COVID‐19, public health, and the politics of prevention

Abstract

In the past few months, questions about the global coronavirus pandemic – its cause, distribution, health and social impacts, and how best to limit its reach through public health measures – have re‐centred emerging infectious diseases in public and scholarly discourse.1 1 At the time of writing, recent news reports have begun to focus on global protests against racist police and state violence that have been prompted by the murder of George Floyd by White police officers in the United States. Historical scholarship on colonial medicine (Arnold 1994, Anderson 1995, Porter and Porter 1988, Bhattacharya 2012) and social science research on infectious disease in our present (Farmer 2001, Quinn and Kumar 2014, Weait 2007) demonstrate that preventing the spread of infectious disease too often involves curtailing the liberties of those living in conditions of social and economic marginalisation in order to protect the health of those who are most privileged. Taylor argued that the popularity of individual, lifestyle forms of health prevention in the US was not inevitable but arose as a result of political struggle among and within government, the medical profession, public health, corporations, trade unions and social movements, each of which supported particular versions of lifestyle prevention for strategic reasons. The idea is to prevent the spread of local infectious disease outbreaks by bypassing sluggish sovereign channels of official disease reporting and leveraging online sources of news and other informal information about outbreaks accessed through the data mining strategies of early‐warning actor‐networks (Mykhalovskiy and Weir 2006).

Introduction

If the global HIV pandemic and more localised outbreaks of SARS, Ebola and the Zika virus, among others, did not convince us that infectious diseases have been far from conquered, then COVID‐19 must certainly have done so. In the past few months, questions about the global coronavirus pandemic – its cause, distribution, health and social impacts, and how best to limit its reach through public health measures – have re‐centred emerging infectious diseases in public and scholarly discourse.1 1 At the time of writing, recent news reports have begun to focus on global protests against racist police and state violence that have been prompted by the murder of George Floyd by White police officers in the United States. Such coverage has helped surface important messages about how inequality and systemic racism threaten the lives of Black People, Indigenous Peoples and People of Colour. And yet, COVID‐19 continues to act as a key framing device in such news stories in, for example, claims about how the protests represent a public health risk.

Like past epidemics, COVID‐19 has been characterised by widespread fear and anxiety, social disruption and dramatic inequalities of suffering and death. The incredible speed with which COVID‐19 has become a worldwide phenomenon, the dramatic force of public health responses, and the endless cacophony of information about the virus and pandemic strain collective efforts to make sense of what is going on.

In thinking and writing about COVID‐19 we have found the notion of the ‘politics of prevention’ a helpful orienting concept. Much sociological writing on public health and on epidemics is coordinated conceptually by trajectories of thought about risk and risk governance (Bunton et al. 2003, Petersen and Bunton 1997, Petersen and Lupton 1996, Polzer and Power 2016).2 2 See also the journal Health, Risk and Society. This makes good sense, given the centrality of technologies and discourses of risk within public health. And yet, the established possibilities for critique afforded by risk thinking, including the now characteristic, if belaboured, focus on neoliberal forms of healthy citizenship and governance of the self, seem too limited to fully address the political, social and economic consequences of the public health response to COVID‐19.

In this commentary, we suggest how the politics of prevention can act as a heuristic device for framing reflections on key dimensions of the public health response to the COVID‐19 pandemic. We begin by sketching out what might be meant by the politics of prevention, emphasising two linked, underlying assumptions: the possibility of scientific prediction and the capacity for controlled government intervention in social life (Freeman 1992). Drawing on the situation in Ontario, Canada, we then offer remarks on tensions and struggles arising in efforts to scientifically know COVID‐19 and to intervene through a range of different public health measures. We stress, in our concluding remarks, that officials have accorded insufficient attention to a variety of unintended consequences that accompany these measures that sociologists of health and illness are well positioned to help illuminate.

The politics of prevention

By using the politics of prevention as an organising concept we do not mean to jettison risk from analysis of the many implications posed by COVID‐19. After all, prevention is about efforts to act on the present in an attempt to reduce the likelihood of future harms. What we do hope to do through use of the term is foreground how COVID‐19 is a crisis of public health, centre prevention within discussions about pandemic response, and bring forward some of the antinomies with which prevention is associated.

