Are pandemic times really unprecedented?

Podcast
October 26, 2022

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Description

On January 30, 2020, the World Health Organization declared the Covid-19 outbreak a public health emergency of international concern after an outbreak of the coronavirus 19 was discovered in Wuhan in November 2019. And on March 11, the situation has been characterized as a pandemic, leading multiple countries around the world to introduce lockdowns to stop the spread of the disease.

Today we talk about the still-evolving COVID-19 pandemic, a health crisis that’s often been called ‘unprecedented.’ But was it? Gabriel Miller is joined by Madeleine Mant, Assistant Professor of Anthropology at the University of Toronto to explore this question through the lens of pandemics past.

 

About the guest 

Headshot of Madeleine Mant

Madeleine Mant Phd. MSc. BA is Assistant Professor, Anthropology, at the University of Toronto, Faculty of Arts &  Science. Key research focus on health inequities in marginalized or institutionalized human groups through time using bioanthropological, archival, and survey/interview datasets. Her current research includes children's morbidity in 18th-century British hospitals, highlighting health experiences in 19th-century prison and poorhouse records, and a longitudinal study of young adult experiences and vaccine confidence during the COVID-19 pandemic.  

Mant has a theatrical background, acting as an extra-curricular during graduate school, which she now channels into thematic costumes during lessons, which she believes better engages students, and centres individual human experiences as part of larger historical events. 

She graduated from McMaster University and was a Banting SSHRC Postdoctoral Research Fellow at Memorial University. 

 

Madeleine Mant in the news 

  • Broken Bones - Memorial University gazette
  • Lessons from a year under cover: How the mask went from a discouraged piece of protection to a politicized symbol of the pandemic - Toronto Star
  • Pandemic lessons from the colony of Newfoundland in a time of cholera - CBC 

[00:00:00] Gabriel Miller: Welcome to the Big Thinking Podcast, where we talk to leading researchers about their work on some of the most important and interesting questions of our time. I'm Gabriel Miller, and I'm the president and CEO of the Federation for the Humanities and Social Sciences. Today we talk about the still evolving COVID 19 pandemic, a health crisis that's often been called unprecedented. But was it?

[00:00:32] I'm joined by Madeline Mant, Assistant Professor of Anthropology at the University of Toronto to explore this question through the lens of pandemics past. I hope you enjoy it.  

[00:00:48] You teach a course on the anthropology of health, and I'm wondering if I decide tomorrow to go back to school and I register for that class, what sorts of things should I expect to talk about and to learn in the classroom with you? 

[00:01:05] Madeleine Mant: Well, you should expect to have a great time, first of all, I promise. But the anthropology of health, so this is part of the anthropology of Health Stream that we're developing at University of Toronto Mississauga.

[00:01:15] So this class is essentially the gateway into taking the rest of the anthropology of Health Stream. So we go back to. The roots of biomedicine. We talk about the idea of western biomedicine. Where did it come from? We think about it as a form of ethnomedicine that it's not necessarily the only form of medicine that's out there.

[00:01:31] It certainly isn't. So we dig into topics like diet, nutrition. We do talk about infectious disease. I get a full two weeks on that, as well as growth and development, the concepts of stress and social race. We talk about mental health, so it's getting students to turn the lens a little bit on their own healthcare experiences to start thinking about problematizing words like health and disease and illness and wellness and sickness, and thinking about what they can do with that.

[00:01:57] Gabriel Miller: When I read about you, what- the picture that comes through is someone who's really fully embraced the opportunities to pursue her passions and her interests as a researcher and as a teacher, including a brief examination of your Instagram account will show a passion for wearing period costumes in the classroom.

[00:02:22] When you think back over the years, what do you remember about the decisions that led to this career path?

[00:02:31] Madeleine Mant: So I think you hit upon it there. There's a lot of costumes involved. I have always been a musical theater kid, and so throughout school I had a chance to, There was a couple of crossroads where I thought, do I try to go to theater school or do I go and get a degree in anthropology?

[00:02:45] And I realized that I could. Continue to act and I could continue to bring theater into the classroom within my real passion for history and anthropology. So I've been really lucky to be able to carve out a career where within the research and teaching as well as some of the service I do, I am able to bring costume theater play into the classroom.

