Orthodoxy, illusio, and playing the scientific game: A Bourdieusian analysis of infection control science in the COVID-19 pandemic

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dc.contributor.authorGreenhalgh, Trisha
dc.contributor.authorOzbilgin, Mustafa
dc.contributor.authorContandriopoulos, Damien
dc.date.accessioned2023-07-23T14:30:30Z
dc.date.available2023-07-23T14:30:30Z
dc.date.copyright2021en_US
dc.date.issued2021
dc.description.abstractBackground: Scientific and policy bodies’ failure to acknowledge and act on the evidence base for airborne transmission of SARS-CoV-2 in a timely way is both a mystery and a scandal. In this study, we applied theories from Bourdieu to address the question, “How was a partial and partisan scientific account of SARS-CoV-2 transmission constructed and maintained, leading to widespread imposition of infection control policies which de-emphasised airborne transmission?”. Methods: From one international case study (the World Health Organisation) and four national ones (UK, Canada, USA and Japan), we selected a purposive sample of publicly available texts including scientific evidence summaries, guidelines, policy documents, public announcements, and social media postings. To analyse these, we applied Bourdieusian concepts of field, doxa, scientific capital, illusio, and game-playing. We explored in particular the links between scientific capital, vested interests, and policy influence. Results: Three fields—political, state (policy and regulatory), and scientific—were particularly relevant to our analysis. Political and policy actors at international, national, and regional level aligned—predominantly though not invariably—with medical scientific orthodoxy which promoted the droplet theory of transmission and considered aerosol transmission unproven or of doubtful relevance. This dominant scientific sub-field centred around the clinical discipline of infectious disease control, in which leading actors were hospital clinicians aligned with the evidence-based medicine movement. Aerosol scientists—typically, chemists, and engineers—representing the heterodoxy were systematically excluded from key decision-making networks and committees. Dominant discourses defined these scientists’ ideas and methodologies as weak, their empirical findings as untrustworthy or insignificant, and their contributions to debate as unhelpful. Conclusion: The hegemonic grip of medical infection control discourse remains strong. Exit from the pandemic depends on science and policy finding a way to renegotiate what Bourdieu called the ‘rules of the scientific game’—what counts as evidence, quality, and rigour.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipThe work reported here received no direct funding. TG’s research on COVID-19 is funded from the following grants: Wellcome Trust (WT104830MA to TG), National Institute for Health Research (BRC-1215-20008, TG as BRC Theme Lead) and ESRC (ES/V010069/1 to TG).en_US
dc.identifier.citationGreenhalgh T., Ozbilgin M. and Contandriopoulos D. (2021). Orthodoxy, illusio, and playing the scientific game: a Bourdieusian analysis of infection control science in the COVID-19 pandemic. Wellcome Open Res, 6:126 https://doi.org/10.12688/wellcomeopenres.16855.2en_US
dc.identifier.urihttps://doi.org/10.12688/wellcomeopenres.16855.2
dc.identifier.urihttp://hdl.handle.net/1828/15226
dc.language.isoenen_US
dc.publisherWellcome Open Researchen_US
dc.subjectSARS-CoV-2
dc.subjectaerosol transmission
dc.subjectBourdieu
dc.subjectillusio
dc.subjectorthodoxy
dc.subjectsymbolic violence
dc.subjectevidence-based medicine
dc.subjectinfection prevention and control
dc.subject.departmentSchool of Nursing
dc.titleOrthodoxy, illusio, and playing the scientific game: A Bourdieusian analysis of infection control science in the COVID-19 pandemicen_US
dc.typeArticleen_US

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