The Multiple Temporalities of Epidemic Endings

▼ AbStrAct The beginnings of epidemics are often told as if they are simple to locate in time. They take the form of a crisis, and as such, function as great synchronisers of different temporalities, bringing social temporalities “in line” with biological ones. In the case of the COVID-19 pandemic, for example, political processes that are usually slow were accelerated in order to “catch up with” the fast pace of the virus's reproduction, as policymakers saw a need to contain the virus. The end of an epidemic, on the other hand, is more difficult to pinpoint. This can be attributed to the fact that the myriad actors involved in and affected by an epidemic operate on diverging time scales. Although seemingly synchronised from its outset, these lifetimes become un-synchronised as the epidemic unfolds. Some effects of an epidemic outbreak are easily observed, such as infection rates and the number of deceased. Others—psychological or medical after-effects, or the lasting memory in a population—may be harder to spot. Declaring that an epidemic has “ended” usually relies on the ceasing of the former, not the latter. However, as this article argues, the ending(s) of an epidemic should be regarded in the plural, each operating within its own rhythm and scale. This article explores the multiplicity of lifetimes involved in epidemics—human, microbial, institutional—and tries to give an explanation as to how epidemics end (or linger on) using an approach of multiple temporalities.


The Multiple Temporalities of Epidemic Endings
Diseases are among the most complex interfaces, or sites of exchange, between human and non-human entities.As diseases become epidemics or even pandemics, they involve a unique range of actors, practices, and institutions.There is the spread of pathogens, the development of disease, and reproduction and mutation of microbes on the one hand, and all the medical, social, and political interventions on the other.People plan for pandemics, they impose political restrictions and curtail movement, develop vaccines to try to eradicate the disease; they seek to alleviate pain and engage in medical research to bring sick people back to health. 1 As such, few matters involve as wide a range of objects and actors, human and non-human, from presidents to bacteria. 2ince so many things and actors need to be included when trying to account for an epidemic as a whole, no single temporal scale can easily be imposed on all the objects under study.They all operate on radically different time scales, with different lifetimes. 3In his Metakritik of the new "critical philosophy," published in 1799, the German theologian and philosopher Johann Gottfried Herder offers a paradigmatic formulation of the multiplicity of lifetimes: In reality every mutable thing has its own inherent standard of time; this exists even if nothing else is there; no two things in the world have the same standard of time.My pulse, my step or the flight of my thoughts is not a temporal standard for others; the flow of a river, the growth of a tree is not a temporal standard for all rivers, trees and plants.Life times of elephants and of the most ephemeral are very different from each other, and how different are not the temporal standards on all planets?In other words, there are (one can say it earnestly and courageously) in the universe at any time innumerable different times. 4is is not purely a philosophical point, but has a practical side.The lifetimes of microbes can be measured in seconds, minutes, hours; infection rates in days or weeks; human bodies in months and years; institutions in decades and centuries; and the cultural prerequisites that shape what political actions can be legitimised have lifetimes of centuries.If one takes scientific papers from relevant disciplinesbiology, immunology, public health administration, history, demographics, sociology, and political science-and tries to align the x-axes of graphs dealing with epidemics, there would simply be no practical way of reconciling the time scales.This practical side of Herder's philosophical formulation comes with a methodological implication: we cannot reduce epidemics to a single temporality.
Although epidemics cannot be reduced to a single temporal scale, the temporalities involved are entangled, as changes in one temporality have consequences for For the first point, see Caduff (2015).Fishel (2017).Time in the plural is a methodological point that is increasingly becoming accepted in the humanities and social sciences; see Adam (1990); Jordheim (2014).Herder (1799/1998, p. 360).