[00:03:03] So I was trained as a bio archeologist. I work in bio archeology and paleo pathology first, which is looking at health and disease within human skeletal remains that are coming from archeological and historical sites. But my passion for the historical side of it meant that I started spending a lot of time in archives looking at medical history, looking at these types of primary documents, and thinking again about some of these same questions of, who is accessing healthcare? How is that embodied, like literally into the bones, but also how does that play out in terms of traces of human lives we might find in an archive? And then that also brought me to medical anthropology. So actually analyzing those medical systems in which people find themselves.

[00:03:42] So I do dress up in the classroom. If you were to come to Anthropology of Health, I go decade by decade. So I start in 1908 and we end up in the 2000s over the course of the fall semester talking about achievements in public health through time. So we talk about things like how did we get to have pasteurized milk?

[00:04:00] What is the Canadian Health League and why? What was it and why is it not here anymore? We talk about the foundations of the Canada Food Guide. We talk about seat belts not being a thing for quite a long time, and now being part of our legal system. So bringing in those concepts. What is public health?

[00:04:15] Because I think it really helps the students to start to see that public health can be found everywhere, that their lives are actively affected by it every single day, whether or not they're aware of it. And also how close in time we are to something that might seem quite historical. There's so many lessons that we can learn from things that might have just happened.

[00:04:33] So it helps me bring my sort of love for vintage fashion into the classroom. But at the same time, I think it's so helpful because students, you know, in the early part of the semester will see me in these long Titanic style dresses, this sort of ardian fashion, et cetera, and it looks out of place. I get a lot of stares on the way to the classroom, but by the time we hit the fifties and sixties, my clothing is back in fashion again.

[00:04:54] And so I think it helps them really connect with the idea that this just happened, that it sends a lot of students home to talk with their parents or ask their grandparents who all have stories about various diseases, about various government mandates, et cetera, that come through that I think really helps them connect it to their own lives.

[00:05:10] A lot of students at UTM are the first in their family to go to university. We've got a lot of first generation Canadians, so the stories, I focus it within Canada. But say, but think about what this means for you. Please go talk to your families and ask about what was going on maybe in your country of origin at this time.

[00:05:24] And it starts to bring in this concept of global health without maybe labeling it as such for the students. 

[00:05:29] Gabriel Miller: It's so interesting and it's so nice to hear you talk about this side of your work. I really feel like it's relevant to our experience with COVID, because there's a tendency or maybe an instinct to think that fighting a pandemic is all about people in lab coats doing science, quote unquote.

[00:05:51] Madeleine Mant: Yes.
Gabriel Miller:  And of course that's a vital part of it, but what we've seen is there are contributions that are vital from a whole host of other disciplines in our universities. And that how this information, this knowledge is shared with people is. Maybe as important as generating the knowledge in the first place, or at least a really critical component of any effective response there.

[00:06:18] I think about thousands, probably of scholars in the humanities and social sciences who were pursuing research in their own areas like you were and who were thrust into an urgent conversation in our society in March, 2020. When suddenly the questions that needed to be answered historically, culturally, socially, economically, and of course medically all revolved around this pandemic.

[00:06:50] What do you remember about your own feelings and thoughts in that month or two in early 2020? When this was on the horizon and then it hit.

[00:07:01] Madeleine Mant: So I recall the university giving us some direction and saying potentially if this is early, mid to mid-March, if something happens, having a plan in place would be good for the rest of the semester.

[00:07:13] And then two days later we got an email saying, do that plan . Hope you had a plan. It's now we've gotta go home. And it was very jarring. I know it, it really upset so many of the students that these relationships that we had built in the classroom, or suddenly going online. But there was a feeling of trust I felt, within my university career.

[00:07:31] I felt with the students, I said, We're going to be okay. You're not gonna suddenly fail the class because we can no longer be together in the classroom. So at that level, it felt like I can be a leader in this small space to help these particular people. On a personal level, my partner’s a physician, so it was terrifying.