Prevention has long been a fundamental principle of public health reasoning and practice. It enacts a temporal logic sequenced in terms of past, present and future. Within this logic, actors learn from the past and intervene in the present with hopes of preventing harms from manifesting in the future. Today, prevention has the dual character of being widely accepted – who, after all, objects to reducing future harms – while, at the same time, having a low public profile. Public health prevention initiatives typically work in the background; they often have the curious quality of seeking to preserve the nonevent and they demonstrate effectiveness when nothing happens. When prevention works well, it is given little attention.

While the idea of prevention may be ‘soothing’ (Freeman 1992:47), prevention also has a less sanguine side. Historical scholarship on colonial medicine (Arnold 1994, Anderson 1995, Porter and Porter 1988, Bhattacharya 2012) and social science research on infectious disease in our present (Farmer 2001, Quinn and Kumar 2014, Weait 2007) demonstrate that preventing the spread of infectious disease too often involves curtailing the liberties of those living in conditions of social and economic marginalisation in order to protect the health of those who are most privileged.

Perhaps because of its common‐sense nature and proximity to practical domains of action, prevention has not generated sustained scholarly reflection of the sort sociologists of health and illness have given to concepts such as structure or risk. One of the few scholars to engage critically and theoretically with the idea of prevention is Richard Freeman (1992, 1999). Freeman understands prevention as central to multiple domains of policy‐making and intervention including, for example, crime, child welfare and public health. He emphasises that prevention is a quintessential modernist project, a social engineering effort that builds on common sense ideas embedded in culture and institutions about managing threats. As noted above, Freeman suggests that the concept of prevention is an ‘amalgam of two others: prediction and intervention’ (1992:35). It rests on underlying assumptions about our ability to: (i) use scientific knowledge to predict the future; and (ii) intervene to forestall future harms through organised government action (Freeman 1992, Gough 2013).

The phrase politics of prevention is used widely in the social science literature to signal a critical disposition towards cross‐cutting ideological, political, economic, scientific, technological and cultural developments that support or discourage a range of preventive initiatives related to disease and injury (Mamo and Epstein 2014, Padamsee 2017, Roumeliotis 2015, Stewart 2016). One of the earliest uses of the phrase can be found in the work of sociologist Rosemary Taylor (1982). Taylor argued that the popularity of individual, lifestyle forms of health prevention in the US was not inevitable but arose as a result of political struggle among and within government, the medical profession, public health, corporations, trade unions and social movements, each of which supported particular versions of lifestyle prevention for strategic reasons. A second important use of the term is found in an article that prefigures later scholarship on health, identity and biological citizenship. Also writing from the US context, Deborah Stone (1986) argued that in the 1980s, the politics of prevention had shifted from health reformers pursuing prevention to alleviate health inequities to groups of individuals (e.g. immunisation critics) who organised around victim identities to seek exemption from the reach of prevention interventions.

This commentary focuses on dimensions of the politics of prevention that relate to what might be called the unintended consequences (Broom 2008) of public health efforts to prevent the onward transmission of SARS‐CoV‐2, the virus that can cause COVID‐19. We recognise that a range of public health measures including physical distancing, isolation, quarantine, handwashing, wearing masks, the temporary closure of public spaces, testing and contact tracing may be necessary to control the COVID‐19 pandemic. And yet, we are concerned that these measures and the manner in which they are enforced may aggravate structural inequalities based on intersections of race, gender, class and other dimensions of social differentiation. We thus explore the politics of prevention as a matter of tensions internal to the project of limiting the reach of infectious disease. Doing so reanimates longstanding social justice traditions associated with public health, while focusing attention on structural inequalities that, at times, are not fully addressed by other modalities of critique.

Knowing

In earlier work, we emphasised how efforts to prevent the spread of infectious disease outbreaks beyond national borders mobilised concepts, methods, practices and apparatuses designed to detect and know health events as (or even before) they unfold (French and Mykhalovskiy 2013). Organised internationally as an early warning outbreak detection and alert system and often characterised as a post‐Westphalian intervention in sovereign control over infectious disease reporting (Weir and Mykhalovskiy 2010), these efforts aim to know about outbreaks of potential international concern as quickly as possible through ‘real‐time’ forms of surveillance. The idea is to prevent the spread of local infectious disease outbreaks by bypassing sluggish sovereign channels of official disease reporting and leveraging online sources of news and other informal information about outbreaks accessed through the data mining strategies of early‐warning actor‐networks (Mykhalovskiy and Weir 2006).

