The concept of disease in the time of COVID-19

Area of Science:

• Philosophy of Medicine
• Medical Ethics
• Public Health

Background:

• Philosophical accounts of disease vary, impacting disease and sickness judgments.
• The concept of disease influences who is considered ill and their associated social roles.
• The coronavirus disease 2019 (COVID-19) pandemic provides a case study for examining disease concepts.

Purpose of the Study:

• To analyze how different disease concepts affect judgments regarding coronavirus disease 2019 (COVID-19) status.
• To explore the implications of disease concepts on social measures and responsibilities.
• To evaluate the suitability of disease concepts that include social harm, especially in non-emergency contexts.

Main Methods:

• Conceptual analysis of disease definitions.
• Application of an ideal diagnostic test for COVID-19 across four population groups (positive/asymptomatic, positive/symptomatic, negative, untested).
• Examination of disease and sickness judgments based on varied disease concepts.

Main Results:

• Different disease concepts lead to divergent conclusions about disease and sickness status for COVID-19 positive and negative individuals.
• Disease concepts incorporating social harm (risk of harm) are implicitly used in sickness judgments and social measures during the COVID-19 outbreak.
• Problems arise when applying disease concepts with social harm components beyond emergency situations.

Conclusions:

• The definition of disease significantly impacts clinical and social responses to illness.
• Social measures during health crises often rely on disease concepts that include potential harm to others.
• A critical evaluation of disease concepts is necessary, particularly when extending them beyond their intended scope or emergency contexts.