Social Construction of the Disaster Risk Triggered by COVID-19

The key assumption of the social-construction-ofdisaster-risk paradigm, which emerged in response to the physical or technocratic vision of disasters based on a hazard-centered approach (^{Hewitt, 1983}; ^{Smith 2002}; ^{Hilhorst, 2003}), points to understanding risk as a function of various underlying or root causes and risk drivers derived from the configuration and dynamics of social, political, and economic processes over time. From the above, hazards, vulnerability, and exposure are identified as the necessary ingredients to demystify the natural - as opposed to the social - causality of disasters (^{Blaikie et al., 1994}; ^{Canon, 1994}; Oliver-Smith, 1998; ^{Wisner et al., 2004}).

Figure 2 Key relationships and processes in the social construction of disaster risk. RD means disaster risk, E exposure, V vulnerability, A indicates various hazards including natural (N), socio-natural (SN), biological (B), socio-biological (SB), technological (T) and Natech (resulting from the combination of natural and technological threats) (adapted from ^{Oliver-Smith et al., 2016}). 

Understanding disasters demands an in-depth knowledge of the causality chain of the various dimensions of existing and emerging risks - and, hence, hazards and vulnerability - produced by the set of interactions between humans and nature, which are expressed in space and time in the exposure through and across territorial and governance scales (^{Alcántara-Ayala et al., 2021}).

(1) The Hazard: COVID-19, a Socio-Biological Perspective

According to ^{Liu et al. (2020)}, December 1, 2019 was the earliest date when symptoms related to a new type of human pneumonia first appeared in Wuhan City, China; however, it was until the end of that month that the first signs were identified. The virus responsible for this type of pneumonia was officially designated as Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2. Although the disease was initially called Wuhan Pneumonia, the World Health Organization (WHO) preliminarily named it as a new Coronavirus (2019-nCoV) and later officially coined it as Coronavirus disease (COVID-19) (^{Liu et al., 2020}).

While SARS-CoV-2 is a natural virus that causes the Coronavirus disease (COVID-19), in technical terms the latter stems from the interspecies transmission of an animal coronavirus, that is, the passage of a virus or other pathogen from an animal carrier to a first human carrier, the “patient zero”, followed by and the acquisition of humanto-human transmission capacity (^{Liu et al., 2020}).

The United Nations Office for Disaster Risk Reduction defines hazard as “a process, phenomenon or human activity that may cause loss of life, injury, or other health impacts, property damage, social and economic disruption, or environmental degradation” (^{UNISDR, 2017, p.19}). Biological hazards are conceived as “of organic origin or conveyed by biological vectors, including pathogenic microorganisms, toxins, and bioactive substances” (^{UNISDR, 2017, p. 20}). Considering the latter term, COVID-19 is then defined as a biological hazard.

In the context of characterizing pathogenic biological agents from an ecological viewpoint, ^{Dobson and Carper (1996)} identified three fundamental processes for determining the impact, persistence, and spread of pathogens and parasites: size and spatial distribution of the host population, movement of infected and susceptible hosts and vectors, and nutritional status of the human host population.

Although these aspects concern the impact, persistence, spread, and dynamics of pathogenic biological agents and are, therefore, linked to the characterization of the COVID-19 hazard, it is important to recognize that they are strongly linked to the susceptibility, vulnerability, and exposure of the human population. Thus, the current consequences of the pandemic - over 59 million cases and more than 1.4 million fatalities recorded worldwide so far (February, 2021) (JHU), in addition to economic losses estimated in 82 billion dollars over the next five years (Centre for Risk Studies), and the effects on mental health - undoubtedly describe a global disaster, even a catastrophe (^{Lavell and Lavell, 2020}).

Current events associated with the impact of the pandemic have renewed the interest in understanding the complex relationships of pathogen transmission from animals to humans. According to ^{Johnson et al. (2020)}, those species that are abundant and have become adapted to anthropized landscapes will likely continue to be an important source of such transmission. These authors also emphasized that human actions, particularly wildlife exploitation through hunting and trade, not only threaten species with extinction, but also promote the spread of viruses. In other words, among threatened wildlife species, those with populations that have declined as a result of exploitation and habitat loss share the most viruses with humans.