Now seven months into a global pandemic, it is clear that early‐warning outbreak detection did not successfully contain COVID‐19 and that proclamations of a post‐Westphalian system of global public health governance underestimated the durability of state control over epidemiological knowledge of infectious disease. State‐based reporting of formal epidemiological case data and mathematical modelling that aims to predict COVID‐19 trajectories on the basis of alternative public health response scenarios are at the forefront of pandemic response. Preventing the further expansion of COVID‐19 is now less about circumventing formal epidemiological knowledge with informal sources of information than it is about the widespread use of epidemiological case data and its popularisation through media and other channels.

The salience of epidemiological knowledge for prevention is central to Freeman’s analysis of prevention. Freeman (1992: 36) takes aim at the population‐based, statistical nature of epidemiology that, he argues, ‘makes for controversy over the legitimacy of preventive interventions in respect of actual individuals’. Our concerns about knowledge and the politics of prevention centre less on the formal character of epidemiology or its application to individual circumstances and more on the configuration of actual systems of epidemiological disease surveillance. We are particularly concerned with how decisions about what is measured and how – what Martin and Lynch (2009) call the politics of counting – can contribute to prevention efforts that may aggravate structural inequalities.

Given protests against anti‐Black racism that have occurred across the world in recent weeks, an important site for considering COVID‐19 and the politics of counting is the measurement of race and class. Sociologists of health and illness have made important contributions to a long history of research that identifies and critiques the sources of race and class health inequities (Cockerham et al. 2017, Feagin and Bennefield 2014, Phelan et al. 2010). Historical work on epidemics has also shown that the harmful effects of pandemics are disproportionately felt by racialised immigrants and people living in circumstances of economic and social marginality (Hays 2009, Rosenberg 1989, 1992, Snowden 2019). These insights have not always translated into an architecture for epidemiological surveillance and pandemic modelling that fully takes into account race, class and other social determinants of health, with potential serious limiting consequences for preventive interventions.

A particularly stark example is the longstanding failure to systematically collect race‐based health care data in Canada. At the height of the pandemic, multiple jurisdictions released epidemiological data that clearly demonstrated the disproportionate number of COVID‐19 cases and deaths taking place among racialised populations (Perkel 2020). Not so in Ontario, Canada’s largest province. It was only with the provincial government’s reluctant release of neighbourhood data showing high rates of COVID‐19 in areas with large racialised populations, that Black and other community health advocates could support, with epidemiological evidence, what, from experience, they knew to be the pandemic’s impact on their communities.

In Ontario, community‐led struggles for the systematic collection and communication of race‐based data were a central dimension of the politics of prevention. The absence of race‐based epidemiological data delayed widespread recognition of the scale of race‐based disproportions in the impact of COVID‐19 upon which prevention efforts addressing structural inequalities in health might have been based. In the context of growing calls for racial justice, struggles to establish race‐based epidemiological data collection should not be understood simply as technical tinkering in epidemiological measurement. Rather, they are interventions in White privilege (Massaquoi 2019). They seek to create knowledge of COVID‐19 that represents how race and other structural forms of inequality shape contours of the pandemic. They are part of efforts to redirect prevention away from its characteristic individualist focus to forms of prevention that address conditions of precarious employment, underhousing, public transit safety and other dimensions of structural inequalities that heighten vulnerability to COVID‐19 for Black and other racialised people.

Related concerns have been raised about the measurement assumptions built into mathematical modelling efforts to predict the spread of SARS‐CoV‐2. Mathematical modelling has captured the attention of policymakers around the world and, through widespread media coverage, has emerged as an important basis for public knowledge about COVID‐19 (Rhodes et al. 2020). In Ontario, Rangel et al. (2020) offer an important critique of the mathematical model released by the provincial government on 3 April 2020. They call attention to how the model propels decisions about the use of containment measures on the basis of preventing a narrow range of indicators – COVID‐19 cases, COVID‐19‐related deaths and hospital intensive care utilisation. Drawing on a social determinants of health perspective, they call for an expansion of what gets measured to include, for example, the health and social and economic costs of job loss, accumulated family debt, intimate partner violence and social isolation that are associated with protracted containment measures. Such changes, they argue, are necessary in order to make known the unintended consequences of public health measures on health inequities among Indigenous, racially marginalised and economically disadvantaged people. Their critique illustrates very well Freeman’s observation that, when it comes to the politics of prevention, what is often at issue ‘is not so much the problem itself, but its passage from one social domain to another’ (Freeman 1999: 239). In ‘disappearing’ certain facets of a problem or some kinds of problems from view, powerful actors like states may be working to absolve themselves of their responsibilities and accountabilities (Razack 2015). Case counts, absent the kind of data called for by Rangel and colleagues, do just this; they yield a form of knowing that militates against integrating long‐standing, historical, structural inequalities into prevention thinking.3 3 In response to pressure from community advocates, Ontario has initiated a set of regulatory changes that will enable the collection of information on race, ‘along with data on income, household size and languages spoken’ to be collected for all newly reported COVID‐19 cases (Allen 2020). However, this decision is raising concern amongst advocates, who worry that ‘the racialised communities most affected’ might not ‘have oversight and input on whether the data is being used to answer questions that create policies that counter the pandemic’s unequal toll’ (Camille Orridge, cited in Allen 2020).

