A wink and a recommendation: thick description in the covid-19 pandemic

By Rachel Irwin

In The Interpretation of Cultures (1973), Clifford Geertz discusses Gilbert Ryle’s notion of thick description with winks and twitches.  Both appear as a contraction of the eyelid, but a twitch is involuntary, while a wink is a form of communication. There are countless messages conveyed by the wink, and there are countless ways in which a person can wink back. Analysis based on thick description, untangles the “hierarchy” of meaning in which different types of winks are “produced, perceived and interpreted.” In the Covid-19 pandemic, the same approach applies to the term “recommendation,” which I demonstrate with the Swedish example.

In Sweden, most social distancing measures are voluntary and based on individual responsibility. The general advice from the Public Health Agency (Folkhälsomyndigheten) includes staying home if you are sick, washing your hands, and avoiding others. Most enforceable policy measures have to do with shops, bars and restaurants.  For example, only table service is allowed to prevent people from mingling at the bar while waiting to place an order, and shops need to rearrange their floor space to prevent crowding. In practice, the implementation of the latter is largely dependent on the layout of the shop and, to some extent, up to the discretion of the shop manager.

But voluntary recommendations directed at individuals are not actually voluntary. The Public Health Agency’s recommendations should be followed, even if there are no fines or penalties. In several speeches, the Prime Minister Stefan Löfven has stressed the duty and responsibility to follow recommendations as a form of solidarity. At a press conference on the 27th of March, he stated:

Every citizen must also continue to do one’s duty: follow the authorities’ advice, stay up to date [with the situation], and if you have the ability to help a person who might belong to a risk group – to do shopping or another errand – do it.

All of us as individuals must take responsibility. We will never be able to legislate everything, we will never be able to prohibit all harmful behavior, but now it is also actually a matter of moral common sense and decency (folkvett).  There is an individual responsibility and every individual must take responsibility for oneself, for one’s fellow human beings and for one’s country. If everyone does this then our society will manage through this crisis. We will do this together.

The question of how to define a recommendation has also featured in English-language reporting on Sweden. At a press conference on the 27th of March, a reporter from Radio Sweden, which provides English-language news, asked the Public Health Agency, “What do you mean when you use the word ‘recommend?’” Anders Tegnell, the state epidemiologist, explained in English:

We’re getting into the trickier of legalities. We are very careful in the Swedish language with what words we use when there is a legal obligation to do things, a legal obligation to achieve something. Or just a general advice to do something thing. And I don’t think that’s really what we’re talking about here.

I think what we’re talking about here is the sort of Swedish culture. How they interpret recommendations from authorities … Most people see it as very clear advice on how to do this in the best possible manner. And see it as a very strong recommendation. Then that we don’t use the world shall, because shall in Sweden means there is a legal obligation to do something, and that it why we use the word recommended quite a lot.

There is a long tradition in Sweden … to follow the advice of the authorities … I think there is a cultural difference which I think also shows very clearly in Stockholm right now. When we give the advice to stay home when you can or when you have a slight cold or something, a lot of people are staying home.

In another example, Swedish residents were strongly recommended against travelling at Easter.  Nevertheless, one could imagine a number of situations in which travelling was necessary, for instance if a pipe burst at one’s summer house or if one were recently diagnosed with terminal cancer, and this was the last opportunity to visit a loved one. The deputy state epidemiologist, Anders Wallensten, spoke along these lines during a press conference on the 24th of March:

We’re partly putting this [responsibility] on the individual because there are so many different circumstances. If you have a total prohibition on things, then people suffer completely unnecessarily. We’re putting a certain responsibility [on the individual] to not take unnecessary trips and to think about how you can prevent the spread of disease, this is the basic point. We don’t want to stop all trips if they don’t lead to more spread of disease.  We’ve said this before – what happens if you end up in a small town where you put pressure on the local health service …. But it is a very individual decision.  