actors or phenomena playing out in another.In the words of Vicky Kirby: "Entanglement suggests that the very ontology of entities emerges through relationality: that entities do not pre-exist their involvement." 5Diseases are the perfect example of human/non-human entanglements in that regard: they arise precisely as a multi-species network, and come to involve viruses, medicines, and vaccines, as well as humans and their institutions.Introducing the concept of "temporal entanglements," I wish to explore temporality as a lens into this complex.How do the intricacies of epidemics become visible when looking at them through the various times and temporal dynamics they instigate?Temporal entanglements occur when humans in their social and political practices interact with different, non-human time scales and temporal experiences, and arrange them in new ways in order to navigate the world by means of decisions, plans, and actions.Or put another way, the fast mutation and spread of microbes impinges on the temporalities of politics and social lives, and we humans do things to prevent that.Because the lifetimes of microbes are much shorter, and hence faster, than those of most social and political processes, it becomes necessary to declare "a crisis" in order to "catch up."All the other processes are accelerated beyond recognition to "catch up" with the tempo of the spread of pathogens and its immediate consequences. 6As Caduff and Peckham have both argued, the apparatus for detecting and dealing with contagious outbreaks rely heavily on acceleration of social and political processes. 7hether one sees the outbreak of an epidemic as easily locatable in time depends on the degree to which one emphasises the social or biological aspects of its definition. 8Charles Rosenberg's now-classic 1989 paper "What Is An Epidemic?" is perhaps one of the foremost cases of the former, insisting that without its social aspects, an epidemic is not an epidemic.Based on his emphasis on the social aspect of an epidemic, Rosenberg claims that there is a particular temporal structure, even a dramaturgy, to epidemics: Epidemics start at a moment in time, proceed on a stage limited in space and duration, follow a plot line of increasing and revelatory tension, move to a crisis of individual and collective character, then drift toward closure.… Epidemics ordinarily end with a whimper, not a bang.Susceptible individuals flee, die, or recover, and incidence of the disease gradually declines.It is a flat and ambiguous yet inevitable sequence for a last act. 9Kirby (2011, p. 76).Italics in original.For more on the concept of "entanglements," see Barad (2007); Nuttall  (2009).The kairotic aspects of the COVID-19 outbreak are well captured by Peckham (2020).Caduff (2014); Peckham (2020).See Beckett (2013); Roth (2020).See also Lynteris (2014a), who discusses the dialectics between processual and evental aspects of an epidemic outbreak.Rosenberg (1989, pp. 2, 8-9).Italics are mine.This narrative structure is neat, but as an emergent literature of rejoinders have noted, it is problematic in numerous ways. 10Charters and Heitman use Thucydides' account of the plague of 430 BCE is a characteristic example: "We know that the epidemic is over only because it is no longer part of the plot." 11Still, the whimper, the petering out, or disappearance from the plot are more difficult to locate in time than the potential closure of a narrative "bang."My argument here would be that this is because Rosenberg's definition overlooks the multiplicity of temporalities involved in an epidemic. 12Rosenberg is correct that the outbreak of an epidemic is often told as if it is very coherent. 13Scholars who emphasise the biological aspects of an epidemic, such as those searching for undiagnosed cases of COVID-19 in Europe in January 2020 or HIV/AIDS in the United States in the 1970s, and the epidemiological search for "patient zero" in all epidemics, would on the other hand complicate the temporalities not just at the end, but also at the beginning of an epidemic. 14I here take the approach that epidemics are fairly unique among large-scale phenomena in that they are not temporally reducible to either their social or biological aspects, since these are inextricably entangled.In other words, while we may search for multiple temporalities also at its beginning, an epidemic is not an epidemic until people act accordingly.And "acting accordingly" means entering a kind of crisis mode, where a lot of things happen as fast as possible, synchronising temporalities and seemingly accelerating time itself.This, at least for "the first," creates the sense of a momentous event. 15n this article, I present a multiple temporalities perspective to explain how and why epidemics would seem to end in a whimper, and to tease out how to deal with their ends in the plural.Whereas speech acts, such as the declaration of a "public health emergency of international concern" (PHEIC), can set in motion the social and political apparatuses of the epidemic and make beginnings fairly easy to identify, the end is unfocused because the lifetimes it once synchronised are again out of synch. 16Because epidemics involve so many temporalities, their ends are also multiple-occurring not at a single moment in "natural time," but as each of the lifetimes that an epidemic involved peter out.

Lifetimes of Consequences
While each aspect of the epidemic operates with a radically different lifetime, it is difficult to argue for when exactly that lifetime ends and when the consequences or Charters & Heitman (2021); Greene & Vargha (2020).See also Vargha (2020), who argues that although Rosenberg's dramaturgy is useful for organising the experiences and expectations of an epidemic, it obscures the multiple and conflicting temporalities at work.Charters & Heitman (2021).
