacceptably high rate, it is those behavioural and sociological aspect of the jigsaw puzzle that simply have to be better understood if remedies are to be uncovered.(14) Equally, it is the study of politics and economics that helps us with acquiring better understanding of the differing responses of different countries and their governing authorities to serious threats of this type.

One lesson to emerge from covid-19 is that we may all need to re-think where academic attention and finite resources would best be focused if the human race is to have the greatest chance of overcoming and reducing the continuing spread of this infectious disease.

In addition, as everyone looks apprehensively towards the future, we should also be taking planning seriously for the emergence of other potentially lethal successors to covid-19. The study of the humanities/social sciences-related aspects of this formidable challenge will provide some of the essential building blocks for taking that work forward.

References

1. https://www.bmj.com/content/370/bmj.m2982
2. https://blog.oup.com/2020/06/why-global-crises-are-political-not-scienti...
3. https://science.sciencemag.org/content/368/6495/1035/tab-e-letters
4. https://www.bmj.com/content/369/bmj.m2033/rr-2
5. https://www.bmj.com/content/369/bmj.m1442/rapid-responses
6. https://jamanetwork.com/journals/jama/fullarticle/2767022
7. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31640-8/fulltext
8. https://jamanetwork.com/journals/jama/fullarticle/2766370
9. https://www.vox.com/2020/5/21/21266413/coronavirus-face-masks-trump-cdc-n95
10. https://www.bmj.com/content/369/bmj.m1442/rr-16
11. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30565-X/fulltext?dgcid=raven_jbs_etoc_email
12. https://www.journalofinfection.com/article/S0163-4453(20)30290-5/fulltext
13. https://www.acpjournals.org/doi/10.7326/M20-0912
14. https://www.bmj.com/content/369/bmj.m1859/rr

Competing interests: No competing interests

03 August 2020
Stephen T Green
Honorary Professor of International Health
Dr Lorenzo Cladi
Sheffield Hallam University & University of Plymouth, UK