The COVID-19 Contagion–Pandemic Dyad: A View from Social Sciences

The objective of this concept paper focuses on the relevance of the analytical potential of Social Sciences for understanding the multiple implications and challenges posed by the COVID-19 contagion–pandemic dyad. This pandemic is generating a global threat with a high number of deaths and infected individuals, triggering enormous pressure on health systems. Most countries have put in place a set of procedures based on social distancing, as well as (preventive) isolation from possible infected and transmitters of the disease. This crisis has profound implications and raises issues for which the contribution of Social Sciences does not seem to be sufficiently mobilised. The contribution of Social Sciences is paramount, in terms of their knowledge and skills, to the knowledge of these problematic realities and to act in an informed way on these crises. Social Sciences are a scientific project focused on interdisciplinarity, theoretical and methodological plurality. This discussion is developed from the systems of relationships between social phenomena in the coordinates of time and place, and in the socio-historical contexts in which they are integrated. A pandemic is a complex phenomenon as it is always a point of articulation between natural and social determinations. The space of the discourse on the COVID-19 pandemic can be understood as the expression of a coalition of discourses, i.e., the interaction of various discourses, combined in re-interpretative modalities of certain realities and social phenomena. The circumstantial coalitions of interests, which shape the different discursive records and actions produced by different agents of distinct social spaces, enable the acknowledgement and legitimation of this pandemic threat and danger, and the promotion of its public management.

[Integrating clinical research into epidemic response: the field perspective in the Ebola experience]

During the 2013-2016 west African Ebola outbreak that affected West Africa, accelerated clinical trials, testing unproven but promising and potentially lifesaving experimental interventions emerged as a key component of the global outbreak. In 2017, no Ebola medical countermeasures had proven antiviral efficacy in patients. However, in September 2014, the World Health Organization inventoried a list of potential drug candidates developed or repurposed with demonstrated antiviral efficacy in vitro or in animal models. Numerous therapeutics were considered or explored during the outbreak, including nucleoside and nucleotide analogues, nucleic acid-based drugs and immunotherapeutics. Drugs in clinical trials were tested within the framework of optimized supportive care with fluids and electrolytes and management of severe compromise of multiple organs resulting from viral cytopathology and immune-mediated cell damage. Assessment of those therapeutics with encouraging preliminary efficacy or safety profile, like the repurposed direct antiviral agent favipiravir or the combination of antibodies ZMapp requires further investigation to confirm their efficacy in humans, propose appropriate doses and evaluate the possibility of treatment combinations. During the lull before the next epidemic, major challenges for managing future Ebola epidemics include scientific, clinical and public health preparedness with establishment of innovative patient care and clinical research support in remote poor areas where Ebola and other deadly infectious diseases typically reemerge.