The ^{UNISDR (2017)} terminology referred to above, together with the definition of natural hazards, encompasses the socio-natural hazard concept proposed by Lavell (1996). He considered that socio-natural hazards are produced or exacerbated by some type of human intervention on nature, so they can be mistaken with natural events; often, there is no strict correspondence between the space of causality and the space of impact. In other words, the consequences of hazards are not always or not only experienced by the social agents that created or induced them.

Consequently, this study states that COVID-19 should not be regarded as a merely biological hazard. This disease should be classified as a sociobiological hazard for two fundamental reasons. On the one hand, in a context of global change and biodiversity loss, the exploitation of wildlife associated with human practices or interventions, such as the often illegal wildlife trade, induce the spread of viruses. On the other hand, the asymmetry between its causality space in Wuhan, China, and the space of its worldwide impact is a clear example of an effect spread far beyond the source of the hazard.

The need to decipher and understand COVID-19 as a new hazard and develop a vaccine to mitigate its spread poses a challenge for scientific and technological development. Since the onset of the pandemic, numerous research groups from many disciplines around the world are dedicated to understanding the various medical and biomedical research dimensions of the virus, as well as the public policies and governance of disaster risk, with complex socioeconomic, political, institutional, environmental, and cultural aspects of the population exposed to and affected by COVID-19. These perspectives allow identifying several factors linked to the susceptibility, vulnerability, and exposure to this disease.

(2) Susceptibility, Vulnerability, and Exposure to COVID-19

Susceptibility and Vulnerability

The current conceptual framework of disaster risk reduction lacks an implicit distinction between susceptibility and vulnerability, which are often used interchangeably. However, setting a differential connotation seems appropriate in the case of COVID-19.

The population in different age groups is differentially susceptible to COVID-19 due to various genetic, morbidity, and age-related aspects, which are still under study. Therefore, susceptibility to COVID-19 should be understood as the uniqueness or singularity of the individual stemming from his/her genetic, health, and immune system attributes, as well as his/her oxidative stress condition or old age, all of which determine his/her intrinsic sensitivity to contagion as a physical process inherent to the organism.

The degree of vulnerability of people to COVID-19 and other hazards is determined by the existence and combination of various socioeconomic conditions historically grounded on models, priorities, and processes of unsustainable development that have gone hand in hand with globalization and its effects over the past decades. Such conditions are evidenced as inequality, lack of access to health services, sanitation and education, malnutrition, addictions, and poverty, among others (^{Alcántara-Ayala et al., 2020}).

Therefore, vulnerability to COVID-19 is linked to the pre-existing and current psychosocial and economic status of a person or group of people, derived from extrinsic social processes that, in addition to the intrinsic natural susceptibility of the individual, increase the predisposition to being adversely affected by the disease.

The current multi-dimensional disaster triggered by COVID-19 shows that, together with the poor healthcare service architecture and institutional fragility linked to a weak disaster risk governance and lack of comprehensive risk management strategies, other factors including marginalization, poverty, inequality, and exclusion are the main drivers of vulnerability and exposure in various parts of the world; Mexico is no exception (Figure 3).

Figure 3 Main drivers of disaster risk by COVID-19 and their associated dimensions of vulnerability and exposure of the population (own elaboration). 

Exposure

Although mosquitoes, ticks, and fleas are among the major vectors of disease, the COVID19 pandemic has evidenced the substantive role of humans as vectors, as SARS-coV-2 is quickly transmitted from one individual to another. The spread, spatial distribution, and prevalence of COVID-19 throughout the world are strongly intertwined with exposure and vulnerability factors of societies. All these factors are key inputs for understanding the negative impact of COVID-19 as a consequence of various conditions stemming from globalization. The exposure of the population to COVID-19 is strongly linked to the mobility of individuals and, the nuclear family or group of people with whom they live on a daily basis to meet their economic, social, and emotional needs, both in urban and rural areas.