[00:07:47] I was thinking, I wonder when we're gonna start blaming people. I wonder when people are gonna start fleeing. I wonder when the hierarchy of social class will suddenly make a huge splash onto the scene. And then all those things started to happen. And then as the vaccine got developed, I thought, I wonder which celebrity we'll get it.

[00:08:08] And then it was Tom Hanks. Tom Hanks got COVID. And then we had various celebrities talking about pushing the vaccine and I thought, all of these events, particularly the sort of social effects that we started to see. There is precedent for this. It was a really complicated time, personally and professionally for everybody to try and figure out what is our day to day?

[00:08:26]  How can I do my job? How can I live my life responsibly, and how can I pick through the immense amount of information that's out there and ensure that I actually am taking in and critically thinking about what I'm hearing? 

[00:08:37] Gabriel Miller: So March 2020 was not just the start of the pandemic, it was the start of us all needing to hear the word ‘unprecedented’ at

[00:08:46] ] least two dozen times a day. Absolutely. And part of our recovery from the pandemic, I think is recovering from the oversaturation of that word, but I don't think there's any getting away from the fact that one of the questions hanging over the experience for a lot of Canadians is, how unprecedented was it?

[00:09:10] How unique was this event and this experience? And of course, that matters because our ability to learn lessons from previous pandemics and lessons from this one will have a lot to do with how we manage when we face other challenges in the future. So when you hear an unprecedented crisis, what's your reaction to that description?

[00:09:36] Madeleine Mant: Whenever I hear the term in general, unprecedented crisis, I always think we should go talk to a historian. We should maybe go talk to an archeologist. When the term unprecedented started to get attached to COVID, this was almost immediately, so you're right. We've heard that word so many times and I've been asked the question, is COVID unprecedented?

[00:09:58] Are these pandemic times unprecedented? And I always think, Yes and no. But I think looking back in the last couple of years, we've certainly seen unprecedented scale of global cooperation, which has been wonderful. We've seen the speed of the information dissemination is something that is getting faster and faster, and we know that many governments took unprecedented measures within their own

[00:10:20] histories to restrict people's movements. We've seen in some places unprecedented economic effects or certain hospitals with unprecedented levels of need, et cetera. So I think it comes down to context because in general, I would say almost every social effect that we've seen. No, it's not unprecedented.

[00:10:37] When you need to ask more complicated questions like for whom is this unprecedented? Where and when in that temporal scale, are we talking about what specifically is unprecedented about our personal response to these current pandemic times? So saying something is unprecedented with, or your own lifespan, that just become more interesting and more accurate because the social effects of this particular pandemic

[00:11:00] have precedent looking at these historical outbreaks, I think can provide really useful tools to predict, to understand, to contextualize, and I think with any luck to actually act, to think about these effects, to bring some action both individual and collective forward.

[00:11:17] Gabriel Miller: When you look at and think about

[00:11:20] other historical events and we've heard comparisons especially to the 1918 flu, but others as well. As you reflect on this experience and draw on your historical knowledge, what parallels between what we've been through in the past few years and other events historically jump out to you?

[00:11:43] Madeleine Mant: So what have we seen before?

[00:11:45] I can think about a few actions we've seen before. We have seen. Vaccine mandates before, as far back as the 19th century for smallpox, we have seen the use of quarantine through time. We have seen face masks. We have seen vaccine and sanitary passports. We have seen situations where there is a large number of deaths that seem to then fall out of the collective memory.

[00:12:08] We have seen massive efforts to quote, get back to normal as quickly as possible. We have seen the blaming and shaming of people that seem to be other or whose national background or perceived behaviour or lifestyle mean that they deal with intense stigma. And that's some negative stuff in there, of course, and some sort of just regular government

[00:12:28] intervention. But a lot of this has happened before, and so looking at specific diseases I think can be a really good vehicle for picking up what are the themes that we've seen before? How might that have affected people? But I think it can also really help people contextualize the idea that vaccine testing, for instance, is not brand new, or where does the gold standard come from?

[00:12:48] And you say, let's tell you about Jonas Sal and the polio story. There's, There tend to be these touchstones that I think can be so powerful for folks within the vaccine context that might be feeling vaccine hesitant. And then I think for folks that also just might be feeling maybe a little adrift and maybe alone or isolated in thinking about, am I the only one that feels this way?

