In this study, we conduct a detailed analysis of qualitative survey data focusing on adult populations in the UK, Japan and Mexico to address the following question: How has the COVID-19 pandemic changed people’s lived experience of their bodies, other people’s bodies and the world? We identify five themes: (i) fear and danger, (ii) bodily doubt and hypervigilance, (iii) risk and trust, (iv) adapting and enduring and (v) changes in perspective. We use two theoretical frameworks: first, Mary Douglas’ anthropological work on purity, risk, danger and symbolism is applied to understand how social and cultural meanings attached to the body have changed during the pandemic. Second, we use the concept of bodily doubt developed by Havi Carel to interpret how people experience their bodies and other people’s bodies differently during the pandemic. While we recognise the significant variation in people’s embodied experience of the pandemic, our findings suggest there are commonalities that span different countries and cultures. Specifically, we look at responses to COVID-19 protective countermeasures such as national lockdowns and physical distancing which we suggest have reduced people’s ability to put faith in their own bodies, trust other people and trust the political leadership. We conclude by proposing that the changes to our lived experience during the COVID-19 pandemic have prompted changes in perspective and a renewed focus on what people consider important in life from a social, moral, cultural and political point of view.
- philosophy of medicine/health care
- medical anthropology
- surveys and questionnaires
- qualitative research
Data availability statement
Data are available in a public, open access repository. The datasets presented in this study can be found in a Figshare online repository (doi: 10.6084/m9.figshare.20443182) at the following link: https://figshare.com/articles/dataset/The_Pandemic_Experience_DATE_RANGE_/20443182.
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- philosophy of medicine/health care
- medical anthropology
- surveys and questionnaires
- qualitative research
During the COVID-19 pandemic, governments around the world introduced protective strategies aimed at mitigating the further spread of the virus and preventing healthcare services from becoming overwhelmed (Berrocal et al. 2021). For example, mandatory lockdowns, physical distancing rules, intensive ‘test and trace’ processes and large-scale vaccination programmes were put in place to monitor and control the disease.1 The likely consequences of these methods, and of the virus itself, have been widely discussed from epidemiological and clinical perspectives (Telenti et al. 2021; Wiersinga et al. 2020). While these studies are vitally important for understanding how the virus transmits and behaves, they cannot tell us how the pandemic has changed people’s lived experience, in particular their experience of their bodies, other people’s bodies and the world.
In this paper, we explore these changes by providing an account of ‘the pandemic body’: the lived body as it is experienced in pandemic times. Our account is based on a close analysis of qualitative data drawn out of an anonymous survey focusing on adult populations in the UK, Japan and Mexico ‘Experiences of Social Distancing during the COVID-19 Pandemic’ conducted in 2020 (5 June to 31 July 2020) and in 2021 (7 April to 31 July 2021). We provide more information on survey design, data collection and analysis in the ‘Methods’ section of this paper. Our primary source of information comes from the written responses of these survey participants (Froese et al. 2021; James et al. 2022).
To capture the essence of a ‘pandemic body’, we draw inspiration from two theoretical frameworks. The first was developed by social anthropologist (Douglas 1966 ⇓)and explores how socioculturally determined concepts such as dirt, purity, risk and danger become attached to bodies as symbols of what they are and stand for. The second considers how concepts such as ‘bodily doubt’ (Carel 2007, 2013, 2016) in the phenomenology of illness can be applied to better understand how people experience their and other people’s bodies differently during the pandemic. These frameworks provided a lens for examining the survey responses and helped inform our decisions about the most suitable themes and subthemes for explaining what a pandemic body is and how it is experienced by the self and others. The main themes identified are: (i) fear and danger, (ii) bodily doubt and hypervigilance, (iii) risk and trust, (iv) adapting and enduring and (v) changes in perspective. Although we recognise there are many ways of discussing and analysing the role of the body, the themes draw on how different embodied aspects of the pandemic experience have been expressed in our participants’ narratives.
We provide a comprehensive account of these narratives in the ‘Findings and discussion’ section, where we show how during the pandemic our bodies and the bodies of others became subject to social rejection and distrust, seen as doubly infectious, alert to physiological symptoms and physically distant. Paradoxically, people also reported a sense of ‘craving’ for interpersonal relationships in the form of touch, valued their friends and family more and became overall more reflective about their lives (Kearney 2021; Todorova et al. 2021; Delgado et al. 2021).
To demonstrate how different aspects of the pandemic experience are embodied, this study asks: How has the COVID-19 pandemic changed people’s experience of their bodies and the world? We further ask the following subquestions: (1) What effect has the lockdown and other measures against the virus had on the way people perceive their bodies and other people’s bodies? (2) What cultural and symbolic meanings are attached to the body and if so, how did they change? (3) To what extent do the risks associated with the COVID-19 virus threaten people’s sense of bodily security and safety?
In the ‘Literature review’ section, we review phenomenological and non-phenomenological literature on the COVID-19 pandemic, with a specific focus on the body and embodiment. First, we present work from researchers from across the social sciences, humanities, psychology and medicine who have discussed people’s lived experiences of the pandemic and of their bodies. Second, we present phenomenological accounts that provide support for our notion of a ‘pandemic body’. The ‘Methods’ section presents methods and respondents’ data collection, and analysis. The ‘Two theoretical frameworks: Douglas and Carel’ section provides an account of the theoretical frameworks used to guide our interpretation of findings, followed by ‘Findings and discussion’ and ‘Conclusion’ sections.