Despite the extremely simplified view of associating urbanization with greater exposure and rural areas with less exposure, given the accessibility to material goods and mobility of persons, the essential vulnerability-exposure binomial moves dramatically and bidirectionally across the urban and rural spheres, and global to local and individual dimensions. In line with the above and as per the Index of Vulnerability to COVID-19 in Mexico proposed by Suárez et al. (2021), regardless of the nil or low initial contagion in municipalities with low population density, the most marginalized municipalities of Mexico, whose character is not urban, were documented as the most vulnerable ones.

In addition to reflecting the spread of COVID-19 from China to even remote locations around the world thanks to the connectivity of international trade, this situation also reveals the dramatic conditions of inequality, poverty, marginalization, and institutional fragility inherent to the still ongoing social and economic ruralization process, especially, but not exclusively, in countries with emerging and developing economies. This does not mean that the urban space is exempt of this situation; on the contrary, it raises the question of how valid the vulnerability-exposure binomial is as a conditioning factor of risk to COVID-19 in different territorial contexts, although the high population density in urban areas facilitates the massive and dynamic exposure of people to contagion.

In parallel with globalization processes, the connectivity linked to international trade has contributed to the spread of the virus and the increased exposure of the world population. In addition, the mobility patterns of (voluntarily or involuntarily) displaced persons and migrants have fueled the emergence of a group that is highly vulnerable and highly exposed to COVID-19. Relative immobility has also been a factor in increasing both vulnerability and exposure. Closed spaces such as jails, nursing and retirement homes pose adverse conditions and high contagion risk for their residents.

Factors that promote exposure to the virus at the household level are associated with socioeconomic status and conditions, the use and extent of transformation of the territory, as well as the quality of social relations. Although the potential exposure of the population to COVID-19 is largely defined in terms of socioeconomic vulnerability at the individual or family level, it is also linked to conditions at broader territorial scales.

(3) The Layout of Disaster

For the characterization of the current risk and disaster, the early observations suggested that the main root causes of the disaster associated with COVID-19 are related to the human disruption of the natural environment through wildlife exploitation and overexploitation, loss of natural habitats linked to environmental degradation, legal trade and illegal trafficking of wildlife, as well as the ensuing magnification of the emergence and spread of zoonoses in a context of globalization, global change, and deficiencies in healthcare governance and disaster risk management systems. In parallel, the intrinsic susceptibility of people to be infected by the virus, as well as the vulnerability and extrinsic exposure of individuals and societies as a whole (largely derived from marginalization, poverty, inequality, and exclusion), are conceived as the key risk drivers (Figure 4).

Figure 4 Cardinal elements of the construction of the disaster risk associated with COVID-19 (own elaboration). 

Due to the unique features of this pandemic, rethinking the nature of disasters from the global to the local scale and vice versa will be mandatory and utterly important for future policies. At the same time, policy matters will have profound implications for the living conditions of people at risk, at individual, collective, and global levels.

Although characterizing the susceptibility of individuals to COVID-19 is a complex issue, the common denominator of risk is the spread of the socio-biological hazard due to the connectivity of territories at the global and local levels. Nevertheless, the key explanation lies in the temporal and multi-scale spatial dimensions of the disaster, which are configured - similar to other types of disasters triggered by natural or socio-natural hazards - in decision-making and practices inherent to risk governance. In turn, these are based on (existing, usable, and used) scientific knowledge and specific interests linked to the prevailing vision of development and socio-territorial equality in communities with varying degrees of pre-existing vulnerability and current exposure to this hazard.

(1) A Syndemic Pan-Disaster

Although the ongoing disaster was triggered by a viral zoonosis (i.e., a socio-biological hazard), the risk of disaster was indeed configured within the spheres of vulnerability and exposure intertwined at the edges of economy, society, and the environment, stemming from globalization and global change.