Although not focused on the end, for a take on the multiple temporalities of epidemics, see Fissell, Greene,  Packard, & Schafer (2020).Greene & Vargha (2020).For HIV/AIDS, see Pépin (2011).For epidemics as crises versus events, see Lynteris (2014b).For speech acts, see Austin (1962).afterlife of the epidemic take over.One may say that although many lifetimes may be involved in the making of an epidemic, the consequences will play out in the span of the lifetimes of those marked by the epidemic because they have been involved in it.Identifying a clear end for an epidemic may therefore have to do with the difficulty of distinguishing between these two modes: the fact that the epidemic is made up of a great many actors and objects with different lifetimes and temporalities that are out of synch except for a very brief moment "in the event"; and the fact of having been made part of it, willingly or unwillingly, and thus having one's lifetime potentially drastically affected by the pandemic.
That people may be suffering from long-term effects from the moment that the acute infection ends does not need to be pointed out.What is less commonly included are effects that come long after the acute infection.The polio epidemic may have been declared eradicated in most countries decades ago-vaccines made it largely impossible for the polio virus to spread-but many polio survivors have discovered that their mobility reduces quickly in old age even if they fully recovered from the acute infection with little or no apparent long-term effects. 17Although most of the lifetimes of the polio epidemic have come to an end, some still linger. 18For someone discovering late in their life that their mobility is gradually impaired because of something they only have a faint memory of, polio is not entirely over.This would run contrary to Charters and Heitman's point about sequelae-the medical term for conditions and diseases that occur as the result of another disease-being evidence for the end of an epidemic. 19Rather than being evidence of the end, some of the lifetimes of the polio epidemic are slower, and hence longer, than others.Similarly, as Eliza Williamson has observed in the case of the Zika epidemic in Brazil, effects of an epidemic last long after the epidemic itself has been declared over, as those children who were affected live their entire lives with microcephaly. 20This heavily impacts the children, their families, and the health care services in Bahia and in Brazil, for as long as those children live.The temporalities of all these lifetimes are out of synch, and hence it is very difficult to pin down an "end of Zika" or "end of polio" in the singular.
Although the long-term effects of a disease may seem obvious in human bodies, they are not unique to human bodies.Rather, they play out in the lifetimes of all the bodies, sites, institutions, and actors involved in the epidemic.Memories and adaptations will last long after the virus or bacteria are dead.One does not have to reach for macro-historical books claiming "The Black Death and the Transformation of the West"-pointing teleologically from the plague to the "rise of the West" on a global scale-to see that its consequences played out along lifetimes reaching long past 1350. 21In history books, we typically find dates where the author seeks to fix the beginning of the plague pandemic, but there is less often an authoritative description of how it ended. 22This is not meant as a competition to see who can find the longest-lasting consequences or the longest temporality of an epidemic, or to argue that an epidemic never ends.Rather, while epidemics may seem like momentous events when they break out, their moment of ending seems uneventful because the ends come in an asynchronous manner.

Crises, Events, and Afterlives
Just like the World Health Organization (WHO) declared the beginning of the COVID pandemic, it will also declare its end.By invoking the concept of crisis, calling what was playing out "a global health crisis," the WHO was trying to impose a single temporality upon a very complex phenomenon through speech acts that mark out the pandemic's authoritative lifetime. 23Such speech acts have legal and political consequences, as the WHO's declaration gives legitimacy to certain crisis measures taken by governments, as well as giving contracting parties an official reason for non-performance of contracts on account of there being a pandemic. 24he complexity of declaring an end is not simply due to Charters and Heitman's point that there may be "false ends"-such as in the case of the Ebola epidemic, where declarations of its end were increasingly less triumphant each time-but rather that the ends are unsynchronised. 25The WHO's declaration of a global health crisis and then, 5 or 6 weeks later, a pandemic, gave governments legitimacy in calling an exception to normal procedures. 26This was different, this was unique: it was crisis, and crises call for extraordinary measures.And it happened in a synchronous manner, giving governments around the world the same impetus at the same time.
