Much has been written of late on the ‘biosocial’ in the social sciences and humanities — see for example Ingold (2013), Meloni et al (2016), Lloyd and Muller (2018) — including postings in Somatosphere (Béhague 2020; Meloni 2014). In part this stems from the limits of ‘representational’ approaches and a need to marry the biological and social in response to pressing contemporary problems and material matters like global health inequalities or the challenges of the Anthropocene. In equal measure though it has been prompted by moves within the biosciences themselves in more ‘pro-social’ directions, from social neuroscience to epigenetics, thereby raising important new questions and challenges for the social sciences and humanities (Meloni et al. 2016).
Engagements too of an avowedly biosocial kind are now appearing in response to the pandemic, particularly from within the (medical) anthropology community. Sarma and Fuentes (2020) for example, from an evolutionary anthropological perspective, have recently argued that it is imperative to see the pandemic as a biosocial event involving biological, social, cultural, historical, political and economic factors. Moreover, pandemics like this one they stress, from an evolutionary viewpoint, are relatively recent, emerging out of a complex combination of factors including population numbers and density, as well as social, cultural, economic and ecological practices which have facilitated its emergence (see also Fuentes 2020). Gibbon and colleagues (2020) have likewise offered a series of medical anthropological reflections on the biosocial aspects of the pandemic, including discussions of evolutionary approaches, the human body and the city, biosocial difference and embodied inequalities as well as ageing, zoonosis and the Anthropocene. To this of course we should add the return to related biosocial and biocultural terms such as syndemics (Singer et al 2017) and situated biologies (Niewöhner and Lock 2018) with these pandemic matters in mind. Take the editor-in-chief of The Lancet (Richard Horton), for example, who in his introduction to the webinar launch of the Covid-19 Marmot Review (2020), was at pains to stress the need to see the pandemic in syndemic terms as a synergist interaction of the virus with existing diseases and disorders of the non-communicable kind, along with a host of other social and environmental factors, including conditions of material deprivation and injustice (see also Hart and Horton 2017).
Here we add an emphasis on rhythms to these emerging or evolving biosocial responses to the pandemic. Rhythms after all are another vital biosocial matter, occurring in time, space and everyday life. Part of their appeal concerns the way in which rhythms demonstrate, once again, the always already entangled relations not simply between the body and society but between the biological and the social, the cyclical and the linear. Rhythms, in other words, provide another vital bridge between the biological and the social, thereby encouraging if not demanding more avowedly biosocial ways of thinking and doing research.
Lefebvre (2013 ) is a key point of reference here of course, not simply through the rhythmanalysis he forges and fashions, bringing bodies, space and time together in so doing, but through the many other rhythmanalytical studies he has inspired in the social sciences and humanities in recent years (see for example Edensor 2016, Lyon 2019). Chronobiology provides another key point of reference, which Lefebvre and many others in the social sciences and humanities have long drawn on for insights into these biological rhythms of life (see for example Young 1978, Rifkin 1989, Adam 1990). All life, from a chronobiological viewpoint, is rhythmic, from single cellular organisms to complex organisms such as ourselves (Foster and Kreitzman 2004). Moreover, living out of sync with these rhythms of life, as we are now increasingly told today, has implications for our health, well-being and the optimisation of all we do according to ‘when’ we do it. Timing matters, in short, on these circadian counts. Hence the rise of chronobiology in society today is not simply a way of understanding but of governing these rhythms of life itself.
What then of the pandemic? What further light do rhythms shed on life and living in these pandemic times? And what biosocial matters does this raise both now and in the aftermath of the pandemic? In this post, we briefly focus on five interrelated issues which we suggest are particularly important and deserve further analysis elsewhere.
The first and perhaps most obvious issue concerns the problems of bio-social arrhythmia in pandemic times. On the one hand of course, these problems are nothing new. Chronobiology after all, as already noted, has long since warned of these problems and risks in society today, including the claim that many of us are suffering from so-called ‘social jet lag’ — the social equivalent of a transatlantic flight without ever boarding a plane caused by the clash or mismatch between ‘biological’ and ‘social’ time (Roenneberg 2012) — and the claim that we disturb, disrupt or neglect these circadian rhythms of ours ‘at our peril’ (Foster 2017). On the other hand, the pandemic may itself be considered not simply a biosocial event but an arrhythmic biosocial event on a global scale sending shock waves around the world and disrupting all our lives in more or less profound and significant ways, including our everyday rhythms and routines in and out of lockdown.