Interestingly, supplementing the social- construction-of-disaster-risk perspective - coined within the public and community health framework based on the medical anthropology approach - the term “syndemic” used herein refers to the co-occurrence of various infections or diseases, and their interactions and links with social, cultural, economic, physical, and environmental factors, especially as a consequence of social inequity and the unfair exercise of power (Singer, 1990).

The correspondence between the two approaches, particularly in the case of the COVID-19 pandemic, involves a multi-scale analysis of the groups exposed because the syndemics theory emphasizes the interaction of the disease at both the population and individual levels (Singer, 1990). This multidimensionality allows identifying the whole range of causes, from those derived from large-scale social complexity to those related to individual biological traits, as well as the ensuing synergistic interactions at the individual and population levels (^{Gravlee, 2020}).

Within the framework of the syndemic concept formulated by Singer (1990), the current pandemic can be understood as a set of intertwined health issues magnified by a context where adverse social and physical conditions occur. These conditions can significantly affect the disease burden and the health status of a population, thus contributing to recognize the causality beyond the disease itself. This causality is inherently conceived through the paradigm of the social construction of risk through the identification of root causes and drivers of disaster risk (^{Alcántara-Ayala et al., 2020}).

Combining the correspondence perspectives just mentioned supports our assumption that, given the planetary dimension of the current crisis arising from the pandemic, it is possible to describe it as a “syndemic pan-disaster”. That is, a multiscale disaster with global impact within a syndemic context that involves an extreme disruption of the functioning of society. This brings about adverse social, economic, cultural, political, and institutional consequences created by the concatenation of population health issues exacerbated by the intrinsic susceptibility of individuals, exposure to individual and collective contagion, and preexisting vulnerability conditions of society.

In the current Anthropocene epoch, characterized by social and environmental imbalances (^{Crutzen, 2002}), it is necessary to encourage transdisciplinary approaches to link the effect of human intervention on the emergence of socio-biological hazards whose impact, embedded in a structure of social inequalities in a globalization context, poses highly complex challenges for disaster risk governance.

Reflecting on the role of multi-scale processes in reproducing vulnerability of the population as a whole and the spread of the virus as a fundamental aspect of the exposure of individuals and entire societies to the potential impact of the COVID-19 is indeed necessary. Thus, in addition to analyzing the socio-environmental context, it is important to evaluate the various spheres of human vulnerability based on the relationships produced at the intersection of the global and local scales, and the individuality of people.

A first approach to the anatomy of the disaster triggered by the global spread of COVID-19, herein referred to as a “syndemic pan-disaster”, recognizes the importance not only of the infinite dimensions of the adverse impact for societies in the short, medium, and long-term, but also of its causality and the dynamic factors that place it in the domain of the social construction of disaster risk and the syndemics theory.

(2) Comprehensive Management of the Disaster Risk Triggered by COVID-19

While efforts from the public health perspective are undoubtedly invaluable and urgent, few governments in the world have addressed the COVID-19 crisis from a comprehensive disaster risk management (CDRM) perspective.

Disaster risk management can be understood as “a social process whose ultimate goal is the anticipation, reduction, and permanent control of disaster risk factors in society, in line with, and integrated into the pursuit of, sustainable paths of human, economic, environmental and territorial development” (Narváez et al., 2009, p. 33). From it, the need to consider its multi-scale dimensions of comprehensive and transverse intervention stemming from coordinated efforts, and encompassing from the global to the family and even the individual level, becomes evident.

These tasks must include both corrective and prospective approaches to undertake actions aimed at reducing existing risks and avoid creating future risks in the short, medium, and long terms, by executing the six essential CDRM processes: generate knowledge on disaster risk in different realms; prevent future risk; reduce current risks; response preparation; respond and rehabilitate; and recover and rebuild (Narváez et al., 2009).

In general, risk management strategies for COVID-19 should address the following cardinal challenges:

Knowledge Generation

Preventing Future Risk

Reducing Existing Risk and Response Preparation

Response, Rehabilitation, Recovery, and Reconstruction