The COVID-19 pandemic has been widely discussed by scholars from a range of disciplines, including social sciences, humanities, psychology and medicine. Scholars from these fields have addressed specific research questions with the aim of understanding how factors such as fear, risk and trust affect compliance with COVID-19 protective strategies such as national lockdowns, wearing face coverings and physical distancing. For instance, Biswas, Chatterjee, and Sultana (2021) reported a breakdown of trust, stemming from fear and suspicion of other bodies as well as some groups in society seen as responsible for spreading the virus.
Low levels of trust have been shown to have a negative effect on adherence to COVID-19 protective behaviours (Balog-Way and McComas 2020; Kuper-Smith et al. 2021; Lieberoth et al. 2020). Lieberoth et al. (2020) found that high levels of stress and concern about the virus were linked to low levels of trust in government strategies used to control it. This finding corresponds with Thoresen et al. (2021), who also found lower levels of generalised trust among individuals who worried a lot about the pandemic or perceived their own health risk to be high.
Concerns about dying and becoming seriously ill with COVID-19 have also been widely reported in psychological studies (Coelho et al. 2020; Enea et al. 2021; Quadros et al. 2021) that identify COVID-19-related fears as contributing factors of poor mental health and low well-being. For example, Enea et al. (2021) identified feelings of loneliness, mortality awareness and a greater preoccupation with spirituality as positive predictors of fear of COVID-19. These existential issues are significant because they show how factors in addition to the discernible fear of infection and illness create feelings of anxiety experienced through our bodies and collectively as a society (Wheaton, Prikhidko, and Messner 2021).
Other important differences in the way bodies are conceptualised and treated during the pandemic have been discussed by Ali (2021), who demonstrates how ‘symbolic ownership’ by the government over COVID-19 deceased bodies transformed them from ‘normal’ to ‘viral bodies’.2 Ali (2021, 6) also shows how disruption to ‘culturally normative rites of passage’ and other sense-making rituals that facilitate proper grieving and connection with one’s traditions, culture and history can negatively impact mental health. These findings share commonalities with other works also documenting how some countermeasures associated with the pandemic have resulted in significant losses and in many cases prevented proper grieving processes (Richardson et al. 2021;Ratcliffe 2022).
Despite its many challenges, the pandemic and its countermeasures have had some positive effects too. For example, many people were inspired to take up new or dormant hobbies, helping them to regain a sense of purpose and become more creative (Kapoor and Kaufman 2020). Additionally, in response to reduced social interaction, boredom and loneliness. many people engaged in yoga, meditation and mindfulness to help them cope. Mindful practices such as these have been shown to help people develop bodily awareness and promote well-being during the pandemic (Antonova et al. 2021; Behan 2020).
Additionally, the pandemic and its hardships forced many people to experience a shift in moral, social and personal perspectives. This phenomenon was observed by researchers who investigated how social and health-related inequalities, as well as environmental issues such as the climate crisis, have been amplified by the pandemic and compelled people to revaluate what really matters to them (Bojanowska et al. 2021; Thompson 2021; Wyns 2020). For example, Bojanowska et al. (2021) documented how global health concerns such as the pandemic cause people to attach higher significance to prosocial values such as humility, benevolence and universalism. In line with these findings, Thompson (2021) offers a narrative of hope in response to the virus outbreak and invites people to ‘lean into the adaptive moral challenge of stewardship for the future of humanity and the planet’ (Thompson 2021: 215). These studies are a sample of the wider literature documenting positive pandemic experiences and reporting an increase in community-level trust and solidarity among families (Frenzel et al. 2022), ill patients (Liu and Liu 2021), healthcare professionals (Delgado et al. 2021) and nations (Berrocal et al. 2021), who have supported each other in difficult times.
Phenomenological and embodied accounts of the COVID-19 pandemic
During the pandemic, many clinical researchers adopted a phenomenological framework to develop an understanding of how some groups in society such as, people infected with the virus (Missel et al. 2022; Liu and Liu 2021; Son et al. 2021), pregnant women (Mortazavi and Ghardashi 2021), black people (Aliyu et al. 2021) and other group-specific populations (Bhatt et al. 2020) have been affected by it.
For example, in a qualitative study of embodied experiences of a COVID-19 illness trajectory, Missel et al. (2022) explored how people experienced their bodies and other people’s bodies differently during and after infection with the virus. Scholars observed how participants ‘come to doubt their own body and the body’s capabilities of normal functioning’ resulting in a loss of trust in the body (Missel et al. 2022, 4). The study concludes that the body has become a ‘symbol of awe and alienation for others’ while it is experienced as something vulnerable and ‘marked’ for recovered individuals (Missel et al. 2022).
Liu and Liu (2021) also use a phenomenological framework to demonstrate the rejection and stigmatisation experienced by hospitalised patients with COVID-19 even after recovery. A poignant example of these attitudes is provided in the following testimony: ‘Everyone calls it “Wuhan Virus”. We are “Wuhan Virus” that can kill others. The prejudice is painful. (Participant 11)’ (Liu and Liu 2021, 5). Discrimination and stigma of this kind have also been reported by Bhatt et al. (2020) whose qualitative study shows how healthcare workers, people infected with COVID-19, people returning from abroad and some religious groups were shunned by the rest of the community. In the study, the researchers document reports from healthcare workers who were blamed for spreading the virus and subsequently denied housing on that basis (Bhatt et al. 2020). Attitudes such as these demonstrate how the physical body has become symbolic of contamination and disease during the pandemic. Furthermore, they show how the lived body has become objectified both for the individual and for others who perceive it as a site of contagion, danger, stigma and taboo.
