Biopower under a state of exception: stories of dying and grieving alone during COVID-19 emergency measures

Abstract

During the COVID-19 pandemic, restrictions for visitors and caregivers in healthcare settings and long-term care (LTC) facilities were enacted in the larger context of public health policies that included physical distancing and shelter-in-place orders. Older persons residing in LTC facilities constituted over half of the mortality statistics across Canada during the first wave of the COVID-19 pandemic. Using the poststructuralist work of Agamben, Foucault and Mbembe we conducted a thematic analysis on news reports. The extracts of media stories presented in our paper suggest that the scholarship on (bio)power and necropolitics is central for understanding the ways the COVID-19 crisis reveals the pragmatic priorities—and the ‘health’ and political values—that undergird the moral imagination of the public, including the educated classes of advanced Western democracies. Our critical analysis shows that by isolating individuals who were sick, fragile, and biologically and socially vulnerable, undifferentiated population management policies like social distancing, when piled on the structural weakness of health systems, reproduced inequities and risk for those in need of medical care, advocacy, and social companionship in acute moments of illness, death and grief. Considering the unprecedented deployment of governmental power via public health interventions based on social regulation to protect the population during the crisis—how can we understand so much death and suffering among the most vulnerable?

A breach in the social contract: Limited participation and limited evidence in COVID‐19 responses

“…At the time of their first implementation, ‘lockdowns’ were conceived as a strategy of last resort, intended as transitory due to their theorized differential cost on society 8 . The costs of these interventions have since gone from a set of measurable possibilities to measured empirical realities 52,58–60 . Turning to the Canadian provincial case again, the OSAT, whose composition is dominated by medical and other health experts, has never made publicly available an evaluation of the short‐term gains of the social interventions (which are mathematical projections of infections and hospitalizations); it has recommended vis‐à‐vis the widespread short‐ and long‐term effects for the entire population 61,62 .…”

“…8 The costs of these interventions have since gone from a set of measurable possibilities to measured empirical realities. 52,[58][59][60] Turning to the Canadian provincial case again, the OSAT, whose composition is dominated by medical and other health experts, has never made publicly available an evaluation of the short-term gains of the social interventions…”

“…A society's norms and values often reflect the preferences and interests of those in positions of privilege, which are dominated by the financially well off and the well‐rewarded professional elites. In a heterogeneous society, this hegemony in determining the authorized voices and sources of evidence can inadvertently further marginalize, silence and harm those without the necessary material and symbolic resources to contest the value preferences of those in positions of privilege 52 . Radical social interventions, such as lockdowns, can deepen existing health and social inequities 53,54 and create new ones, 55–57 which vulnerable populations may not be able to resist or contest as even protest can be vilified or criminalized (e.g., the Canadian trucker convoy).…”

“…In a heterogeneous society, this hegemony in determining the authorized voices and sources of evidence can inadvertently further marginalize, silence and harm those without the necessary material and symbolic resources to contest the value preferences of those in positions of privilege. 52 Radical social interventions, such as lockdowns, can deepen existing health and social inequities 53 , 54 and create new ones, 55 , 56 , 57 which vulnerable populations may not be able to resist or contest as even protest can be vilified or criminalized (e.g., the Canadian trucker convoy). Whether one agrees or disagrees with the leaders and the causes of a particular social movement, the long‐term consequences of the marginalization or criminalization of protest based on public health regulations require careful examination.…”

“…8 The costs of these interventions have since gone from a set of measurable possibilities to measured empirical realities. 52 , 58 , 59 , 60 Turning to the Canadian provincial case again, the OSAT, whose composition is dominated by medical and other health experts, has never made publicly available an evaluation of the short‐term gains of the social interventions (which are mathematical projections of infections and hospitalizations); it has recommended vis‐à‐vis the widespread short‐ and long‐term effects for the entire population. 61 , 62 We, therefore, need to ask socially and scientifically urgent questions about the ways in which medical and other health experts in positions of authority use, interpret and deploy decisions based on the available data.…”