[00:13:09] I know some of my colleagues were saying when losing certain mask mandates saying, are we Cassandra? Are we just gonna run around and try and say we think that something bad is coming, but nobody will listen to the warning or are we able to maybe harness some of these lessons in ways that help? 

[00:13:26] And I talk to my students, I say, If what you take away from this class is I want you to think critically about the information. I want you to vote , and I want you to never feel that your individual action isn't doing something, those actions are meaningful and individual actions add up to the type of collective action that we need.

[00:13:43] I think that could be quite defeating, but how can we harness what we've learned to actually move forward for a society that I think that values equality better and values vulnerable and marginalized people better to make sure that we're not just doing studies that tell us that folks are dealing with worse health consequences, but that we're actively working to lessen those health consequences.

[00:14:11] Gabriel Miller: I'd really like to stick with what you've just said about equity, and it brings to mind for me the visible and invisible aspects. A crisis like Covid, the virus is invisible. Many of its effects are obviously very visible and very tangible, and one of the important questions is, which problems do we see, and which ones do we not see?

[00:14:42] Which problems get attention and which problems get ignored? I'm interested in your thoughts from not just this epidemic, but some of the other examples you mentioned, including polio. How have questions around equity and diversity affected. Our response to these kinds of crises. I think 

[00:15:09] Madeleine Mant: I'd like to maybe, maybe connect this to some of the history of smallpox, if you'd be willing to go there with me, because smallpox is, it's the disease that we've eradicated, and so it's a great example of global cooperation and understanding diverse settings in which smallpox.

[00:15:25] Still affecting people into the mid, mid to late 20th century. So small box is connected, I think, to some of these topics because it's connected so clearly to the development of things like medical testing and informed consent alongside the history of vaccination. And I think when you talk about the visibility, this is what made me think of it, because small box is a very visible disease.

[00:15:45] It's, you know, acute, it's highly contagious. Is causing, you know, flu-like symptoms, et cetera. But then we have these rashes and blisters that can affect people all over their bodies, and a lot of folks ended up deeply scar. Because of the disease. And so a person who had smallpox scars would be telling you that they were immune to smallpox by their scars, but also that they had been affected and survived.

[00:16:07] There's questions of whether or not, maybe that's why Queen Elizabeth the first wore such heavy makeup because we know that she'd had small PPOs and we've got, we noticed this ancient disease. We've got various Egyptian mummies showing pock marks on their faces. So it's something that would have been understood so that it wouldn't necessarily upset somebody apart as truly different.

[00:16:25] But when we start to move into questions of how to deal with. It's actually really wrapped up in questions of the British Empire and colonialism because this term variation is the first method that was used to immunize individuals against smallpox was something with deep roots. In Asia. We have a woman named Lady Mary Wortley Montague, who's the wife of a British ambassador who she herself was deeply scarred by smallpox and she was worried about her children getting it, but she.

[00:16:51] In Turkey in 1717 because of her husband's work and learned about this inoculation and tried to bring it back to Britain, and so you start to get this movement. But of course, a woman of high social status bringing back this idea, she's very impressed. She had her son inoculated in this way goes back to London.

[00:17:09] London is having an enormous small box epidemic, and the Royal College of Surgeons and physicians is very. About this concept because you can get that sense of, I mean, if you just call it racism, but we can also a little of xenophobia, but this question too of is this good enough for the higher classes?

[00:17:26] So you start to get that kind of questions of, these questions of equity immediately come into it. So the College of Surgeons says, Okay, we are interested in this. We like the idea of not people not dying of smallpox, but they say, But we need to test the procedure. Who do you test the procedure upon? You test it upon people who basically have no rights.

[00:17:42] So they go to the folks who are on death row in Newgate Prison and say, If you quote unquote volunteer for our study and are willing to get inoculated if you live we'll let you go free. So the question of consent and informed consent there is quite intense of course. And they did volunteer , six prisoners volunteered.

[00:18:02] They all promised they'd never had smallpox before. They all went through this inoculation procedure. Five of them started to develop the smallpox symptoms and then eventually were deemed to be immune. The sixth person did not develop smallpox symptoms because they'd lied and they had it before. But this actually helped almost as a case control to show that once you're immune, you are immune.