Governments around the world took, gave themselves, or were granted by parliamentary assemblies such extraordinary powers.That way, the epidemic also served to synchronise the lifetimes of different states' legal proceedings, tying them together and to the epidemic in that moment.States that had previously had no provisions for emergency law made such in record time. 27Others that already had them, imposed them quickly. 28In many places, executive power set aside the legislature in a way that has historically involved the risk that such a concentration of power would become permanent.The rationale for doing so is by and large temporal; the time it takes to involve the legislature in decision-making, with its hearings, debates, propositions, drafts, and re-drafts, is simply too slow when entangled with the epidemic spread of pathogens.Hence, the temporality of legislature-and indeed most democratic decision-making that involves multiple parties-is difficult to speed up sufficiently to keep abreast of epidemic developments.Indeed, this is also the case for regular Charters & Heitman (2021)."Coronavirus Declared Global Health Emergency by WHO" (2020).See also Fassin & Pandolfi (2010).Beckett (2013).The recurrence of cases after the declaration is something also raised by Charters & Heitmann (2021).Schmitt (2005), but also Beckett (2013).See, for example, Koronakommisjonen (2021, pp.294-298).Jordheim, Lie, Ljungberg, & Wigen (2020).
bureaucratic decision-making.The solution, then, is to set many of its functions aside, for a shorter or longer period of time.In Norway, the executive branch of government first tried to give itself emergency powers for 6 months, but was only given 1 month by parliament, which was then renewed once. 29If we follow Schmitt, we could say that it was the Norwegian parliament that called the exception, thus asserting its sovereignty vis-à-vis the executive.
The lifetime of such an exception is notoriously problematic in history.Its end is neither synchronised across the world, nor with the rest of the temporalities of the epidemic.Historically, exceptions of the sort where the normal operation of parliamentary oversight are set aside have tended to last for years, if not decades.No research that I am aware of systematically studies whether this also applies to exceptions made to deal with an epidemic.However, there are places in the world and periods in history where states of emergency, once declared, have had a tendency to last decades.A single individual asserting his or her sovereignty by calling an exception tends to come at a moment of kairos-exactly like this current pandemic offered-yet playing out over a much longer lifetime than the spread of pathogens across a continent.30

Declared and Undeclared Ends
In the historical accounts of the COVID-19 pandemic, it is not unlikely that the WHO declarations will be the authoritative dates that impose a single pandemic lifetime or narrative along Rosenberg's schema.But although the WHO may be useful for political and legal reasons, and its speech acts may have great empirical interest, they serve a limited analytical purpose.As others in this special issue are arguing, the most likely end to the pandemic will come as COVID-19 becomes a seasonal matter, being endemic in some populations and then spreading across the world as seasons shift, much like influenza viruses have been doing for the past decades.Whether or not "long COVID"-with symptoms including fatigue, breathlessness, anxiety, heart palpitations, chest pains, joint or muscle pain, and "brain fog"-is a general condition, it is clear that the effects of COVID-19 will play out both in individual bodies and on a collective level regardless of the WHO's speech acts.It is of course difficult to follow the lifetime of each individual to get a fuller grasp of the temporality of the pandemic and track its end.We could postulate more generally on what kinds of timescales the lifetimes might play out.
Human lives may vary in length.They can be measured in years or decades, but it makes little sense to measure them in centuries.How we measure the parts of these lifetimes affected by COVID-19 depends on what we emphasise.Sticking to a purely medical definition, we're talking days or weeks.But for those whose lives ended because of COVID-19, one might say that all the potential that lay after has been affected.This is the perspective taken by those dealing with risk, assessing the value (typically in financial terms) of the remainder of a life and then multiplying that by the chance of it disappearing.Social workers have been warning that the measures imposed to contain the COVID-19 pandemic are likely to have severe psychological consequences for vulnerable people. 31Whether it can be termed an epidemic of its own-it might be by journalists-it will certainly be a sequence of consequences unfolding in one of the many social lifetimes of the pandemic itself.In other words, realising that the pandemic itself is an entanglement of microbes, humans, and their institutions, and is at once a social and natural phenomenon, implies that we as social scientists cannot in any simple manner draw a line dividing the "pandemic proper" and its unfortunate consequences thereafter.