Looking at these statements by the Prime Minister and the state and deputy state epidemiologists, what emerges is not an interpretation but rather a proclamation that following recommendations is a duty and a responsibility.  Recommendations are about taking individual responsibility for society. But use of the term “recommendation” is also a recognition that it is impossible to legislate every situation, and that it is ultimately up to the individual to use good judgement, to adapt the recommendations to one’s own life and to follow the recommendations to the best of one’s ability. This is why the Public Health Agency’s recommendations are phrased with an understanding of people’s individual situations: “work at home if you can” or “do not travel during rush hour if you can avoid it” (emphasis added). The suggestion that it is part of Swedish culture to follow recommendations from authorities is highlighted as well.

However, there are limitations to explaining recommendations as a cultural code.  Here is one example of people who are perceived to not follow recommendations.  In the early phase of the Swedish pandemic, news emerged that Swedish Somalis were disproportionally affected, with the Järva area of Stockholm, where high numbers of people with immigrant backgrounds live, being particularly affected (it is not clear to what extent this is still true).  Following the logic that “Swedes know what a recommendation is and how to follow it,” the narrative picked up by the far right, and even some in the mainstream, turned to “Immigrants do not understand Swedish cultural codes.” 

Certainly, culture plays a role in the spread of disease. Jihan Mohamed, who sits on the board of the Swedish-Somali Doctor’s Association, appeared on the news program Agenda and noted that “in Somali culture it’s important to hang out, support and visit each other, especially if one is sick.” However, she and other commentators from Järva also addressed this narrative, turning it into a discussion on class (Randhawa 2020; Daham 2020). In news reports, they have explained how, in comparison to wealthier parts of Stockholm, Järva residents are more likely to live in crowded, multi-generation households. They are less likely to hold white collar jobs, instead working in public transport, health and social care or in shops. That is, they cannot work at home, and many are exposed to people all day as part of their jobs. There is also a higher prevalence of health conditions such as high blood pressure or obesity, which increases the risk for severe covid-19 illness.  Following this, I would suggest that residents of Järva are, in fact, following the recommendations to the best of their abilities, but their ability to do so is limited by social inequalities, not culture. 

There are parallels between Gilbert Ryle’s winks and the Swedish recommendations to prevent the spread of covid-19. Recommendations are a cultural code, but they are also interpreted and applied in relation to class, gender, history, law and many other factors. The interpretation of recommendations generates endless questions: When is a recommendation a prescription, and when does a recommendation provide a strategy but leave implementation open-ended? When is a recommendation a suggestion, and when is it a duty? When is it acceptable or necessary to ignore or adapt a recommendation to one’s own individual situation? Thick description is needed to untangle the “hierarchy” in which these different types of recommendations are “produced, perceived and interpreted.”

Rachel Irwin is a researcher in the Department of Arts and Cultural Sciences at Lund University.  Her current project traces the history of Sweden’s role in global health and development and is funded by the Swedish Research Council.  She is the co-editor (with Kristofer Hansson) of the book Movement of Knowledge: Medical Humanities Perspectives on Medicine, Science and Experience (Nordic Academic Press, forthcoming).

References

Randhawa R. 2020. Läkarförening larmar: Flera svensksomalier bland coronadödsfall i Stockholmsområdet. SVT Nyheter [Internet] 2020 March 24 [cited 2020 May 5]. Available from: https://www.svt.se/nyheter/inrikes/lakarforening-larmar-over-halften-av-de-doda-ar-svensksomalier

Daham O. Vi har inte lyxen att jobba hemifrån eller fly till landet. SVT Nyheter [Internet] 2020 April 15 [cited 2020 April 16] Available from: https://www.svt.se/nyheter/lokalt/stockholm/vi-har-inte-lyxen-att-jobba-hemifran-eller-fly-till-landet

All cited press conferences were broadcast on Swedish Television’s on demand service, SVT Play.se. Most recordings are only available for up to a week after broadcast but access can be requested from the Swedish Media Database (Svensk Mediedatabas) at the National Library of Sweden.

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