[00:18:22] So they all survived. They were all released. Lots of great history there. But what happened to them afterwards? Some of them ended up going to Australia, of course. But this question. Who can we test things upon to make it good enough for people of a certain status? These are really interesting questions, and they play into questions of race and of status and class and all these interesting aspects that I think we forget when we move into, now we have a vaccine, we know it's safe, we can move on.

[00:18:46] We need to think about the folks who have been. On that journey. So we can talk about vaccine equity in the 21st century, but also thinking about medical testing, equity through time. It didn't all begin with a white woman bringing something back to Britain, of course. But that particular action, that individual action starts a lot of other things into motion.

[00:19:04] So it's a really interesting question to look at questions of equity and diversity throughout, I think throughout time, but specifically with questions of disease for sure. 

[00:19:12] Gabriel Miller: And as we turn to talk about the vaccine, And vaccination. It's a really helpful reminder that there's the conversation we're having in the moment and then there is all sorts of baggage that these ideas and these responses carry with them in all sorts of different forms in our society.

[00:19:37] This pandemic, I feel, it will be perhaps most remembered in terms of the dialogue around the vaccine. And of course there is much more to it than that, but it feels like the vaccine is, on one hand, the vehicle for our hopes of an end and a really remarkable medical response to this challenge. And then at the same time, the realization.

[00:20:03] Both that a vaccine relies on trust and on the willingness of people to have it administered, but also that it isn't a magic bullet, that the virus continues to mutate and evolve, and that there, you can't just throw away the other measures for containing it. You did. Really timely work, uh, at the University of Toronto to examine questions around attitudes about a vaccine before the vaccine was even available.

[00:20:39] Would you tell us a little bit about that research?

[00:20:41] Madeleine Mant: So with this particular survey, we were indeed capturing, at least to the best of my knowledge, the earliest data surrounding young adult perceptions of what was going on. We opened up our survey in March of 2020. And realizing this was gonna be a snapshot that needed to continue.

[00:20:57] We ran it again in June of 2020, in September of 2020, and then again twice in 2021, and most recently in the spring of 2022. So we've got two years of data talking about this, and we started in that second survey in June of 2020 to start asking questions more actively about vaccines. So we, our aim through this by surveying and interviewing.

[00:21:19] Before vaccines were available while they were being tested, and then once they were publicly available to ask questions about this willingness of young adults to receive a vaccine. Because there's a lot of research that's gone on with university age students. A lot of research suggesting fairly low vaccine knowledge, really low seasonal flu vaccine uptake among students.

[00:21:39] And a lot of previous studies have been trying to investigate where is information coming from and found in many cases that parental influence is a really big factor in predicting if a student or a young adult will take a vaccine. So we went through, we were asking questions about perceived severity.

[00:21:55] If the students knew anybody that had experienced covid or themselves or someone you know, in their circle. Did they feel they were susceptible to catching it? Did they take previous seasonal flu vaccines, et cetera? So a lot of this was quantifiable information, and we were finding that perceptions of severity were statistically significant drivers of the willingness to take a vaccine.

[00:22:13] So students who were saying, yes, I think it's very severe, were statistically more likely to say, Yes, I'd be willing to take a vaccine, which made a lot of sense. Whether or not a student had been personally affected by Covid was a big driver of their willingness. And really most interesting to me was that students who said that they would trust a doctor or a pharmacist, pharmacist's advice were 76 times more likely to say they would take the vaccine than those that said that they weren't really willing to listen to a doctor.

[00:22:38] So this was important information, just giving us that sense of who are folks listening to, how are they feeling? But it was really the interview experience. So bringing it back to how did it feel to be doing the research, The interview experience was such a revealing process for me, because the interviews added so much nuance to this, we were speaking with about 20, 30 young adults with a range of opinions regarding vaccines.

[00:23:01] So we, we had folks that were nervous about the testing, folks that were nervous about potential side effects, but maybe were still willing to get it as the vaccine became available. Folks were talking about how they might have a family member who was very much against the vaccine, but that they themselves had actually secretly gotten vaccinated because there was an awareness that I might not get to go back to school or I, I know there's high risk members of my family.