Further phenomenological accounts of how the COVID-19 pandemic has changed our relationship with bodies and the world are provided by Aho (2021), Carel and Kidd (2020), Carel, Ratcliffe, and Froese (2020), Carel (2020), Dolezal (2020) and Trigg (2021) to name a few. Dolezal (2020) draws on traditional phenomenological ideas developed by Merleau-Ponty to claim that in pandemic times the lived, habitual body (Leib) is replaced with an objectified, physical body (Körper). She explains this transformation in terms of changes to lived experience during the pandemic specifically, lockdowns and physical distancing that challenge our intercorporeality as fundamentally social beings. In a similar vein, Aho (2021) argues that the disruption caused by the pandemic has disclosed a state of uncanniness (das Unheimliche) that is the true nature of Being (Dasein) in a Heideggerian sense. He explains how hypervigilant hygiene practices during the pandemic have changed his relationship with his own body, especially his hands. Aho’s idea echoes reports of hypervigilance and bodily doubt (Carel 2013, 2016) narrated by our participants. Trigg (2021) argues that the circumstances surrounding the pandemic have ‘thematised the body in its thing-like status’, which challenges our sense of bodily ownership. Trigg argues, ‘the body of COVID-19 is not simply an “ill” body that is ravaged by disease; it is also an anxious body, a suspicious body, a distanced body, and a concealed body’ (Trigg 2021, 94).
A different phenomenological analysis deploys the notion of transformative experience by Paul (2014), claiming that the pandemic has been such an experience, collectively transforming us personally and epistemically. The pandemic gave us an experience containing new knowledge (what it is like to live in a pandemic) that we could not have had otherwise and has thus epistemically transformed us. It has, in addition, profoundly shaken our values and beliefs and has thus personally transformed us (Carel and Kidd 2020). Jointly, the epistemic and personal transformation amount to what Paul calls transformative experience (ibid.). Froese et al. (2021) highlight how background assumptions that underpin our social world have been disrupted by the pandemic, giving rise to anxious uncertainty. And finally, Carel (2020) uses the normal/pathological distinction to describe what she calls the ‘pathological’ states caused by the pandemic. These novel states are important to describe, and, crucially, shed light on our previous ‘normal’ experiences. Moreover, the very assumptions about normality that have been made visible now, also mask our vulnerability, dependence on others, finitude and mortality which have exploded into our collective consciousness with the pandemic. Our tacit expectations of smooth and predictable continuity have been shattered by the pandemic and in this, these expectations have become explicit and hence available for scrutiny (ibid.).
These phenomenological studies provide support for our account of the ‘pandemic body’ insofar as they recognise that the pandemic and the countermeasures it can involve have caused heightened awareness of the body as something ‘contaminated’ and therefore dangerous, yet highly resilient and adaptable. However, these studies only provide a partial view of how the symbolic meanings of the body have changed during the pandemic. We aim to fill this gap here by providing a more comprehensive account of how the body is experienced by the self and others in pandemic times through an exploration of first-person testimonies that reflect changes in embodiment. Conceptualising the body in this way can provide valuable insight into how people evaluate risk and respond to a global health crisis like COVID-19. Furthermore, it can help inform future policy decisions about the efficacy of strategies aimed at mitigating the spread of the virus and create greater awareness and understanding of how concepts such as risk, trust and danger interact.
People’s lived experience of the pandemic was investigated using an open-ended SurveyMonkey anonymous survey ‘Experiences of Social Distancing during the COVID-19 Pandemic’ conducted in 2020 (5 June to 31 July 2020) and in 2021 (7 April to 31 July 2021). The first round (2020) was distributed through press releases from involved academic institutions, publications, presentations, Facebook advertising campaigns and the authors’ social networks. In the second round (2021), participants were recruited by email from among the 1036 people who agreed in the previous survey to take part in a follow-up study. The survey consisted of six sections with a total of 42 questions (see online supplementary appendix tables 1 and 2), and participants were free to answer as many questions as they liked (for details see Froese et al. 2021; James et al. 2022). The minimum age required to participate in the survey was 18 years and participants were demographically diverse. The team recruited residents of the UK, Japan and Mexico to gather geographically diverse reports from participants in Asia, Europe and Latin America (Froese et al. 2021). A full description of the corpus was published in August 2021 (Froese et al. 2021) and again in August 2022 (James et al. 2022).
ATLAS.ti software was used to explore the data in a systematic, flexible and creative way. Our focus was on survey participants’ narratives that describe lived experiences of the pandemic as an embodied experience. We were particularly interested in descriptions of emotions in response to specific countermeasures such as national lockdowns, and physical distancing, as well as questions related to awareness of breath, other bodily awareness, coping, grief, trust and hopes for the future (for full questionnaire see figure 2).
Researchers used a reflexive thematic analysis method for its accessible and intuitive approach to the analysis of qualitative data (Braun and Clarke 2012, 2019; Braun, Clarke, and Weate 2016; Clarke and Braun 2018).3 The study adhered to the six-phase analytical process that Braun and Clarke propose: (1) the researcher gets familiar with the data, (2) generates codes, (3) constructs themes, (4) reviews potential themes, (5) defines and names themes and (6) produces a report (Braun and Clarke 2012). To ensure reliability, trustworthiness and transparency of the study, researchers also used the Standards for Reporting Qualitative Research reporting guidelines (O’Brien et al. 2014).
JR and KB ran a lexical search on words (ie, trust, distrust, doubt) to assure that we did not miss answers related to the topic outside the questions we mainly focused on. JR and KB read the survey questionnaire in its entirety to understand the participants’ general experience of the pandemic and categorise answers into code groups according to context.
