From HIV/AIDs Infrastructure to Covid-19 Rapid Response: The Reconfiguration of Public Health Expertise during Crisis

Claire Decoteau, University of Illinois at Chicago
Cal Garrett, Wake Forest University

This paper examines the transferability of expertise in the public health response to COVID-19 from existing public health and knowledge infrastructure organized around HIV/AIDS in Chicago. Research on the HIV/AIDS epidemic in the US has shown that, in response to initial lags in state response, activists organized to build a durable structure of public health expertise both inside and outside of formal policymaking institutions. The efficacy of the HIV/AIDS public health response was its attention, directed by impacted communities, to building a wraparound infrastructure that included both expert public health resources and resources for comprehensive social services like housing and income to increase resiliency among vulnerable groups. When faced with COVID-19 outbreaks in the first half of 2020, Chicago public health authorities drew heavily on expertise and individual experts from the HIV/AIDS infrastructure to assemble testing, contact tracing, case investigation operations and vaccination efforts. Yet, the wraparound services that have been so critical to effective public health response to HIV/AIDS have been slow to materialize in the case of COVID-19, even as other aspects of the HIV/AIDs infrastructure are replicated. Based on interviews with public health policymakers, experts, and workers in Chicago and archival research on relevant policies, we find that funding streams, the construction and expansion of public health expertise, and the field of public health are implicated in this case. We suggest that this might be explained, in part, by three different features of the way that experts apprehend the COVID-19 epidemic in Chicago: (1) a tension between program-based initiatives focused on particular illnesses and/or vulnerable populations and broader infrastructural investments, (2) the singular focus on public health outcomes as opposed to general social welfare, and (3) the emphasis on rapid response to fundamental causes of vulnerability during the pandemic rather long-term structural consequences.

No extended abstract or paper available

 Presented in Session 265. Fields of Expertise: Structure and Transformation