‘Viral Loads: Anthropologies of Urgency in the Time of COVID-19’: Book Review

Susie Russell reviews Viral Loads: Anthropologies of urgency in the time of COVID-19, edited by Lenore Manderson, Nancy J. Burke and Ayo Wahlberg (UCL Press, 2021).   

There is something eerie about reading Viral Loads at the start of 2022, in the thick of the spread of COVID-19’s Omicron variant. A spread that bears out the editors’ observation, written in February 2021, that “COVID-19’s lethality has not unfolded” (20). Given that COVID-19 will go on unfolding, from pandemic into endemic, at various rates in different parts of the world, future readers of this book could well say it felt strange too – reading about the beginning of a time of “mutating reality” (Taussig 2020: 34).  

The scope of Viral Loads is admirable and informative. Its 23 chapters are grounded in Cuba, South Africa, Romania, India, and many other locales, and in topics including conspiracy theories, disability and chronic illness, sexual and reproductive health, gender, racism, and poverty. These chapters, written by 45 academics, activists, and health and social practitioners, are organised by five thematic sections: ‘The power of the state’; ‘Exclusion and blame’; ‘Unequal burdens’; ‘The reach of care’; and ‘Lessons for a future.’ This is the second volume in UCL Press’ ‘Embodying Inequalities: Perspectives from Medical Anthropology’ series. Fittingly, the book is freely available to download, and in the 5 months since publication it has been downloaded more than 2,000 times.

 A significant strength of Viral Loads is that its authors, affiliated with institutions on 5 continents, draw their analyses from various parts of the global north and global south: a truly international effort. Many regions are covered, with a notable exception of Oceania/the Pacific. While less affected by COVID than other regions, ethnographic insights about living in, and being from, places yet to experience cases in a global pandemic could well have added another welcome dimension to the book. Such work could have spoken directly to multiple, related urgencies, including the implications of being ‘COVID-free’ for international relations, strategic partnerships, and — as we have recently seen in Tonga — humanitarian aid and disaster relief.  

More surprising, for several reasons, is the absence of a chapter on China. Firstly, because many of the phenomena discussed in the book — lockdowns, health care responses, and so on — happened first in China. Secondly, precisely because this book is part of the ‘Embodying Inequalities’ series, one would expect sustained engagement with the COVID-inspired waves of racism against people of (or perceived to be of) Chinese origin world-wide; instead, this finds passing mention in a few chapters. Some of these passing references — primarily Rebecca Marsland’s discussion of western imaginings of China as a place where ‘spillover’ across the species barrier is likely (411) — could have served as strong foundations for ethnographies of anti-Chinese racism. Additionally, while some authors highlight disproportionate effects on indigenous peoples to the extent of genocide (Fonseca and Fleischer 248), and the need to centre indigenous peoples in political analyses (Lasco 439), overall Viral Loads lacks collaboration with indigenous peoples or a sustained focus on indigeneity. This is against a backdrop of indigenous theorising about the pandemic that seems to be widely accessible and responsive (the ‘Accessing Deep Indigenous Knowing Amidst COVID-19’ webinar series by the Knowledge in Indigenous Networks in 2020 is one example).

 Despite the volume’s impressive breadth, some orientations and emphases recur throughout. A major thread, set up in the editors’ introduction, is how COVID-19 has deepened “stratified livability”, meaning “the COVID-19 pandemic loaded onto already existing socio-economic inequalities, racial discrimination and uneven access to healthcare…” (2). As this quote demonstrates, the editors carry the phrasing around ‘loads’ from the volume’s title (which invokes discussions of HIV/AIDS) into their narrative more generally.

Perhaps the most persistent memory punctuating Viral Loads is COVID-19’s 2020 twin: the murder of George Floyd, a Black man, by a white police officer in the United States. In the wake of Floyd’s killing, questions of grievability haunted — and continue to haunt — people across the world. Lenore Manderson and Susan Levine’s chapter, ‘Militarising the pandemic: lockdown in South Africa’, poignantly cites Kneo Mokgopa’s reporting on the murder of Black South African Collins Khosa by the South African National Defence Force (SANDF) in a poor Johannesburg township. Mokgopa asks why SANDF’s assault on Khosa — ostensibly for the non-crime of drinking in his yard while alcohol sales were prohibited under lockdown — or any other killings of Black South Africans by South African law enforcement, did not ignite similar protest action locally (62). 

A theme taken up in several chapters is the syndemic approach. Coined by critical medical anthropologist Merrill Singer in the 1990s, the term ‘syndemics’ (synergistic epidemics) encodes a bio-social perspective, attentive to how existing health disparities enable multiple epidemics/disease clusters to form. In their chapter, ‘COVID-19 in Italy: a new culture of healthcare for future preparedness’, Chiara Bodini and Ivo Quaranta directly reference The Lancet Chief Editor Richard Horton’s declaration in September 2020 that COVID-19 is a syndemic rather than a pandemic. However, nowhere is there a reference to a rejoinder by medical anthropologist Emily Mendenhall, who argued that COVID-19 is not uniformly syndemic (Mendenhall 2020). Some reliance on the term ‘syndemic’ is an example of how Viral Loads tends to use some theoretical framings without attending to their limitations or critics. However, no book can do everything, and perhaps, on balance, the urgency Viral Loads addresses calls more on ethnographic detail and documentation than in-depth theorisation or historicising medical anthropology.  

