Social pathologies and urban pathogenicity: Moving towards better pandemic futures

Abstract

In this article, we suggest rethinking how to move forward in a way that better elucidates socio-economic and political factors driving inequities, and in turn points to more broad sweeping, deep-rooted changes necessary if pandemics in the future are finally going to be mitigated pre-emptively rather than reactively. To this end, we argue that a more comprehensive, flexible and incisive approach is necessary – a hermeneutic framework that focuses analytical attention and action on interventions upstream, on the multifaceted interrelations necessary before lives currently deemed disposable are lost. Unlike dominant public health and epidemiological approaches, that is, Social Determinants of Health and Syndemics, proven unlikely to fuel structural change or to enable pre-emptive response, we propose the framework of pathogenicity and apply it to urban contexts to answer questions concerning the relationship between microbes on the one hand, and on the other, the urban, social, political, ideological, global, scientific, economic and many other relations that galvanise these into pathogens. By employing pathogenicity in the context of two case studies in the US and Turkey, we shift emphasis away from tackling microbes to better understanding what makes those microbes, and even the interventions implemented to stop them, so destructive.

Metagenomic and Culturomics Analysis of Microbial Communities within Surface Sediments and the Prevalence of Antibiotic Resistance Genes in a Pristine River: The Zaqu River in the Lancang River Source Region, China

“…A prime illustration of this phenomenon was observed during the transformation of Vibrio cholerae from non-pathogenic to pathogenic variants, the process of which entails the acquisition of the type IV toxinco-regulated pilus (TCP) followed by infection with the filamentous phage CTXϕ, exploiting pilus as an entry point and introducing genes coding the production of cholera toxin. Current studies strongly indicate that specific distributed genes and gene combinations play crucial roles in determining which kinds of strains are most likely to act as pathogens [73][74][75]. The most prevalent pathogen genes included RpoB (belonging to Acinetobacter baumannii), followed by RSc0454 and speC (Ralstonia solanacearum), as well as CcoN2 and rmlA (Pseudomonas aeruginosa).…”

Urban public health emergencies and the COVID-19 pandemic. Part 2: Infrastructures, urban governance and civil society

“…Building upon the extensive research on pandemics and social inequalities, Atuk and Craddock (2023) propose an innovative 'pathogenicity' framework to rethink how cities can be better prepared for future public health emergencies. The 'pathogenicity' framework, originally proposed by Hinchliffe et al (2016) in the context of global biosecurity, reconceptualises disease as a situated matter: that is to say, disease is not a fixed object but a process of various conditions being formed which allow for disease emergence and transmission.…”

“…The ‘pathogenicity’ framework, originally proposed by Hinchliffe et al (2016) in the context of global biosecurity, reconceptualises disease as a situated matter: that is to say, disease is not a fixed object but a process of various conditions being formed which allow for disease emergence and transmission. By translating Hinchliffe et al’s (2016) ‘pathogenicity’ framework to urban settings, Atuk and Craddock (2023) make a compelling argument that making communities healthier at all times would have greater effectiveness in managing pandemics than episodic public health preparedness in times of crises. As Atuk and Craddock (2023: 1670) write, COVID-19…has shown that the neoliberal tendency to address harm only when there are crises and disasters, and to divest from programmes that might eradicate some of the root causes of unequal burdens of disease such as reduction of public investment, privatisation of healthcare and impoverishment of public health infrastructures…becomes quite literally murderous to millions.…”

“…Beyond offering critical reflections on historical and contemporary failures, the search for better urban planning and governance practices highlighted in Part 2 of this Special Issue leads to the development and validation of new planning and governance paradigms such as the ‘urban pathogenicity’ theory proposed by Atuk and Craddock, 2023) and the neighbourhood co-governance practice proposed by Liu et al (2023). The ‘urban pathogenicity’ theory calls for upstream interventions that fully address communities’ social pathologies, healthcare austerity and the racisms that have made certain populations more vulnerable than others.…”

“…In much of the urban West, for instance, stay-at-home orders were easy to conform with for middle-class, white families with private gardens and sufficient space to combine living and homeworking; those living alone, those in small homes, precarious ‘gig’ workers and those reliant on neighbourhood life for companionship and sustenance struggled (see Part 1 of the Special Issue; Buffel et al, 2023, Hong and Chakrabarti, 2023). This points to the continued, and in some cases growing, influence of neoliberalism and authoritarianism in the biopolitical and spatialised management of public health emergencies (Atuk and Craddock, 2023).…”