Intervening

In addition to the prevention politics of knowing, we should think critically about the prevention politics of intervening. Our earlier work (French and Mykhalovskiy 2013, French et al. 2018) considered these prevention politics by arguing for the need to carefully attend to the material configuration of actor‐networks designed to intervene contra pandemics. Ontario illustrates the continued importance of this analytic focus for several reasons.

First, as the locus of the Canadian SARS epidemic in 2003, its public health system was the subject of considerable critical scrutiny in the early 2000s (e.g. Ontario, EPS and 2003 and 2004). In the months and years following the SARS epidemic, it was widely recognised that Ontario’s public health system, at that time, was ‘not acceptable’, and in dire need of ‘revitalisation’ (Ontario and CRC 2005: 1–2; see also Ontario and CRC 2006, Ontario and The SARS Commission 2006). Although the province took some actions to begin to invigorate Ontario’s public health system in the years following SARS, the post‐SARS bump in attention quickly waned. During the 2010s, Federal and provincial governments, seeking to implement ‘austerity measures’, were once again cutting public health budgets (Potvin 2014: e401). As Guyon et al. (2017: e3‐e4) note, for instance, the implementation of a 2015 funding model in Ontario ‘resulted in flat‐line funding, significantly reducing capacity in the majority of the province’s 36 boards of health’. In the months leading up to the COVID‐19 pandemic, the Ontario government froze the budget of Public Health Ontario – the province’s public health agency, which was created in response to Ontario’s failures during SARS – and announced plans to slash public health funding by $1 billion over a decade (Warnica 2020). These funding politics illustrate a key public health prevention paradox: in the absence of a justificatory crisis like a pandemic, cost‐cutting governments can easily target investments that enable communities to be resilient in the face of such crises.

Second, since funding cuts have undermined the capacity of local and provincial public health organisations to respond to crises, and given a general failure to adequately invest in social welfare programmes that address poverty and ensure housing and food security (e.g. Gazso et al. 2019, Power et al. 2019, Smith‐Carrier et al. 2020), health officials have been left with few policy levers. From this perspective, it has not been surprising to see public health officials respond in reactive and even coercive ways. Ontario’s first response to COVID‐19, shortly after the Premier told people not to worry about cancelling mid‐winter travel plans, was to prevent the province’s youth from returning to public schools following the annual winter ‘March break’ (Stone et al. 2020). On 17 March, it then declared a state of emergency and ordered the closure of some businesses, including daycare centres, bars, restaurants, theatres and private schools. This was followed by the closure of all ‘non‐essential business’ on 23 March, and by the closure of all provincial parks and outdoor amenities by 31 March 2020 (Ontario and Public Health Ontario 2020a: 2). These measures, which caused a wide swath of the population to ‘stay home’ (Ontario Premier Doug Ford, cited in Benzie 2020), made a certain amount of sense, at least for those living in the type of wealth and privilege that affords a spacious domestic arrangement with access to private, outdoor space. However, they did not help those living on the street, in precarious housing, in overcrowded urban environments or in long‐term care facilities. They were not done with sufficient, careful forethought about how they might unequally affect people.

