Mediating scarcity in pandemic times: an ethnographic study on the prevention and control of SARS-CoV-2 infections during the emergence of the corona crisis in the Netherlands.

peer reviewed[en] BACKGROUND: In this paper we explore how staff involved with infection prevention managed the emerging COVID-19 crisis in the context of scarcity of Personal Protective Equipment (PPE), focussing specifically on the (re)writing of guidelines. We conceptualize guidelines as 'mediating devices' as they translate between evidence and clinical practice, between management and the workplace, as well as the different values embedded in these domains. It is this mediation, we argue, that adds to the resilience of healthcare organizations. The setting for this research is an elite academic hospital in the Netherlands during the emergence of the COVID-19 pandemic. METHODS: We conducted non-participative observations, semi-structured interviews, and document analysis during the emerging pandemic (March-July 2020). We observed meetings from the crisis team and the unit for infection prevention (210 hours), interviewed members of these teams (21 interviews) and analysed guidelines and flowcharts concerning infection prevention, as such collecting a unique and rich qualitative dataset. Analysis was done through thematic coding. RESULTS: Our results show the writing and rewriting of guidelines as a fundamental characteristic of dealing with scarcity and adding to resilience. We found three main practices our research participants engage in while trying to manage the uncertain situations emerging from the scarcity of personal protection equipment. The first practice we observe is defining safety; dealing with different perspectives and experiences of what 'working safely' means. The second entails the anticipation of scarcity by which our participants aim to control the situation through monitoring, research and creating scenarios. The third practice we observe is finding new ways to use PPE that is available, by experimenting and tinkering with the material. CONCLUSION: Infection prevention guidelines are crucial in managing the emerging crisis. We discuss how the writing of guidelines mediates between different settings, timeframes, and different worlds of quality. Through (re)writing there is a constant negotiation and discussion with the various actors about what works, and there is a continuous adaptive attitude. At the cost of a lot of work and struggle, this creates a resilient and inclusive work environment useful in a long-lasting crisis

Mediating scarcity in pandemic times: an ethnographic study on the prevention and control of SARS-CoV-2 infections during the emergence of the corona crisis in the Netherlands

Background: In this paper we explore how staff involved with infection prevention managed the emerging COVID-19 crisis in the context of scarcity of Personal Protective Equipment (PPE), focussing specifically on the (re)writing of guidelines. We conceptualize guidelines as ‘mediating devices’ as they translate between evidence and clinical practice, between management and the workplace, as well as the different values embedded in these domains. It is this mediation, we argue, that adds to the resilience of healthcare organizations. The setting for this research is an elite academic hospital in the Netherlands during the emergence of the COVID-19 pandemic. Methods: We conducted non-participative observations, semi-structured interviews, and document analysis during the emerging pandemic (March–July 2020). We observed meetings from the crisis team and the unit for infection prevention (210 hours), interviewed members of these teams (21 interviews) and analysed guidelines and flowcharts concerning infection prevention, as such collecting a unique and rich qualitative dataset. Analysis was done through thematic coding. Results: Our results show the writing and rewriting of guidelines as a fundamental characteristic of dealing with scarcity and adding to resilience. We found three main practices our research participants engage in while trying to manage the uncertain situations emerging from the scarcity of personal protection equipment. The first practice we observe is defining safety; dealing with different perspectives and experiences of what ‘working safely’ means. The second entails the anticipation of scarcity by which our participants aim to control the situation through monitoring, research and creating scenarios. The third practice we observe is finding new ways to use PPE that is available, by experimenting and tinkering with the material. Conclusion: Infection prevention guidelines are crucial in managing the emerging crisis. We discuss how the writing of guidelines mediates between different settings, timeframes, and different worlds of quality. Through (re)writing there is a constant negotiation and discussion with the various actors about what works, and there is a continuous adaptive attitude. At the cost of a lot of work and struggle, this creates a resilient and inclusive work environment useful in a long-lasting crisis

“Selecting and reproducing farm animals in times of ecological disasters: modes of valuation of cattle livestock in Belgium and The Netherlands”

The field of livestock selection and reproduction has been going far into the economization of life and the convertibility of productivity factors into sound cur-rencies. However, farming practices are undergoing a lot of stresses; economic stress, climatic stress and social stress with cultured meat arising together with strong moral and ethical claims from vegetarian and vegan consumers. Farming institutions are trying to cope with these challenges and, in so doing, advocate other sets of values that would allegedly « remedy » what would be best described as a state of enduring disaster. Part of these responses partake with the scientific and rational endeavor livestock farming inherits from, especially with the prolonga-tion of genetics into genomics. While genetics afforded impressive increases in productivity, it has also led to exhaust living organisms, biodiversity in herds and environments. In this contribution, focusing on the case of cattle livestock selection and reproduction through genomics practices, we will unfold and contrast two dif-ferent modes of valuation that are more qualitative than qualitative. We will focus on cases of Belgium and The Netherlands, to show how different values such as the « heath » of herd animals or « the environment » are cast, defined, and enacted in practices of selection and reproduction. This will hint us into the variety of « modes of valuation » as both performative and ontological operations, which end up ma-terially shaping bovine bodies and rendering certain farming practices possible or impossible.“The Body Societal

Dancing with a Virus: Finding new Rhythms of Organizing and Caring in Dutch Hospitals

This paper uses the metaphor of the dance to envision how hospitals in the Netherlands engaged in organizing and delivering care during the first months of the COVID-19 outbreak. Drawing on an ongoing ethnographic study in a Dutch university study and interviews with nurses in various hospitals, we show how hospital actors (nurses, physicians, managers, directors, patients) engaged in different dances following the changing rhythms of the virus outbreak and related policy measures, as well as mutual interactions driven by ‘old’ and ‘new’ private and collective interests. We discern three dance patterns in the unfolding crisis—learning to dance; the dance marathon; dancing to a cacophony—each requiring a new choreography of organizing and caring, rearranging personnel, spaces, and materials to adapt to (the consequences of) the virus outbreak. We argue that dance is a powerful metaphor to provide an affective narrative of how hospitals operate at different levels and in various ways to accommodate a new group of patients while flexibly finding alternative ways of organizing and caring in a highly political and uncertain context