Take sleep, for example, which provides us with a prime biosocial indicator of these rhythmic matters in pandemic times. Biosocial that is to say, given sleep involves a complex interplay of always already entangled biological and social factors, including the relationship between ‘socially dictated sleep-wake timing and sleep property driven by circadian physiology’ (Dijk and von Schantz 2005). Rhythmic too of course, given the rhythmic nature of our sleep-wake cycle. Whilst the pandemic, to be sure, has enabled some of us at least to explore or experiment with more flexible forms of sleep, as Wolf-Meyer (2021) has recently argued, this is clearly only part of the unfolding pandemic storyline here on the sleep count. A variety of studies indeed now point to the sleep problems many have experienced during the pandemic across both general and healthcare populations (Salari et al. 2020; Partinen et al. 2020, Partinen 2021; Jahrami et al 2021; Zitting et al. 2021). In part perhaps, returning to the notion of more flexible forms of sleep, this may be due to the fact that people’s sleep patterns during the pandemic no longer reflect prevailing or hegemonic sleep norms pre-pandemic, thereby making them more likely to see or perceived their sleep as ‘problematic’. However any such argument cannot be pushed too far. As Hurley (2020) notes, neurologists are “seeing an increase in sleep disorders associated with COVID-19, a surge they’re terming “COVID-somnia.”The anxiety, stress, worry, and depression the pandemic has engendered have undoubtedly played a role here, particularly for those in disadvantaged socio-economic circumstances, of which more shortly. It may also be the case, somewhat ironically perhaps in the light of the foregoing flexible sleep arguments, that the relative freedom or flexibility the pandemic has afforded from the disciplines of institutionalised clock-time — through home working and home schooling – coupled with our increased screen time as a consequence, has created as many sleep problems as it has solved (Cellini et al 2020). More fine-grained research is now shedding further light on the differential sleep profiles during the pandemic — of the ‘reduced’, ‘delayed’ and ‘extended’ time in bed varieties (Robillard et al 2020) – including links to a variety of socio-demographic, behavioural and psychological factors (Jackson et al 2020; Robillard et al. 2020; Falkingham et al 2020; Ruppanner et al. 2021). In short, sleep provides us with a valuable and indeed vital window onto these arrhythmic biosocial relations in pandemic times.
A second closely related point concerns the potential not simply for biosocial arrhythmia and circadian disruption of the aforementioned kinds, but for the development of new more synchronised or resynchronised biosocial rhythms and routines during the pandemic, particularly during lockdowns. This of course is far from true for everyone, as already noted above, not least perhaps those frazzled parents juggling home working and home schooling who may long ironically for a return to life pre-pandemic however frantic or arrhythmic that may have been. For some nevertheless, the fortunate few perhaps, the pandemic may have provided time and space to take stock, to re-evaluate, to return to previously cherished pursuits and pastimes, to take more exercise, get outdoors, reconnect with the rhythms of nature and to take pleasure in the simple things in life previously unnoticed or taken for granted, like early morning birdsong for example. This no doubt explains the variety of articles and posts which speak to the upsides of the pandemic, including recourse to terms such as resilience, positive gains from adversity (PGA) and such like (Ungar 2020). It may also of course, returning to the aforementioned sleep matters, have enabled some of us, particularly young people perhaps without other family responsibilities, to realign their sleep behaviour with their evening chronotypes if, that is, they were able to sleep in more in the mornings thanks to remote schooling (Robillard et al. 2020; Hisler and Twenge 2021); a case of more flexible norms and forms of sleep that is to say of the kind Wolf-Meyer (2021) has in mind. It is not simply then, on these counts, a case of biosocial arrhythmia in pandemic times, important as that is, but of new opportunities for more resynchronised if not eurhythmic forms of biosocial life, for some of us at least. These opportunities may be long lasting; with polls suggesting that families anticipate there will be ‘more walking and family chats’ post lockdown (Easton 2021) and reports of some companies such as the multinational social media giant Twitter allowing workers to work from home ‘forever’ (BBC 2020).
A third critically important issue here, which any biosocial approach to these rhythmic matters much surely attend to, concerns chronobiology’s own engagements with the Covid-19 pandemic so far, including a virtual conference in July 2020 by the European Biological Rhythms Society (EBRS) on “Chronobiology of COVID-19” (Cermakian, N., & Harrington, 2021). That various aspects of our immune response are tied to our circadian rhythms has long been established within the scientific community. Studies, mainly on infection with influenza for example, have shown how immune response and severity of illness (e.g. need for hospitalisation) can be linked to the time of infection relative to the circadian day (Sengupta et al 2020). There is also some evidence to suggest that response to antivirals and the timing of vaccine administration is tied to immune response, with one study showing higher antibody responses when older adults were given influenza vaccinations in the morning compared with the afternoon — see Sengupta and colleagues (2020) for a review of the scientific literature on this count. Translation of this scientific knowledge into medicine or clinical practice in the shape of chronotherapies is still somewhat lagging on these particular counts. These findings nevertheless lead to speculation that timing of infection could also be important in terms of susceptibility to Covid-19 infection and severity of illness and that timing of treatment or vaccination could be of importance in determining an individual’s immune response (Sengupta et al, 2020; Ray and Reddy 2020; Haspel et al, 2021). Whilst this perhaps suggests a radical rethink of how best to approach the reopening of society regarding the timing of activities to avoid viral exposure at particular times of the day, or indeed, the timing that vaccinations are administered, particularly for those in the most vulnerable groups, it is also quite a leap from where chronobiology currently finds itself. What is clear however, is that the pandemic has provided chronobiologists with renewed reason and opportunity to study and better understand how our bodily rhythms are involved in critical illness and our responses to treatment: issues that is to say with potentially important biosocial implications for medicine and society within and beyond these pandemic times of ours.