Indeed, an unintended consequence of these initial reactive measures coupled with delays in the provision of personal protective equipment at work sites deemed ‘essential’ by government may have been to contribute to the increase in transmission of SARS‐CoV‐2 in poorer, urban neighbourhoods. Consider, for instance, that people living in poorer areas with low‐paying ‘essential’ jobs (e.g. working in long‐term care facilities or grocery stores) were at higher risk of coming into contact with SARS‐CoV‐2. Because of poor housing conditions in these neighbourhoods characterised by small, overcrowded dwellings with many family members sharing a single bathroom, the prospects for successful ‘self‐isolation’ if a person became ill were low. It is now starting to be acknowledged by authorities that the most vulnerable members of our society are at elevated risk of harm during this pandemic (Ontario, Ministry of Children, Community and Social Services 2020). As we noted in the previous section, the data, while insufficient for fully comprehending the role of inequality in this pandemic, nevertheless show its disproportionate impact: the rate of COVID‐19 in Ontario ‘is three times higher in areas where there are more racialised people; the hospitalisation rate and ICU rate are four times higher; and death rates are doubled’ for racialised people (McKenzie 2020; see also Ontario, Public Health Ontario 2020b).

At the time of writing, in Ontario, there have been over 6000 confirmed cases of COVID‐19 disease amongst residents of long‐term care facilities, and over 2700 confirmed cases of COVID‐19 disease amongst workers in these facilities. Over 1800 residents, and eight health care workers have died (Ontario, Public Health Ontario 2020c: 12). The situation became so dire – with so many residents and workers becoming ill – that the province called in the Canadian Armed Forces. What the Armed Forces discovered, when they arrived, was shocking: residents in soiled sheets, very poor ‘peri‐catheterisation’ leading to ‘nearly a dozen incidents of bleeding fungal infections’ at one facility; expired medication; residents without a COVID‐19 diagnosis placed in rooms with residents with a COVID‐19 diagnosis; residents found in states of dehydration; new staff that had not been properly trained; and a lack of personal protective equipment for staff (Canada and 4th Canadian Division 2020: A1). The list of atrocities is too long to report here; suffice it to say that long‐term care facilities, which should have been the focus of public health officials’ first interventions, emerged as an afterthought in the prevention politics of COVID‐19.

Meanwhile, just as the province knew about and failed to address structural problems in long‐term care, so too has it known about and failed to address the structural conditions of migrant labour. Sadly, but predictably, Ontario is now dealing with a surge of COVID‐19 cases, with ‘more than 1000 agri‐food workers’ having been diagnosed, and with three ‘temporary foreign workers’ who have died (Urback 2020). As Urback argues, there are several ‘echoes of Ontario’s long‐term care mistakes’, including crowded bunkhouses lacking ‘space and amenities to separate healthy workers from those who become ill’, ‘communal kitchens and bathrooms, some of which are squalid and decrepit’, the management practice of moving workers from farm to farm, and ‘guidance from the province’s Chief Medical Officer of Health that explicitly allows workers who test positive for COVID‐19 to keep working as long as they don’t exhibit symptoms’ (Urback 2020).

All of this amounts to striking evidence of a failure to intervene in ways that address structural and systemic forms of inequality and injustice. Beyond disparities in rates of COVID‐19, a range of other consequences flowed from these measures including mental health effects associated with the prolonged situation of lockdown, the intensification of domestic and gender‐based violence, and a dramatic increase in opioid‐related deaths due to an increase in the use of drugs alone without needed support in circumstances of overdose (e.g. Miller 2020, Pelley 2020, Stroh 2020).

Third, the extended duration of COVID‐19 has amplified an important dimension of the politics of prevention – the challenge of balancing public health restrictions and their enforcement with respect for civil liberties and individual freedoms. As public health and government officials have proceeded with their response to the pandemic, Ontario has seen a ratcheting up of activities designed to ‘police the pandemic’ that raises questions about the proportionality and necessity of the suspension of civil liberties (Luscombe and McClelland 2020). The declaration of a state of emergency helped to transform public health guidance into legal orders ‘with penalties for non‐compliance’ and expanded the powers of police and by‐law officers (Canadian Civil Liberties Association 2020: 4). While the province has not, as a matter of policy, actively turned to the criminal law to enforce compliance with public health orders, at least 18 individuals have faced ad hoc COVID‐19‐related criminal charges, most often in the context of spitting or coughing during police encounters (McClelland et al. 2020). More commonly, authorities have turned to fines, administered by police and by‐law officers, both lacking in public health training, to enforce alleged violations of self‐isolation and physical distancing measures, often without ‘evidence of actual harm to the public’ (Canadian Civil Liberties Association 2020: 4). From 1 April to 15 June some 2853 COVID‐19‐related fines had been issued in the province (Deshman et al. 2020). In Toronto, tickets for not respecting the closure of public amenities can be up to $1000, and bylaw officers can send people to court for fines of up to $5000 upon conviction (City of Toronto 2020). While precise sociodemographic data on who has been subject to fines is lacking, fines of this sort threaten to heighten income inequalities as they will likely be felt disproportionately by poor and underhoused people for whom stay‐at‐home and physical distancing orders are difficult to maintain.

