Local expertise should be used in the management of the pandemic

The success of prevention and control measures depends a lot on how well local lifestyles are known and supported.

“Cause, consequence, prevention, treatment, intervention, follow-up, risk group, risk factor.” The treatment of the coronavirus pandemic has been governed by medical concepts, although the pandemic is much more than a medical crisis – it is also a social and societal crisis.

If the local perspective had been taken into account more in the management of the pandemic from the outset, we might have talked to a greater extent about needs analysis, learning, empowerment, interaction and inclusion.

Before antiretroviral drugs, self-help by local communities proved to be the most effective way to prevent the spread of the HIV-virus. Sexual and gender minorities began talking about safe sex, developed policies and organizations providing social support and mental health services, and supported inclusive entrepreneurship. Information was shared locally on HIV transmission and prevention, condoms were distributed, free testing was offered, and HIV-positive people were brought together to enable peer support.

A similar approach proved effective in the Ebola epidemic in West Africa in 2014. The official strategy was based on virus identification, isolation of patients, safety of treatment procedures, tracing and quarantine of close contacts, and safe burial of the dead. However, the initiative and adaptability of local communities proved crucial: people used coconut water for hydration, used plastic bags to cover their hands when caring for their sick relatives, modified funeral rituals and voluntarily restricted movement in the most difficult epidemic areas. In villages, policies were developed that supported, rather than limited, local lifestyles and activities.

Measures focusing on human behavior and lifestyles proved to be most effective in treating both the HIV and Ebola epidemics, especially in those populations where viruses spread most rapidly. Central to this was an understanding of the cultural contexts that influenced people’s perceptions of viruses, their spread, and means of protection.

In addition to individuals, communities also learn. In the treatment of the coronavirus pandemic, local communities have been important providers of social and health services in the United States, for example. Since the HIV epidemic, amazing crisis awareness and expertise has been preserved in certain metropolitan residential areas. It enabled locals to respond quickly and effectively in the early stages of the pandemic: sexual and gender minorities disseminated information about the coronavirus and distributed free masks and other protective equipment, just as they had done forty years earlier – when public actors were still recovering from the initial confusion.

“Coping with pandemics requires people learn to think like epidemiologists and epidemiologists like locals.”

The prevention and treatment of crises such as a coronavirus pandemic cannot be based solely on the exact science and not only on the biological and medical science. Coping with pandemics requires people learn to think like epidemiologists and epidemiologists like locals.

Therefore, containment strategies must be based on locality: an understanding of how and where people move, what kind of social contacts they have, how local infrastructure exposes or protects against infections, how deep is the gap is between social and medical norms, and how a common understanding – and acceptance – of prevention and control measures is produced between residents and the authorities.

Little attention has been paid to local know-how and knowledge in the management of the pandemic – containment measures have been mainly top-down in authoritarian ways.

It is very likely that crises such as a coronavirus pandemic will recur in the future and restrictive measures will be prolonged or become seasonal. It is therefore essential to consider how scientific knowledge can be combined with social knowledge and know-how, and how local communities can be involved in and committed to pandemic prevention and control measures.

by Marko Kantomaa and Sylvain Sebert, University of Oulu

Originally published in Helsingin Sanomat on 24th September 2021.