This then brings us to a fourth critical issue concerning the implications of these foregoing rhythmic matters for health inequalities both during and post-pandemic. Here we return to the previous discussions regarding the biological embedding and embodiment of social inequalities (Vineis et al 2016, 2020) and more broadly how social and environmental factors, including psychosocial stressors, ‘get under the skin’ as the saying goes. The pandemic as we know has further exposed and exacerbated health and social inequalities, particularly for Black Asian and Minority Ethnic (BAME) groups. Findings from the aforementioned Build Back Fairer: Covid-19 Marmot Review (Marmot et al. 2020), for example, have highlighted the contribution which inequalities in social and economic conditions before the pandemic have made to the unequal death toll from Covid-19 (see also Campos-Matos et al 2020). Again recourse to rhythms may be useful here as another vital piece of the biosocial jigsaw, particularly in light of the foregoing circadian hypotheses and the growing importance attached to circadian disruption of many different kinds (Vetter 2018, Foster 2017). To the extent, for example, that these social, economic and environmental as well as psychosocial factors are linked to differential levels of circadian disruption which in turn impacts both sleep and immune response (National Health, Lung and Blood Institute 2020), then this may in part explain differential risks of (severe) Covid-19 infection. Moreover, if timing of exposure and infection does indeed play a role here in relation to our circadian rhythms, then this may also put shift-workers, particularly night-shift workers, at increased risk in terms of Covid-19 as research is now beginning to show (Maidstone et al. 2020). Ageing too of course is another critical biosocial matter here on these rhythmic counts, including the complex intertwining of existing chronic illness conditions and co-morbidities, circadian desynchronization through ageing, stress and depression from social isolation in pandemic times, disruption to circadian rhythmicity through staying indoors during lockdowns or from shielding (i.e. less daylight exposure), impacts on the sleep-wake cycle (including melatonin production), and higher vulnerability to severe Covid-19 infection (Cardinali et al. 2020): relations which themselves once again are likely to be mediated by social and environmental circumstances and related factors such as active ageing across the life-course.
Here we arrive at a fifth and final set of issues regarding the political implications of these forgoing rhythmic matters. These rhythms of life, it is clear, are not just personal or private matters to do with the inner workings, hidden wisdom or even the ‘recalcitrant nature’ of our bodies. On the contrary, they are political matters through and through concerning these always already entangled relations between the biological and the social, pandemic related or otherwise. It is not simply a case on these counts of living in sync with these rhythms of ours through individual choice or lifestyle change. Nor is it simply a case of regulating, resynchronising or resetting these rhythms of life in the clinic or optimising the timing of all we do by knowing our chronotypes, however helpful this may be at the individual level. At stake here are a far wider set of social, structural and political matters do with life and living under late capitalism prior to, during and beyond the pandemic. What is required here then, in other words, is the brokering of a more bio or chrono-compatible time-order, including the institutional structures and schedules we currently live by under global capitalism. This also of course, returning to point four above, requires a concerted effort to tackle and reduce social and health inequalities so we may indeed begin to build back not just better but fairer after Covid-19 for a more equitable and healthy society (Marmot et al 2020). Upstream not just downstream matters, in short, of a social, economic and political nature.
As for the chances of more synchronised times ahead, two possible scenarios suggest themselves. To the extent for example that the pandemic has put us more in touch with these rhythms of life, even indeed in the case of those experiencing more or less extreme forms of biosocial arrhythmia and circadian disruption, and to the extent that chronobiology continues to gain traction in society post-pandemic, then we may indeed be heading in this more synchronised direction, albeit in a largely piecemeal fashion. If the pandemic too has enabled more flexible forms of remote working and schooling, then this may also translate to some degree at least into more enduring changes of this more flexible kind post-pandemic (Wolf-Meyer 2021). To the extent however that the economic fall-out from the pandemic demands and necessitates are return to pre-pandemic times ‘on steroids’ then any such brokering of a more bio or chrono-compatible time-order will remain a largely distant dream for many of us. Either way we glimpse here once again the political nature of these biosocial rhythmic matters both now in and in times yet to come.
Rhythms, to conclude, in these and countless other ways, are critical to thinking through the biosocial within and beyond these pandemic times. Vital matters for us all indeed as rhythmic beings through and through.
Simon Williams is Emeritus Professor of Sociology at the University of Warwick, UK. He is a medical sociologist whose work spans the body, health, sleep, technoscience and the biosocial, including his co-edited (2016) volume (with Meloni and Martin) Biosocial Matters: Rethinking Sociology-Biology Relations in the Twenty-First Century. His current work concerns the biopolitics of chronobiology in society and the rhythms of life itself.
Dr Catherine Coveney is a medical sociologist and Lecturer in Sociology at Loughborough University, UK. She has expertise in the social and ethical aspects of medicine and health care, with particular research interests in sleep, reproduction, chronic illness and sports medicine.
Rob Meadows is a Professor in the Department of Sociology, University of Surrey, UK. His research interests are located at the nexus of sleep, technology and recovery, including current projects on ‘making sleep’ and ‘making recovery’.
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