Conclusion

~Prevention walks a tightrope between action and inaction, between promising and pretending (Freeman 1992: 46).

Historian Charles Rosenberg has famously drawn on dramaturgical metaphors to think about epidemic trajectories. Each pandemic repeats patterns from previous epidemics, while exerting its unique character through a plot line of increasing ‘revelatory tension’, crises ‘of individual and collective character’, and eventual slow closure (Rosenberg 1989:2). Some seven months into the global COVID‐19 pandemic it is not entirely clear what dramaturgical twists and turns lie ahead. Some political authorities and pundits, anxious to manage public reaction to the pandemic, have dangled the promise of a quick biomedical solution. Once the much hoped for and almost‐at‐hand vaccine or silver bullet medical treatment arrives, all will return to normal. One has only to be reminded of the ongoing HIV pandemic to be disabused of such fantasies of biomedical salvation. As we watch the horrible spectre of dramatic increases in COVID‐19 across the world, following efforts to ease lockdown, we imagine that the virus will be with us for some time, and that when (or if) a biomedical intervention emerges, questions of access to treatment, which reflect extant inequalities, will continue to hamper the pandemic response. Indeed, to invest all of our hopes in a biomedical intervention is to remain precariously perched on a prevention tightrope, stuck between promising and pretending. To get out of this dizzying situation, governments can articulate a new politics of prevention, one more active than reactive, which produces knowledge about systemic racism and other structural forms of inequality, and which truly intervenes on the social determinants of health. We do not need to wait for the discovery of a magic molecule; we can take action today to alleviate poverty and improve living conditions and wellbeing.

The durability of COVID‐19 poses a number of challenges for the sociology of health and illness. It will take some effort to preserve a space within the subdiscipline for research that does not address the pandemic. Scholarly work unfettered by COVID‐19 may seem a luxury in the midst of the upheaval the pandemic has wrought, but it is crucial to the ongoing development of the field. At the same time, there will be pressures for sociologists of health and illness to add our voices to scholarly and public discourse about COVID‐19. We view this commentary as a contribution to emerging sociological work on the pandemic that seeks to centre prevention within scholarly analysis and critique of the public health response to COVID‐19. We do not aim to critique prevention willy nilly. We recognise the importance of strong public health measures to restrict the transmission of SARS‐CoV‐2. Our remarks are more in the spirit of a critical social science with public health that critiques with a view to improving public health practices (Mykhalovskiy et al. 2019). In keeping with longstanding social justice traditions within public health, we have focused on how public health efforts to know and intervene in the pandemic can aggravate structural and systemic forms of inequality. We orient to the politics of prevention as a heuristic device, hopeful for further work that theorises and explores the forms of reasoning and practices associated with efforts to prevent the spread of infectious disease and the social, political and economic consequences of those efforts.

Acknowledgements

We thank the anonymous reviewers for their helpful comments and suggestions. Martin French would like to acknowledge the support of the Fonds de recherche du Québec – Société et culture (Grant #2017‐BJ‐202106).

Author Contribution

Eric Mykhalovskiy: Conceptualization (lead); Formal analysis (lead); Writing‐original draft (lead); Writing‐review & editing (lead). Martin French: Conceptualization (supporting); Formal analysis (supporting); Writing‐original draft (supporting); Writing‐review & editing (supporting).

Notes

1 At the time of writing, recent news reports have begun to focus on global protests against racist police and state violence that have been prompted by the murder of George Floyd by White police officers in the United States. Such coverage has helped surface important messages about how inequality and systemic racism threaten the lives of Black People, Indigenous Peoples and People of Colour. And yet, COVID‐19 continues to act as a key framing device in such news stories in, for example, claims about how the protests represent a public health risk.

2 See also the journal Health, Risk and Society.

3 In response to pressure from community advocates, Ontario has initiated a set of regulatory changes that will enable the collection of information on race, ‘along with data on income, household size and languages spoken’ to be collected for all newly reported COVID‐19 cases (Allen 2020). However, this decision is raising concern amongst advocates, who worry that ‘the racialised communities most affected’ might not ‘have oversight and input on whether the data is being used to answer questions that create policies that counter the pandemic’s unequal toll’ (Camille Orridge, cited in Allen 2020).

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