All researchers (JR, KB and HC) selected a series of responses from each group that related to the overall lived experience of the pandemic and feelings people report having (eg, guilt, anger, disgust and sadness, as well as positive emotions like solidarity, trust and empathy). Based on these responses, researchers generated five key themes: (i) fear and danger, (ii) risk and trust, (iii) bodily doubt and hypervigilance, (iv) adapting and enduring and (v) changes in perspective (see table 1 for full details).4 Importantly, our understanding of what constitutes a theme is informed by a ‘central organising concept’ namely, the body and our lived experience of it during the COVID-19 pandemic (Braun and Clarke 2012; Braun, Clarke, and Rance 2015).
JR, KB and HC regularly met to discuss and review codes, the divergent interpretation of data and develop a shared understanding of the dataset. As the coding scheme became refined, subcodes with shared commonalities were grouped together to form main codes or were assigned to already established codes (see ‘Findings and discussion’ section). The coding process, conceptual framework and results were also discussed with colleagues working on the same project to develop a more nuanced understanding of the dataset and its sociocultural context.
This is an exploratory study, conducted to gain insight into the lived experience of the pandemic and the effect it has on people’s perception of their bodies, other people’s bodies and the world. The following two sections present two theoretical frameworks used in our analysis, after which we present our findings.
Two theoretical frameworks: Douglas and Carel
Mary Douglas on purity and danger
Mary Douglas’ Purity and Danger (1966) examined concepts of ritual purity and impurity, sacred and profane, across societies. For Douglas, people’s perception of dirt comes from a deep human fear of cognitive disorder and chaos. Douglas’ well-known argument defines dirt as ‘matter out of place’ and uses this idea to explain how different cultures distinguish what is considered dangerous or polluting. By rejecting dirt as a concept fixed in the quality of certain objects, substances, animals or human beings, Douglas transforms dirt into a radically contextual phenomenon (van de Geesdt and Zaman 2020). She argues that dirt is identified when people assign or categorise things into places, in terms of a cognitive classification system, that is, religious ritual or mundane activities, and that this process signifies a human tendency for moral ordering (Zaloom 2020). In Douglas’ words, “we are not governed by anxiety to escape disease but are positively re-ordering our environment, making it conform to an idea” (Zaloom 2020, 12).
Categorising dirt needs different practices to deal with it. For example, we might avoid or ignore, we might redefine or invent new classificatory schemas or choose to separate or remove ‘it’ completely. Douglas also claims that in some cases dirt is controlled by tabooing it. She describes this process as ‘a spontaneous device for protecting the distinctive categories of the universe’ (Douglas 2002, xi). Tabooing dirt is one way of looking at how social protective activity occurs as means of safeguarding communities from perceived threats to their stability. These constructions and internalised societal judgements are ‘thought styles’ that perpetuate societies’ order (Douglas 2002).5
Douglas (1992) defines risk as, ‘the probability of an event combined with the magnitude of the losses and gains that it will entail’ (Douglas 1992, 40 cited in McEvoy et al. 2017). This assessment of losses and gains forms the basis of a perceptual social process that recognises certain levels and/or degrees of risk. Risk entails certain norms, narratives and practices created by people and groups put to sociopolitical use around ideas of danger. Risk does not refer to the danger itself, but by exploring the relationship between social cohesion and social stratification Douglas maintains we could find out why some dangers come to be emphasised as risks over others (Douglas 1992). Just like dirt, risk becomes a social and cultural artefact and/or meaning assigned to danger. What constitutes risk depends on communal, social and shared moral judgements that influence subjective perceptions. Interestingly, Douglas suggests that ‘acceptable risk’ can be seen as socially desirable notions of safety and is always a political question, not a probability (Douglas 1992). There is no linear formula for determining what risk is for people. What is accepted as a risk for some and not for others is based on subjective notions of reasonableness (Douglas 1992).
Another important aspect of Douglas’ work is her exploration of how individuals and societies interpret symbols. Douglas states that social values become natural symbols as societies naturalise their worldviews.6 Douglas explores religious ritualistic expressions of the body-society relationship and its impact on religion, and politics and maintains that symbols are grounded in the human body and used as metaphors to convey social experiences and vice versa. To have and to be a body are culturally, socially and intergenerationally transmitted. Ritual symbolism is key to social cohesion, and the body is a natural symbol of society instilled with a symbolic order of purity and dirt, risk and danger (Douglas 2003; Douglas 2002).
To illustrate the symbolic meaning of the body, and the role it plays in society, Douglas provides us with examples of things produced by the body and yet treated differently from it. For example, while rituals surrounding bodily substances such as spittle, faeces, urine, menstrual blood, semen and milk may vary between cultures, they typically become ‘dirt’ when they transgress boundaries between the ‘inside’ and ‘outside’ the body. In her words, “we cannot possibly interpret rituals concerning excreta, breast milk, saliva and the rest unless we are prepared to see in the body a symbol of society” (Douglas 1966 , 116). These symbolic systems help to manage, segregate, treat or contain any organisms that resist or violate them.7
Carel on bodily doubt
The term ‘bodily certainty’ denotes the subtle feeling of “I can” that pervades our actions. This is the feeling of possibility, openness and ability that characterises routine and familiar actions. This kind of taken-for-grantedness—unreflective, disinterested—characterises bodily certainty. Bodily certainty is pervasive and provides the background confidence with which we perform familiar actions. It is simply the immediacy and automatic manner in which we turn to familiar tasks. It is not optional, but a basic mode of action that takes agency for granted (Carel 2013).
Bodily doubt, on the other hand, is the loss or suspension of this certainty. In many somatic and mental disorders, the sense of certainty and confidence we have in our own bodies is deeply disturbed. “What was previously taken for granted, normally for many years—that my legs can carry me, that my brain will continue working as before, that my lungs can support my body’s oxygen requirements—is suddenly and sometimes acutely thrown into question” (Carel 2013, 7). The disruption of bodily certainty in illness reveals the bodily feeling of confidence, familiarity and continuity that is disturbed and a host of assumptions that hang on it. For example, assumptions about the future, one’s projects and one’s values.
