Ambivalent Speculations: Learning to Live with Barrett's Esophagus in the UK Using Facebook Support Groups

Drawing on fieldwork in Facebook support groups, in this article I explore how people, now patients, learnt to live with Barrett's esophagus, a risk state or "precancer" for a type of esophageal cancer. This diagnosis brought the possibility of both facing and averting cancerous futures into the present. Far from passive recipients, members worked to foreground speculations of "wanted futures" in which prompt surveillance successfully prevented cancer deaths, transforming cancer risk into an opportunity for hope. Speculation here was an ambivalent and active process, involving not only the "observation of potentiality," but the opening up and foreclosing of both desirable and undesirable potentialities.

Is Covid-19 a dread risk? The death toll of the pandemic year 2020 in long-term and transnational perspective

"Dread risks" are threats that can have catastrophic consequences. To analyse this issue we use excess mortality and corresponding life years lost as simple measures of the severity of pandemic events. As such, they are more robust than figures from models and testing procedures that usually inform public responses. We analyse data from OECD countries that are already fully available for the whole of 2020. To assess the severity of the pandemic, we compare with historical demographic events since 1880. Results show that reports of high excess mortality during peak periods and local outbreaks should not be taken as representative. Six countries saw a somewhat more increased percentage of life years lost (over 7%), nine countries show mild figures (0-7%), while seven countries had life year gains of up to 7%. So, by historical standards, Covid-19 is worse than regular flu, but a far cry from the Spanish Flu, which has become the predominant frame of reference for the current pandemic. Even though the demographic impact is modest, psychological aspects of the pandemic can still lead to transformative futures, as the reactions of East Asian societies to SARS I in 2003 showed.

Wars and sweets: microbes, medicines and other moderns in and beyond the(ir) antibiotic era

Once upon a time, many of us moderns dreamt that our future was bright, squeaky clean, germ-free. Now, we increasingly fear that bacterial resistance movements and hordes of viruses are cancelling our medicated performances, and threatening life as many of us have come to know it. In order for our modern antibiotic theatre of war to go on, we pray for salvation through our intensive surveillance of microbes, crusades for more rational antibiotic wars, increased recruitment of resistance fighters and development of antibiotic armaments through greater investment in our medical-industrial-war complex. But not all of us are in favour of the promise of perpetual antimicrobial wars, no matter how careful or rational their proponents aspire to be. An increasing vocal and diverse opposition has amassed in academic journals, newspapers and other fields of practice denouncing medicalisation and pharamceuticalisation of our daily lives, as well as our modern medicine as overly militaristic. In this paper, rather than simply rehearsing many of these well-made and meaning debates to convert you to yet another cause, I enrol them in redescriptions of our modern medical performances in the hope of awakening you from your aseptic dream. What follows is my invitation for you to re-enact our mythic antibiotic era in all its martial g(l)ory. I promise that it will bring you no physically harm, yet I can't promise it will leave your beliefs unscathed, as you follow its playful redescription of how our objective scientific descriptions, clinical prescriptions, economic strategies, political mandates and military orders, not to mention our warspeak, have always been deeply entangled with triumphs and devastations of The(ir) Great anti-Microbial Wars (aka our antibiotic era).

Divination and Ontologies

The way types of divination move round the planet means it is not helpful to simply attribute one unitary ontology to specific techniques or to groups of practitioners. Explaining divination in terms of ‘ontology’ homogenizes cognitive and conceptual multiplicity, and pre-empts the possible outcomes of divination. Moreover, this contradicts the fundamentally open nature of divination, and the fact that in many forms of divination the reformulation of questions helps keep futures open. With examples drawn from Mambila spider divination, I suggest what an epidemiology of beliefs and ontologies that gather around divination could look like. On this account, divination acts as a ‘boundary object’, mediating both the cognitive differences among clients and the conceptual differences between clients and diviners.

