Outbreak Mitigation at the Crossroads: Technical Expertise, Political Imperatives, and the Myth of John Snow
Outbreak mitigation always operates within a tension between technical expertise (lo técnico) and political imperatives (lo político). My conversations with epidemiologists in Guatemala over the past twenty-eight years have taught me that this dichotomy places a strain in their daily work that reaches its highest intensity during an outbreak. The essence of this challenge lies in what one seeks to mitigate. The technical prioritizes disease and its effects on population health while the political, in contrast, prioritizes certain social, economic, or political consequences of the epidemic’s spread. In their accounts of outbreaks, several of these epidemiologists have invoked the figure of John Snow, the English physician who in the nineteenth century investigated the causes of several cholera epidemics in London. I argue that Snow functions here not simply as a historical reference, but as a modern myth, one that offers clues for understanding how epidemiologists make sense of the persistent tension between technical expertise and political authority, especially when performing the work of mitigating outbreaks. Below I present examples of this dichotomy and references to Snow, whom I then analyze as a modern myth that offers clues for understanding the place of epidemiology in contemporary society. (read more...)