Bodily doubt is not just a disruption of belief, but a bodily disturbance. It is a disruption of one’s fundamental sense of being in the world, giving rise to an experience of unreality, estrangement and detachment. From a feeling of comfortably inhabiting a world, bodily doubt throws one into uncertainty and anxiety: attention is withdrawn from the world and focused on the body, and the sense of “I can” is replaced by hesitation, anxiety, confusion and a sense of loss of control (ibid.).
Bodily doubt radically changes our experience in three ways: first, it is an experience of a loss of continuity, which is a break from previous experience. Second, it is a loss of transparency in which the body becomes opaque and occluded with worry and pain. And finally, it is a loss of faith in one’s body: a loss of the comfortable trusting taken-for-grantedness which characterises bodily certainty.
The ‘Findings and discussion’ section will present instances of bodily doubt experienced by the participants of this study along with other significant themes identified as characteristics of an embodied pandemic experience.
Findings and discussion
We now turn to participants’ perceptions of the embodied experience of the pandemic and offer an interpretation of the data that is based on ideas from Douglas and Carel. There are many personal, reflective and intimate moments contained in these accounts, and here we present the ones most salient for our topic: the body. While some participants gave concise but powerful answers, others provided more in-depth answers about their experience of physical distancing and general thoughts about the pandemic.
Theme 1: fear and danger
Many of the participants reported a fear of infection and of spreading the virus to others. The virus is perceived as something ‘out there’ in the world, which threatens to transgress bodily boundaries through infection. Some participants expressed feeling anxious when in physical proximity to other people, whose bodies have become symbolic of the virus and the potential ill-health that could occur as a result of infection. Additionally, participants reported feeling afraid of how their bodies appear to other people. Specifically, they felt that their bodies were scrutinised by others who monitored their behaviour for signs of infection such as coughing or other flu-like symptoms. Some examples below:
I feel that it is necessary to stop further spread of the virus, but it is a very unnatural thing to do. The constant message we hear about ’staying safe' and that we have become accustomed to say to one another, gives the constant impression that we are not safe and that we are not safe around other people. (EN_UK_0432)
I feel paranoid that every time I leave the house someone will report me or when I’m in a supermarket and cough, I worry I will get kicked out for suspected virus symptoms. (EN_UK_0262)
Do look at people differently, a little wary of them but try to smile and joke about us all being frightened of each other (EN_UK_0400)
We have spent over a year training ourselves to keep away from folk and feeling fearful when they come close, how can we ever untrain this? (EN_UK_0458)
Douglas’ culturally defined concepts of purity, danger and dirt provide meaningful insight into the participants’ embodied experience of the COVID-19 pandemic and explains both individual and shared approaches to controlling its spread. For example, Brown (2020) draws from Douglas’ framework to discuss how the pandemic has been handled across societies and emphasises features of probabilistic knowledge (ie, framing COVID-19 mortality rates), time-framing (ie, national policies and pandemic countermeasures) and categorisation and ideas of risk (ie, infection transmission). Brown compares these features of the pandemic with social categories or social ‘thought-styles’ (Douglas 1987) that are sustained and reproduced through rituals based on dominant social, cultural and political norms (Brown 2020, see also Brown and Zinn (2021)). Similar to Brown’s study, our participants also expressed fear of not knowing who was infected and often said they felt unsafe around others, or that others might think of them as infected and therefore unsafe. In this sense, Douglas’s concepts offer insight into how societies negotiate moral values during the pandemic and how bodies become symbols of these values.
Another important account of the body which also draws on Douglas 1966  has been provided by Scheper-Hughes and Lock (1987) whose ‘three bodies’ approach provides a useful heuristic framework for understanding the body as simultaneously an individual body (as it is experienced by us), a social body (as it is experienced by and for others) and a body politic (a body that shapes and is shaped by societies). Scholars also draw attention to the way sickness and health are conceptualised in collectivist compared with individualist (typically Western) societies, with the former often making no distinction between individual health and the perceived state of society:
In cultures and societies lacking a highly individualised or articulated conception of the body-self it should not be surprising that sickness is often explained or attributed to malevolent social relations (ie., sorcery), or the village community. (Scheper-Hughes and Lock 1987, 12–13)
As mentioned above, in these highly collectivist societies and groups the physical body and its perceived deficiencies are understood as faults in the nature and structure of society itself. These attitudes risk pathologising individuals whose bodies and/or behaviour deviate from accepted sociocultural norms about ‘health’. The authors also comment on how in these societies the body plays a Further studies in other dreciprocal role whereby societal issues including ‘disharmony, conflict and disintegration’ are played out by the body in illness and other kinds of physiological distress (Scheper-Hughes and Lock 1987, 7). On this note, Scheper-Hughes and Lock (1987) are keen to emphasise a need to expand Western accounts of the body that tend to privilege an overly materialistic, Cartesian view that separates mind from body as distinct entities.8
Theme 2: bodily doubt and hypervigilance
While some participants report feeling fear and danger, others seem highly aware of their bodies and also doubt whether they are carrying the virus. The participants report feeling hyperaware of physiological symptoms such as their temperature, coughing, breathing or a general sense of becoming more aware of how their bodies feel. Interestingly, whereas bodily doubt may remain something some participants can manage alone, seeking medical advice is necessary for others (Asmundson and Taylor 2020). For example, we selected a quotation from a participant in Japan stating that, after consulting a physician to ensure the symptoms were not associated with COVID-19, it proved to be a lifesaver for another underlying condition (final quotation).
