Editor’s introduction: Qualitative research in the course of a pandemic

Abstract

[page 1] In the course of unexpected and overwhelming events such as the ongoing COVID-19 pandemic qualitative research based on narrative inquiry may provide unique and vital insights. It identifies individual survival parcourses with universal valence. These parcourses are all but lost in traditional medical, psychological, and social research that overlooks individual experiences, classifying them as background noises. From these very noises qualitative research extracts the sound of coping mechanisms that allow a person to come to term with his or her own personal tragedy even if death appears all but unavoidable. An example of such itineraries is provided in the memoir of Primo Levi.1 Levi faced death every minute of the two years he spent as a prisoner in Auschwitz. He succeeded in dissipating his own fears and in encouraging his prison mates by rehearsing and quoting Dante’s poem1 La Divina Commedia (The Divine Comedy) where Ulysses reminds his shipmates that no one can rob them of their dignity. This anecdote that inspired victims of wars, persecutions, and natural disasters around the world would have been lost in the official accounts of the Holocaust. The articles that follow emphasize that it is always possible to find a pathway to heal one’s illness even when scarcity of resources withstand medical management. The other fundamental role of qualitative research consists in a more complete analysis of the response to the crisis. The scope of the analysis includes individual impressions and experiences that highlight unsuspected strengths of the system as well as unknown weaknesses. Some of the articles that follow highlighted the sense of solidarity and mutual responsibility among health care workers. Under managers who lead by example this solidarity may become the main resource at a time when confusion prevails and individual roles are muddied. At the mean time an emergency of long duration presents new challenges that involve the burnout of the caregivers, the rationing of limited resources, the economical and emotional impact on the general population. While it may not provide a response to each dilemma, qualitative research puts a human face on each challenge and comforts the practitioner. Some quandaries, such as the rationing of care, may be insoluble. In this circumstance any decision guided by compassion is the best decision. This issue of Qualitative Research in Medicine and Healthcare is dedicated to COVID-19. We collected the testimony of health professionals who have been both patients and caregivers. Based on their embodied experiences, the authors illustrate the healing trajectories available to victims and caregivers of the victims, not only during a pandemic but throughout catastrophes of any type. The pandemic has caught us unprepared at a medical, social, and emotional level. The Western culture held outbreaks of this size all but impossible in the so-called developed world. Widespread hygienic norms should be able to prevent contagion by infectious agents, and a science able to dissect the human genome may certainly find a remedy against new organisms. These expectations might be legitimate, but they need to be placed in a realistic context defined by human reactions and practical conditions. Let’s start with precautional measures. Social isolation proved out of reach for overcrowded residences,2 for retirement homes,3 and for most work related activities that could not be conducted from a distance. Face masks and vaccines are only as good as the willingness to adopt them4 and as long as the demand does not overwhelm availability. The development of vaccines and therapies requires time, and during this time the availability of hospital beds, life-supporting devices, and health care providers5 may become overtaxed. And it is currently overtaxed in some areas of the country such as Southern California. The economic duress caused by the pandemic may delay the treatment of coronavirus as well as of other diseases and may even cause food uncertainty.6 The emotional cost of COVID-197 has not been fully evaluated yet, Editor’s introduction: Qualitative research in the course of a pandemic