[00:23:24] There are cases where folks were helping a friend who had maybe had an anti-vax parent, you know, to go get vaccinated. So there was this really interesting development of. individual decision making surrounding health behaviors. That was very different than the parental inferences we'd seen in this sort of pre covid time.

[00:23:42] So it became so clear that we need to be asking these questions about health behaviors. And about these choices because a lot of folks said, I'm getting the vaccine cause I don't wanna get COVID. Great- self protection is a perfectly valid reason, but we're also seeing lots of altruism, lots of folks talking about people within their own families.

[00:23:59] The idea that I don't want to hurt somebody else because I have an interaction with somebody at my job. So while overall the majority of the students intended to get it, these nuanced concerns about efficacy and safety were really important. But the idea that too, we really need to be ensuring that the frontline family, doctors, pharmacists, other frontline healthcare workers, had access to consistent and clear information regarding the benefits, because this is gonna be critical to encouraging uptake among young adults.

[00:24:25] Some even specifically mentioned that they gotten a mailout from the Canadian government that basically just said, It's safe. Get it. They said, I felt offended by that. I don't like being told what to do. It really opened me up to be, frankly, more empathetic as a researcher to appreciate the nuance better and to think, of course about the importance of some of this longitudinal data.

[00:24:44] Because there were folks that we interviewed two or three times, some of whom said, No way I won't get it. And then a year later said, Oh yeah, I got it. And the booster. And so digging in a little bit to why that had changed for them, some of it's peer pressure, some of it's, it was because of a mandate.

[00:24:56] Some of it was reading a little bit more or talking it out with various others, trusted people in their lives. So, digging into the how and the why is so important. There was a survey done before the pandemic that was asking about vaccine confidence, and I think about 5% of those, this is within Canada.

[00:25:11] 5% had said, I'm completely anti all vaccination, but about 20% expressed a general hesitancy, and I thought that's important. So that's 25% of the total that took this particular survey, were asking some really big questions and so rather than saying it's an us versus them, which really never helps any situation.

[00:25:30] It's so important to be welcoming people into these conversations and digging deep over the last couple of years with these young adults has really opened my eyes to this spectrum that there are folks that will make a decision for a variety of different reasons. And so digging into that kind of the models of protection, motivation theory, and the health belief model, and what are the barriers?

[00:25:49] These are important frameworks because again, what do we do with this information? It's all fine and dandy for me to chat with these students about it, but what do we do with that information? It's about empowering the healthcare workers. It's about creating public health campaigns. They're really targeted to reach out to these folks because within our survey too, we were asking about media use and the folks, the students basically said, We use social media the most for both regular information and COVID-related information.

[00:26:13] It makes us the most anxious and we trust it the least. Versus something like radio or more sort of legacy media options. And so that felt really important to me. This thing we're working on writing up. Now, this idea that we're using something we don't trust , but we're using it the most and we're aware that we're gonna keep using it.

[00:26:29] So this isn't more than just getting health agencies to have slick looking Instagram slides. It's about how do we actually build that kind of trust in the media that's being used as well. 

[00:26:38] Gabriel Miller: You started talking earlier about the, some of the things you hope your students will take with them when they leave your class on the anthropology of health, including voting, which I thought was very interesting and important part of that list.

[00:26:55] Let's imagine you are getting ready to take a trip and you board a plane and you're seated beside the Federal Minister of Health and they unexpectedly are in the mood to chat, and they catch a glimpse of some of the reading that you have with you, and they turn to you and ask, honestly, confidence, complacency, convenience.

[00:27:20] Where should we put our attention first as we start a conversation about being better prepared for pandemics of the future?

[00:27:33] Madeleine Mant: I think on a question like that, I would certainly quote Dr. Mike Ryan, who works with the World Health Organization as Executive Director of Health Emergencies, who early on as the vaccine was being developed, said quote vaccine is no good in the vial, which I thought was such an important aspect.

[00:27:51] So if it's in the vial, it means it has gone through massive levels of testing. And so the idea of building confidence, potentially we need to be really clear about what vaccine testing looks like. This could mean telling people the story of Jonas Salk in the 1954 trials. It could mean digging into that history.

