We
understand that social distancing is inconvenient. In Singapore, which currently has a
mild form of it because the Coronavirus is controlled well here, temperature
checks when going into certain buildings are inconvenient, we eat at
restaurants less often than we would like, and a shopping center (such as the
one housing my gym) is a place to think twice about entering. Other places are
much worse off, with people quarantined to their dwellings except for
emergencies, and all community meeting places and arrangements canceled.
What this
research points out is that places of social inclusion are essential to
society. Places of inclusion are where people gather to have their needs
provided by society, from private actors, government actors, or voluntary
associations. They include the sports stadium of the local team, the
unemployment office, the church, and the soup kitchen for the homeless. All
these are places that provide practical goods and services, but they also serve
a symbolic role of defining the community and affirming people’s inclusion in
the community.
The
importance of places of social inclusion was shown prominently when their
research at a public Emergency Department (ED) in Australia suddenly involved
the Ebola epidemic. ED doctors and nurses handle many kinds of risks to
patients and themselves, but Ebola was unusual because it was an unknown
situation, and one that could lead to exhaustion of ED resources and even temporary
closure of the ED. This was a situation that invoked fear and a feeling of
threat because the physicians understood that turning away any patients was
more than failing to provide medical services; it meant an unmet human need.
Although most people rarely interact with EDs, they are places of social inclusion
that need to stay available.
To manage
the Ebola situation in addition to the regular claims on their resources, the ED
rationed resources carefully and enabled resource use whenever possible. Doctors
and nurses also went to extraordinary lengths to avoid closing down and to keep
the ED safe for both patients and employees. In the end, many ED personnel
dealt with the situation by reasoning that the Ebola risk, although new, was
not so much greater than the risk posed by violent patients or other infectious
diseases, which they already dealt with routinely.
If we tie
this research to the Coronavirus situation, we should be aware of some
differences. The personnel at this ED were very conscious of its role as a
place of social inclusion and did their best to stay open and admit patients. And
when all was said and done, they had treated no Ebola patients, only some
suspected cases. Is that what we will see in the current situation? I doubt it.
Not all
places of social inclusion recognize that they have this role, and few are
staffed by individuals who have taken an oath to protect the patient and the
community, as many doctors do. The Coronavirus will see many places of social
inclusion close, by their own volition or by public policy. Few places of
social inclusion will be as safe from infections as the Australian ED studied
in this research. Ebola was rare and not very contagious but was feared because
it was so grimly deadly. The Coronavirus is now widespread and appears to be more
contagious than the flu, and deadlier.
For a
while, places of social inclusion will be lost, and this will be a great loss
to communities and their inhabitants. A significant measure of community
resilience will be how quickly the places of social inclusion can open again
and serve their community. In the meantime, let’s hope that communities can
improvise safe places of social inclusion, as Italians have done by singing
from their balconies.
Wright, A. L., Meyer, A. D., Reay, T., & Staggs, J. 2020. Maintaining Places of Social Inclusion: Ebola and the Emergency Department. Administrative Science Quarterly, forthcoming.