Despite abounding in rich ethnographic insights, extended discussion of methodology is limited throughout. Linda Rae Bennett and Setiyani Marta Dewi, writing on sexual and reproductive health and rights in Indonesia, uncharacteristically detail the specific digital applications they used for interviews with participants, and some of the ways their virtual interviews with frontline workers working from home embodied an “infusion of domesticity” that bolstered a feeling of informality and intimacy (226). Yet, it was only Bennett’s comments in the Society for Applied Anthropology webinar associated with Viral Loads that provided insights into how ethnography conducted at a distance can differ in power dynamics to fieldwork relationships of physical proximity (Society for Applied Anthropology 2021).   

On occasion, authors offer fascinating glimpses into material culture, and remind us of the prior novelty of some now mundane and institutionalised interventions, as well as their local variations. In their introduction, Wahlberg, Burke and Manderson touch on some new physical and symbolic features of public space: plexiglass shields in shops, as well as between motorcycle drivers and pillion riders in some parts of South-East Asia (8-9). Other material artefacts discussed include handmade signs thanking the NHS in the UK (Gamlin, Gibbon and Calestani), and piñatas in the form of Mexican Undersecretary of Health Hugo López-Gatell Ramírez (Saldaña-Tejeda). Saldaña-Tejeda’s lucid analysis of government-commissioned cartoons also draws attention to the various characters (fantasy and real) accompanying COVID-19, from famous figures singing hand washing songs and animated representations of the Coronavirus (see https://culanth.org/fieldsights/coming-clean) to public officials regularly outlining the latest restrictions. What might it mean to put ostensibly light-hearted representations — stickers, piñatas, and cartoons — into conversation with the kind of “macabre economy” of which Bharadwaj writes (139)? 

Other memorable chapters include Elisa J. Sobo and Elżbieta Drążkiewicz’s theorectically rich discussion of conspiracy theories in Ireland, Poland, and the United States of America. Particularly noteworthy is the authors’ understanding of the labelling of conspiracy theories as both a “lumping device” and a “reciprocating technology” for creating doubt (85). In Part Two, Ato Kwamena Onoma discusses how returning emigrants were scapegoated as spreading COVID-19 in Senegal despite being ‘non-others,’ analysing their persecution in terms of broader concerns about movement and flow. In the same section, Aditya Bharadwaj’s writing on kafan chor (the shroud thief) lingers for its searing commitment to confront collective complicity: “We are all shroud stealers now” (142). Also in Part Two, Cristina A. Pop provides a meaningful example of how existing inequalities deepen and marginalised people strategise, in the form of Roma accessing segregated hospital spaces in Romania in the H1N1 and COVID-19 pandemics (154-5). In Part Three, Fonseca and Fleischer document spontaneous mutual aid among lower income ‘micro families’ (families experiencing microcephaly) in the urban periphery of Brazil, effectively using a syndemic approach. Tsipy Ivry and Sarah Segal-Katz’s chapter on the mikveh in Israel in Part Four is notable for the collaboration between a medical anthropologist and a Halachic instructor/activist, and for their insightful analysis of “the paradox of a purification ritual that had become potentially infectious” (400).  

The pair of chapters I valued most, by Rebecca Marsland and Gideon Lasco, appear alongside one another in the final, future-oriented section. Both seem to connect with Michael Taussig’s (2020) musings on the pandemic, surreality, re-enchantment and open perception. Marsland’s expansive and compelling chapter focused on malaria canvasses the fascinating etymology of pandemic, the colonial association of Africa with viruses, the possibilities of the “pluriversal polydemic” (420), and crucial debates about immunity. Physician and anthropologist Lasco’s chapter on “our more-than-human togetherness” (438) in the Philippines is lyrical, entertaining, and powerful, opening with a case of animals going viral during COVID lockdowns – something that captured mass attention. Lasco’s vision of interdisciplinary and interspecies ‘convivium’ demonstrates that thick description can bring anthropologists into engagement with many others.  

Anyone reading this book (and it is a credit to all involved that the potential audience of this freely available, open access publication can be far more inclusive than the academic norm), will come away with details and insights that ‘stick’. For me, this includes learning that Covid, Sanitizer, and 19 are the names of informal settlements built in Cape Town by people who were evicted from houses when paying rent was no longer possible, and soon destroyed by the Anti-Land Invasion Unit in August 2020 — the larger pieces of tin from these shacks then taken by workers contracted by the city into waiting trucks (58-9). This reality spatialises the lesson that “the COVID-19 pandemic” is plural, multiple, and radically uneven.    

Susie Russell is a PhD candidate at the Centre for Art History and Art Theory at the Australian National University. She is researching sympathetic pregnancy/couvade. Twitter: @suse_russell

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