Developmental psychologists and phenomenologists emphasise that early-life experiences affect us in a greater manner.This has two components.First, there is the simple fact that as more of our potential lives are ahead of us, there is a longer time scale on which consequences may play out and simply more time to affect.The second component is that we are more malleable at an early age, and experiences early in our lives are formative of who we become.It is always difficult to weigh the relative importance of lives lived and lives lost.As was long a truism of the current pandemic, it was the elderly who were most affected medically by COVID-19, but the youngest who were most affected socially and perhaps psychologically by the measures imposed to curtail it.Although the medical side of this may shift with later mutations of the virus, there is a grain of truth here.Since we only have an overview of the first year or so of the disease and post-disease history, we do not quite know on what time scale the consequences of being ill at a young age play out.We do, however, have a whole sub-discipline of psychology devoted to the long-term effects of psychological stress during the formative years of childhood development and coming-of-age.For those children severely affected psychologically by the curfews and lockdowns-in some places a whole year of home schooling under adverse circumstances and with little resources-consequences may play out across their entire lifetimes.
The problem with proposing such a view of a multiplicity of lifetimes that come together in a single epidemic, where the sequlae become part of the lifetime of the epidemic itself and so on, is that it becomes almost impossible to distinguish between the life and the afterlife.In Norway, the epidemic's most narrow legal temporality-in the form of the "corona law"-was only in effect for 2 months.One view of this would be that its lifetime was over long before many other lifetimes of the epidemic, such as vaccine development, had properly gotten underway.A state of exception was declared for 1 month in March 2020 and then renewed once in April.However, as I return to below, planning for "the next" epidemic always happens in light of the previous one, and hence it is difficult to strictly delineate the various lifetimes of an epidemic.Although the lifetime of the Norwegian "corona law" was over long before other COVID-19 lifetimes, it is likely to have an afterlife in pandemic preparedness plans. 32We may say that the "corona law" was born from the epidemic, and hence whatever use it may be put to, its lifetime is inextricably linked to the epidemic.Whether this is then a lifetime of the COVID-19 pandemic is more of a philosophical than a practical question.

The New Normal
Erica Charters and Kristin Heitman have argued that epidemics end when they become normalised-not necessarily endemic in natural science terms, but endemic in people's social lives.In other words, epidemics have to do with collective disruption: Epidemics end once the diseases become accepted into people's daily lives and routines, becoming endemic-domesticated-and accepted.Endemic diseases typically lack an overarching narrative because they do not seem to require explanation.More often, they appear as integrated parts of the natural order of things.By contrast, epidemics-like the recurring narratives they producethrow a society's confusion, fears, and anxieties into high relief.But as a result, epidemics and their narratives can also act to conceal the thickets of disease in which we live, including those lowly and constant problems of heart conditions, acute diarrhoea, and respiratory infections. 33 people die, lives and societies are transformed.Whether we will "return" to a pre-pandemic normal-whatever that may have been-or create a "new normal" still heavily affected by measures designed to prevent infections is really not for me to say.What is clear is that the social adaptations made to live through a pandemic will become part of the repertoire of those who experienced it.Direct experience with crises not only has negative psychological and social effects, it also tends to shape people's readiness, both on an individual and collective level.The social repertoire of pandemic handling may be just as important, or perhaps even more important, than physical resources.Compared to certain rich European countries, a country such as Vietnam's epidemic-handling skills have been quite remarkable.As with so much else, organisation, preparedness, and cohesiveness can deliver results that pure financial resources may not necessarily achieve.
Although there will be one or more declared ends of this pandemic, enacted publicly by the WHO and various national health authorities, as Greene and Vargha point out, there are likely to be a number of undeclared ends.These will take place as people's lives "return to normal."But they also point out that many aspects of the epidemic may not end at all, as the epidemic becomes endemic and is socially regarded as something "we just have to live with."This has been talked about as a "new normal."As what is normal can only be understood in contrast to that which is exceptional, and humans are furthermore very adaptable beings, whatever is normal is what we are used to. 34hatever the new condition will be, it will have lessons that simulations could not provide: actual experience with a real pandemic and a repertoire of "things to do" that will remain with us at both individual and collective levels.When the UK government ran a "war game" simulation for how to cope with an influenza-like virus in 2016, it revealed serious weaknesses in the country's preparedness. 35Yet, simulations seldom impart the urgency of the situation, and it did not make the UK particularly well-prepared for the pandemic that hit 4 years later.As the saying goes, generals always plan and prepare to fight the last war.The scenario that British authorities prepared for-the outbreak of a "Swan flu" in Thailand, which then spreads to the UK-indicates that generals are not alone in this.I would argue that when epidemics break out, things move so fast that there is little time to plan anew.Even improvised decisions based on medical expertise take time, and what can be done through improvisation on the spot is seldom better than what has been planned for. 36Thus, in the heady days of accelerated time as the social processes seek to catch up with the biological ones in an epidemic outbreak, we tend to play out our plans, however poor they may be.