Emerging viral threats and the simultaneity of the non-simultaneous: zooming out in times of Corona

This paper addresses global bioethical challenges entailed in emerging viral diseases, focussing on their socio-cultural dimension and seeing them as symptomatic of the current era of globalisation. Emerging viral threats exemplify the extent to which humans evolved into a global species, with a pervasive and irreversible impact on the planetary ecosystem. To effectively address these disruptive threats, an attitude of preparedness seems called for, not only on the viroscientific, but also on bioethical, regulatory and governance levels. This paper analyses the global bioethical challenges of emerging viral threats from a dialectical materialist (Marxist) perspective, focussing on three collisions: (1) the collision of expanding networks of globalisation with local husbandry practices; (2) the collision of global networks of mobility with disrupted ecosystems; and (3) the collision of viroscience as a globalised research field with existing regulatory frameworks. These collisions emerge in a force field defined by the simultaneity of the non-simultaneous. Evidence-based health policies invoke discontent as they reflect the normative logic of a globalised knowledge regime. The development of a global bioethics or macro-ethics requires us to envision these collisions not primarily as issues of benefits and risks, but first and foremost as normative tensions closely entangled with broader socio-economic and socio-cultural developments.

Biosecurity and the ecologies of conservation. An anthropology of collecting practices among virus hunters and birdwatchers

Abstract This article describes prevention and preparedness as different techniques to conserve the past in order to anticipate the future. It relates the emergence of virology and ornithology to the places where samples are accumulated and classified. It then traces the role of anthropology in museums where cultural artifacts are conserved, to reflect on the possible interactions between microbiologists, birdwatchers and anthropologists in the field. It also asks questions about the position of China as a lack or an empty space in the global collections of museums.

Portable sequencing, genomic data, and scale in global emerging infectious disease surveillance

Emerging infectious diseases (EIDs) occur when pathogens unpredictably spread into new contexts. EID surveillance systems seek to rapidly identify EID outbreaks to contain spread and improve public health outcomes. Sequencing data has historically not been integrated into real-time responses, but portable DNA sequencing technology has prompted optimism among epidemiologists. Specifically, attention has focused on the goal of a "sequencing singularity": the integration of portable sequencers in a worldwide event-based surveillance network with other digital data (Gardy & Loman, Nature Reviews Genetics, 19, 2018, p. 9). The sequencing singularity vision is a powerful socio-technical imaginary, shaping the discourse around the future of portable sequencing. Ethical and practical issues are bound by the vision in two ways: they are framed only as obstacles, and they are formulated only at the scales made visible by its implicit geography. This geography privileges two extremes of scale - the genomic and the global - and leaves intermediate scales comparatively unmapped. We explore how widespread portable sequencing could challenge this geography. Portable sequencers put the ability to produce genomic data in the hands of the individual. The explicit assertion of rights over data may therefore become a matter disputed more at an interpersonal scale than an international one. Portable sequencers also promise ubiquitous, indiscriminate sequencing of the total metagenomic content of samples, raising the question of what (or who) is under surveillance and inviting consideration of the human microbiome and more-than-human geographies. We call into question a conception of a globally integrated stream of sequencing data as composed mostly of "noise," within which signals of pathogen "emergence" are "hidden," considering it instead from the perspective of recent work into more-than-human geographies. Our work highlights a practical need for researchers to consider both the alternative possibilities they foreclose as well as the exciting opportunities they move towards when they deploy their visions of the future.

A fragile assemblage: Mutant bird flu and the limits of risk assessment

This paper examines the recent public controversy sparked by the laboratory creation of a strain of highly pathogenic avian influenza transmissible among mammals. The contours of the controversy can be understood by tracking the assemblage of actors, institutions and devices gathered together in response to the governmental problem of how to manage emerging diseases. The grouping is tenuously held together by a shared commitment to the project of 'pandemic preparedness'. However, as the controversy unfolds, it becomes clear that the main actors involved do not share a common understanding of the problem to be addressed by pandemic preparedness, and the assemblage threatens to decompose. At the center of the dispute is the question of how to assess the risks and benefits of research in a field characterized by urgency and uncertainty.