I had a prolonged cough in Feb. I suspect it was a ‘do not think of pink elephants’ cough ie, somewhat psychosomatic—but I might have been very lucky and had (and got over) a very mild version of the virus. (EN_UK_1670)
When you have asthma, it is hard to determine cause of a cough, which is exacerbated by seasonal allergies. But as long as my puffer works, and I have a wet cough I assume it is asthma. (EN_00_1957)
Calmer but sometimes more alert to physical things happening in my body. (EN_00_0031)
We (my husband and I) started checking our body temperature that day, morning and evening. Mine was higher than normal, but not a lot. In fact, at no point did I have a high fever. On that day we started self-isolation. (EN_UK_0791)
When I consulted a doctor thinking that I was infected by corona, I found out I had a liver tumour and underwent surgery. Without corona, I would have noticed this late, so in a sense, corona saved my life. (JP_JP_ 0545)
We suggest that the concept of bodily doubt applies to people with lived experience of the pandemic, especially those with experience of being seriously ill with COVID-19. The reason for this, we believe, is the disruptive and sometimes destructive effect of the pandemic on almost every aspect of our lives, including how we experience our bodies. The threat of the COVID-19 virus and the possibility of illness it entails challenges the tacit belief held by most people that our bodies will continue to be healthy, and support our individual goals and projects. Importantly, the COVID-19 pandemic has caused many people, including generally healthy and young individuals, to lose faith in their bodies as well as an existential sense of possibility. Countermeasures such as ‘track and trace’ protocols aimed at monitoring the spread of COVID-19 may have intensified feelings of bodily doubt experienced by otherwise healthy individuals who became hyperaware of their bodies, and of their susceptibility to the virus, as a result of regular testing for COVID-19.
Other measures aimed at preventing further transmission of the virus such as physical distancing, national lockdowns and enforced quarantine are further sources of bodily doubt because they restrict the range of possibilities for action; in other words, they remove the underlying sense of “I can” that typically underpins our engagement with the world (Carel 2016, 90). Much like the experience of serious illness, the closing down of possibilities experienced as a result of pandemic-related restrictions creates a sense of doubt that is felt on a bodily level because it disrupts our habits and ways of being-in-the-world as embodied beings.
Instances of bodily doubt are clearly manifested in the narratives of the participants who report heightened awareness of hesitancy and distrust and ‘physical sensation of doubt and hesitation arising in one’s body’ (Carel 2016, 96). However, it is possible that not everyone will experience bodily doubt to the same extent, if at all. Only some will experience severe disruption to their bodily habits and body schema to the extent that they doubt their body’s ability to perform everyday activities.
Theme 3: risk and trust
The risk felt when getting close to others is also a matter of trust. The participants report mistrust of other people, particularly strangers. One person reported that while those close to them are regarded as ‘safe’, strangers ‘are all infected’. This idea relates to the fear of danger and doubt about whether other bodies are trustworthy. Participants reported a lack of trust in the government as well. For example, one participant based in the UK said that they trust the government less during the pandemic which has shed light on systematic prejudice and social injustices, involving socioeconomic, gender and racial inequalities.9 Here, we provide some examples that reflect these concerns and highlight the impact of the pandemic on interpersonal trust relationships between individuals and governments.
As for strangers, I have little trust in them. I suspect they don't keep as clean and careful as I am. (But I have no evidence for this). (EN_UK_1201)
I’ve felt like being with people I live with, or close friends was safe but that strangers were all infected. (JP_JP_1011)
I worry that our perception of risk has become so warped that we will be put under restrictions again in Winter, or that the restrictions will never be fully removed. I wonder how I will live if it becomes illegal for me to see others or start relationships every year. (EN_UK_0379)
I trust the government less. The values that underpin their handling of the pandemic are based on the economy rather than a duty of care towards their citizens. The pandemic has revealed many social injustices here in the UK and I am appalled at the level of corruption at governmental level. (EN_UK_0292)
I pay attention to the infection risk to some extent, even when I meet a relative. (JP_JP_2234)
I have realised that I assumed people were decent and maybe that’s not the case. I have seen a lot of people not taking the guidelines or science seriously, and it has ended some friendships because I don't trust their risk assessment abilities anymore. (EN_UK_0185)
The testimonies above communicate the kind of impact the COVID-19 pandemic has had, and continues to have, on trust relationships between the self, other people and public bodies such as governments (Erhardt et al. 2021; Kye and Hwang 2020). The risks associated with the virus removed the conditions for prereflective trust, the tacit assumption that certain things such as our bodies or other people are generally trustworthy (Bernstein 2011). Carel (2016) also argues that the onset of serious illness can have a profoundly damaging effect on the trust we put in our own bodies, insofar as ‘If action depends, in part, on belief, then the suspension or loss of belief must disrupt action’ (Carel 2016, 103).
In some cases, the participants’ concerns about risk, specifically the chance that other ‘contaminated’ bodies may pass on the virus, have redefined their relationship with other people. For example, one participant said, “it has ended some friendships because I don't trust their risk assessment abilities anymore” (EN_UK_0185). Risk, in this case, becomes a set of social discourses and practices that people use to deal with interpersonal relationships, and danger, dirt and taboo, especially when bodies become natural symbols of risk of infection and disease.