[00:28:08] It could also mean just talking people through what blind testing looks like or what a placebo is, and really breaking down some of that scientific literacy. So I think I would probably say we need to talk about trust first. We need to talk about scientific literacy. We need to talk about trust between a patient and a practitioner.

[00:28:23] It can break it down to those individual places. I think that's the place to start, because if people are not willing to even entertain the fact that they might want to get a vaccine, then how convenient the clinic is to their workplace or home is not gonna be necessarily a factor that matters. But once we get people to feel confident, then I think it really comes down to that convenience.

[00:28:43] We've gotta say it's gotta be available to folks and we can build or maybe try and fight some of that complacency in the midst of things, but it's gotta be a confidence in the product itself. And that means we need to talk about public health transparency. We need to make the scientific trial information more clear.

[00:29:00] Because even the sort of big summaries that are produced are really hard to pick through. Even as somebody who does a lot of this reading, it can be really overwhelming. We need to also start talking about risk in a more active way to think about what does a one in a million chance look like? Really start to break that down for folks and also be really clear about

[00:29:20] talking directly about conspiracy theories, rather than saying that's foolish and just brushing it aside. Start to say, where's that coming from? That's the social science aspect of this, right? Dig? Where is that coming from? How can we help people not fall into logical traps or fallacies? I will, I think I would bring it back to trust first, and then I would, if I actually had the ear of somebody like that, like how long is this flight?

[00:29:41] Are we talking about a puddle jump? Are we going to Britain? Like there's, there would be so much to discuss there about how to get health literacy and scientific literacy into schools. It's not only a minister of health, it's gotta be a ministry of education. You gotta have every, gotta have the whole cabinet on the plane with me to really start to talk about this.

[00:29:56] And I think that's why I mentioned things like voting, is that sometimes I think we can feel so powerless that our own education is only one thing, but. Every vote counts. An individual action does count. We need to have that individual action to push past the complacency and to push past some of that pandemic fatigue, which we have all felt because we're all human, but that these are human stories, that biomedicine is a human made system.

[00:30:18] Things are fallible, and it is not a failure to critique. It's not a failure to analyze and think about other things that could be better. But I think the only way we fail is if we don't ask the questions and we start and we stop caring. 

[00:30:30] Gabriel Miller: Vaccine is no good in the vial. Those will be words that I'll remember for this conversation along with several other things that we've talked about.

[00:30:39] Do you have any final words you wanted to share? Anything that you really felt like it was important to communicate to our audience that you haven't had a chance to say already?

[00:30:47] Madeleine Mant: think a really key point that I always want my students to take away, and I maybe if people can take away from this conversation too, is that infectious disease outbreaks, so epidemics or pandemics help us to basically take an x-ray of society, and I'm drawing this from some amazing scholars who've done a lot of work on these historical outbreaks. The problems we see

[00:31:09] during a pandemic, were there before. This should give us some pause when we're asking questions of ethics, of bodily autonomy of protection and health, motivation of blame and shame, and stigma and victimization of marginalized individuals. There are precedents for this. There are studies of the past that are directly relevant to today and trying to get back to normal, quote unquote, should give us some pause because that normal had a lot of these problems circulating just below the surface that were just brought to the fore.

[00:31:38] We talk about workers' rights, we talk about racism. There's so much going on in the world that needs attention. It shouldn't, in my opinion, take an enormous global health disaster to start making us think about these problems. So look on a local level, look on an individual level at what you can do, but also remember that we have to continue to evolve and change that we can learn from the past, but it's only useful if we're using it to change the future for the better.

[00:32:07] Gabriel Miller: Thank you for listening to The Big Thinking Podcast and to my guest, Professor Madeline Mant. Dr. Mant is Assistant Professor of Anthropology at the University of Toronto. You can follow her Plague Doctor Adventures on Instagram at Plague Doctor Time. I also wanna thank our friends and partners at the Social Sciences and Humanities Research Council.

[00:32:28] Whose support helps make this podcast possible. Finally, thank you to Cited Media for their support in producing the Big Thinking podcast. Follow us for more episodes on Spotify, Apple Podcast and Google Podcast. A la prochaine.

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