It might be better to think about preparedness in terms of skills and repertoires.And while authorities and medical professionals can plan, dealing with epidemics is essentially a bio-political question, including in the more Foucauldian sense.The more a state can get individuals to "act appropriately" and take the necessary measures on their own, the less intervention is needed by the state.It is, in a sense, the ultimate issue of governmentality, where the state wants each individual to appropriate the state's best practice, not because they are being obedient and following laws, but because they are individually tackling a communal problem in ways that are beneficial for the collective.Training and educating individuals for this kind of behaviour takes time.And it is typically quite dependent on the situation.If we think of Ann Swidler's definition of culture as repertoire or a toolbox, one might say that a culture of preparedness is one where people have the tools to handle a given set of situations. 37Since simulations rarely involve whole populations at the same time, it is difficult to train for situations that require the full mobilisation of society.But once done, the tolls and the skills become embodied in the individual who has gone through it.I am not talking here about the disease, but rather all of society, at least where states succeeded in getting large sections of their populations to "behave appropriately."Although "the Blitz" or "the war" is a trite metaphor that the British press brings out to give meaning to almost any kind of collective effort, there is a sense in which it is also apt.Because it was such a momentous experience that left no one unmarked, it was able to shape two or three whole generations, even those For a case of how this plays out differently for those most affected by an epidemic, see Williamson (2018).Pegg (2020).Jordheim, Lie, Ljungberg, & Wigen (2020).Swidler (1986).who had contributed little more than living in fear through the ordeal.Elsewhere, the repertoire of survival skills that this kind of collective crisis situation required individuals to develop, stayed with them until their deaths.In short, the lifetimes of the survival skills honed by the "home front" lasted until the end of that generation.

Conclusion
It is notoriously difficult to reflect on ongoing events in depth.Reflecting on epidemic ends during a pandemic is even more difficult because they are so fundamentally out of synch.We get them in fits and starts, as certain epidemic lifetimes come to an end while others are ongoing.As I have tried to go through various examples of lifetimes within which the epidemic plays out, my own account also easily becomes unsynchronised.Perhaps it is because epidemic outbreaks are great synchronisers that their unsynchronised ends are so difficult to grasp in their totality.The first outbreak appears as a momentous event, as the social and the microbial suddenly align, and the quick temporality of lowly bacteria impinges on the slower temporalities of legislation, budgets, patterns of travel, and life experiences.38Not all geographies and societies were perfectly aligned back in the winter and early spring of 2020.As dealt with elsewhere, the COVID-19 epidemic itself was used as a yardstick and synchroniser, with statements such as "we are where Italy was two weeks ago." 39As the multiple lifetimes of the epidemic run their course, they have long since come out of synch.Some have ended already, others have merely started.The non-contemporaneity of the ends of these lifetimes creates a sense of uneventfulness.
I have set out by defining an epidemic as a multi-temporal assemblage of different actors, objects, and relations, both biological and social, that are out of synch except in the speech act that brings them together in the outbreak as socio-biological fact.As the epidemic assemblage falls apart, little by little, it is difficult to distinguish the consequences of having thus been assembled from whether that lifetime is still part of the epidemic, which makes a case for the epidemic not to have ended.A slow trickle of ends, declared or undeclared, and the simple normalisation of what was once strange and unfamiliar-the social counterpart of the endemic, if you will-create a sense of the singular epidemic falling out of the plot rather than coming to its narrative end after a crescendo; and instead a whole lot of minor lifetimes of the epidemic take over, only to peter out over years and decades.