Further studies in other disciplines also explore Douglas’ cultural theory (1986, 1992) to understand how risk and inequality interact during the COVID-19 pandemic. For example, Manca (2021) reports the separation of newborns from indigenous mothers in Mexico during the pandemic, suggesting that the baby becomes the ‘object at risk’ whereas the mother’s body is thematised as something dangerous and contaminating. Manca points out that classifying pregnant indigenous women as ‘risky’ to their new babies seems valid only when targeting already socially marginalised groups and argues that these assumptions might be seen, as Douglas maintains, ‘a technique of control against the weak and powerless’ (Douglas, 1994, 99 cited in Manca 2021, 329). Discrepancies like this suggest that during the pandemic some bodies are deemed ‘risker’ than others for reasons beyond the ‘real’ risk of infection and may be treated differently as a result.10
Theme 4: adapting and enduring
The pandemic and the measures used to contain its spread have caused widespread uncertainty, resulting in higher anxiety rates and adverse mental health outcomes (Brooks et al. 2020). Nonetheless, many people were able to adapt in ways that helped them cope better with the pandemic and endure its challenges. The extent to which individuals could cope was dependent on their individual circumstances, and many of the coping strategies reported in the survey exhibited similarities. Here are a few examples.
Sleep is bad. Very easy to eat and drink too much. Much harder to exercise because the best part of exercise is cycling or running with your friends and maybe having a coffee afterwards. This is like a prison sentence. No life goals mean life is very boring and very slow. (EN_UK_1231)
I live alone, which has been a real challenge at times, the first month I went to a very dark place and for two days could only stay in bed in the fetal position. I’m a very social person and the isolation was really hard. (EN_00_ 0233)
I also took hugging for granted, and thought a hug was a hug. It isn't. I may be touch deprived and certainly people deprived. (EN_ 00_1885)
I do exercise and yoga to calm myself, keep occupied in my home and garden, keep in contact with family and friends. (EN_UK_1134)
I give people more time. I also give myself more time and I’ve learnt when to say no to social activity and take some time out. I’ve learnt that sometimes people don't require anything from you, you can just exist with them. (EN_UK_0071)
Exercise, write, study the Bible, be near to God. (ES_MX_0489)
While for many people the experience of lockdown during the COVID-19 pandemic was an extremely challenging, often lonely, experience, not every lockdown experience was negative. For some people, the lockdown experience was an opportunity to reflect and revaluate what really mattered to them, just as for Carel, illness experiences are not monolithically negative. Specifcally, Carel (2016) proposes that it is possible to achieve well-being in illness after a period of adjustment to the challenges posed by serious illness. Similarly, participants of this study report a period of adjustment to their new, somewhat restricted, way of life during the lockdown phases of the pandemic. Many people reported that the pandemic enabled them to develop new relationships with themselves, their bodies and other people. Lockdown encouraged some people to take ‘more time’ for themselves or engage with spiritual practices like praying, yoga, exercise and gardening.
Theme 5: changes in perspective
The survey respondents were clear that the pandemic caused a shift in their perspective. Some participants consider death itself and the fragility of life, while others view other people and themselves in a different light. Others judged other people according to how closely they followed COVID-19 guidance or how well they dealt with the pandemic more generally. A recurring theme suggests that the pandemic, and the countermeasures it involved, enabled people to identify underlying issues not previously considered.
It has shown that the feelings I experienced when I was isolated due to illness have been felt by healthy people when they were isolated during the current crisis. Given the common narrative in my country that disabled people are lazy scroungers, this made me feel better about my past self as I knew that that wasn't true and it was okay that I’d felt that way. I feel like my social skills have atrophied. (EN_UK_0050)
Yes of course, the uncertainty of life itself, how life as we know it can change beyond our control in a heartbeat, this can happen without the pandemic of course but this dark time certainly shed light on how fragile life really is. At 74 it has made me value every new day as a precious gift and be very thankful. (EN_00_0073)
I used to be obsessed with marrying my current partner, but the changes have made me see that I wanted this kind of alliance because I felt unsure about my place in the world. Now that the “world” has been removed from the equation, I see much more clearly how my struggles with “the world” have a life of their own, and that I do not need to enlist others to protect me from this struggle. (EN_00_2191)
For most people, the COVID-19 pandemic has disrupted almost every aspect of life, and much like the experience of serious illness, it has played an important existential role in disclosing ‘finitude, disabilty and alienation from one’s body as extreme modes of being’ (Carel 2016, 210).11 The disruption to everyday routines and habits caused by the pandemic, and human suffering has motivated philosophical reflection about the meaning of one’s life and significance of personal and shared values in society. In illness, Carel (2016) describes this kind of experience as a ‘compulsive invitation to philosophise’ that can arise when people are forced to confront their finite nature, vulnerability and lack of control over the body. Similarly, during the pandemic most of the measures used to control the spread of the virus were imposed on individuals and societies, giving rise to a complete loss of certainty and control, which for many led to philosophical reflection and changes in perspective.
The ways in which we define and refine, protect, alter or care for our bodies are a sociocultural phenomenon vital to understanding the embodied experience of the COVID-19 pandemic. As suggested by our findings, the way people think about and categorise notions of purity, risk and danger, including who and what is considered pure or dirty influence our risk assessment abilities and change how we interact with the environment, and with other people whose bodies may become subject to social stigma and marginalisation. Douglas’ cultural theory helps us to address issues such as these by providing the conceptual tools for first identifying, then targeting attitudes in society that sustain or perpetuate the idea that COVID-19-infected bodies are ‘dirty’, and contaminated.
The phenomenological concepts of bodily doubt and well-being within illness (Carel 2007, 2013) were also used to inform our account of an embodied pandemic experience. The concept of bodily doubt allowed us to show how processes such as ‘track and trace’ along with the more general threat of infection during the pandemic created a heightened awareness of the body that was not previously thought about explicitly, or as a matter of concern. The idea of well-being within illness was used to explain why despite challenging times, some of the survey participants found ways to remain positive and achieve a sense of well-being. This idea was supported by Carel’s argument, that in cases of serious illness people can and do find happiness and well-being after a period of adjustment.
In addition to well-being, many of our participants felt motivated to revaluate their life priorities and found new appreciation of everyday activities and surroundings. Suggesting that much like in cases of serious illness, the pandemic and the physical distancing measures that followed presented opportunities for reflection, leading to changes in perspective that influence how people decide to live in the future. All considered it was our aim to use phenomenological concepts to both reveal discreet aspects of an embodied pandemic experience, as well as help us to understand how people experience their bodies and adjust to new ways of being-in-the-world.
As further restrictions are lifted and societies begin to adjust to ‘the new normal’, understanding how people experience the pandemic is important for grasping how people recraft their lives and move forward, while continuing to honour the experiences of 2020–2021 (de Jong, Ziegler, and Schippers 2020). The concept of a ‘pandemic body’ presented in this paper provides an embodied account of the COVID-19 pandemic in the early stages of the outbreak, during national lockdowns, and before vaccines became widely available. Studying this phase of the pandemic provides a level of insight into people’s lived experiences which could assist policymakers with developing a nuanced, phenomenologically inspired response to further unfolding events and to other kinds of crises. Further research could investigate the long-term effects of these features, as well as consider how the easing of restrictions and large-scale vaccination programmes have impacted people’s lived experience of their bodies, other people and their environment and what are the long-lasting effects and legacies of the pandemic.
Data availability statement
Data are available in a public, open access repository. The datasets presented in this study can be found in a Figshare online repository (doi: 10.6084/m9.figshare.20443182) at the following link: https://figshare.com/articles/dataset/The_Pandemic_Experience_DATE_RANGE_/20443182.
Patient consent for publication
The Human Subjects Research Review Committee (HSRRC) of the Okinawa Institute of Science and Technology Graduate University (OIST) approved this study protocol (HSR-2020-020-4). The topic and purpose of this research study was explained to all participants in the introductory section of the survey, and consent to participate was obtained before the start of the survey. All personal information was removed from the corpus.
1. We use the accepted term, ‘social distancing’, to indicate our theoretical orientation, namely, that the embodied nature of our social life means that physically distancing people from one another results in social distancing. We think that the term ‘physical distancing’ is perhaps more specific and hence accurate, but it loses the social connotation, which is key to our findings here.
2. Some bodies are already experienced as ‘property’ either of a state or of some other higher power, for example, people from ethnic minorities, women’s bodies, refugees, children and incarcerated bodies. Ali (2021) defines the viral body as a deceased body, infected with COVID-19 or other infectious diseases at the time of death.
3. We recognise that there are many different approaches to thematic analysis, the reflexive approach we have used for this study is primarily characterised by a recursive process emphasising researcher subjectivity as a resource for knowledge generation, an interpretative lens by which we can try to understand the experiences of others.
4. Our themes are informed by the theoretical frameworks used to guide interpretation of the data, our own lived experience of the COVID-19 pandemic and other salient experiences (eg, illness experiences).
5. Douglas insists that separating and/or categorising dirt or purity is far from negative. She suggests that ordering can be seen as a ‘creative movement, an attempt to relate form to function, to make unity of experience’ (Douglas 1996, 3) and helps us to understand how social systems function, organise and maintain order and social structure.
6. Douglas argues that society members gain loyalty by defining boundaries and internalising internal group controls, which she calls social pressures and defines as ‘grid and group’: high grid, low grid, high grid high group, low grid low group. ‘Integration’ (grouping) refers to how clearly defined a subject’s position is within or outside a group. Grids (regulation) reflect a subject’s position within networks of social privileges, claims or obligations (Douglas 1970). The ‘Grid-group’ framework is intended to provide a systematic account of different forms of social relations, such as indigenous societies or industrialised societies, and help analyse social relations based on cultures, communities, places or individuals.
7. Douglas uses the Indian caste system as an example of a symbolic system based on the image of the body whose primary concern is the order of social hierarchy. In this context, bodies that deviate from the social norm become ‘matter out of place’ insofar as they fail to fit in with the dominant conceptual system. For Douglas, the body as a symbol of society becomes one way to understand societal strengths and dangers, ‘what is carved into human flesh is an image of society’ (Douglas 1996, 27).
8. Scheper-Hughes and Lock (1987) claim that a dualistic view of the body still dominates much thinking about the body in the West, especially in the biomedical and clinical domains.
9. Aliyu et al. (2021), Savulescu and Cameron (2020), Bowleg (2020), Mortazavi and Ghardashi (2021), Prati and Mancini (2021) are just some examples of studies which highlight social inequalities and injustice during the COVID-19 pandemic.
10. The stigmatisation of ‘infected bodies’ has also been discussed by Alaszewski (2021a) who draws on Douglas (1991) ideas about risk and sin to discuss how leprosy features throughout history (Alaszewski 2021a).
11. The study by Zhou et al. (2020) found that ‘those who experienced more disruptions in daily life during lockdown would display more indicators of psychological ill-being by the end of the lockdown’.
Correction notice This article has been corrected since it was published Online First. Funding statement was amended.
Contributors JR and KB contributed equally to this paper and are the guarantors. JR, KB and HC worked collaboratively to analyse, generate themes and provide an interpretation of the data.
Funding JR’s postdoctoral research is funded by JSPS Standard Fellowship. KB’s research is funded by the Arts and Humanities Research Council via the South, West, and Wales Doctoral Training Partnership. The initial stage of this work was supported by JSPS Topic Setting Program to Advance Cutting Edge Humanities and Social Sciences Research.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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