Epistemology and post-Covid

For some, Covid-19 has resulted in symptoms that last weeks or months after the infection. For others, such symptoms develop after a Covid-19 infection. This project investigates post-Covid as an urgent health challenge.

An interdisciplinary endeavor

The project 'Biomedicine, Clinical Knowledge, and the Humanities in Collaboration: A Novel Epistemology for Radically Interdisciplinary Health Research and Policy-Work on Post-Covid-19 Syndrome' sets out to develop a meta-epistemological framework for interdisciplinary health research and health care policy-work, focused on post-Covid syndrome. Given the complexity of this syndrome, the project starts from the understanding of interdisciplinary analyses of its meanings, expressions, implications and co-constituting factors as crucial for apt healthcare, societal response, and policy-making.

Past research on post-Covid has predominantly been clinical and biomedical. It has offered important descriptions of clinical presentations. While engaging with and contributing to these foci, this project expands and studies post-Covid as a biomedical, clinical, socio-political and embodied phenomenon. It engages with post-Covid also from medical humanities perspectives, i.e. from a field that has studied illness and medical practices from humanities and social science perspectives since the 1970s. Further, it offers an interdisciplinary approach than is still rare in medical humanities: it combines approaches from the humanities, social sciences, and clinical medicine, and neurosciences. The project offers analyses of post-Covid through a unique combination of perspectives from phenomenological philosophy of medicine and science, neurology, neuroradiology, neurobiology, rehabilitation medicine, intersectional theory, science & technology studies (STS), medical sociology and medical ethics.

Five subprojects

The project starts from the view that addressing Covid-19 and post-Covid can only be achieved through a framework that acknowledges that health problems are generated across a wide set of institutional contexts, including political and social contexts. Addressing post-Covid, then, requires an understanding of social contexts and embodied experiences of it, as well as clinical and biomedical investigations, and that these perspectives are brought into dialogue with each other – and are combined. The project provides this.

It approaches post-Covid as an urgent health challenge, engaging it as an opportunity to examine knowledge production about ill health in a richly contextualised way, while remaining open and, also, exploring causal frameworks. Following this trajectory, the notions and understandings of ill health and well-being are not understood as neutral, but as inextricably linked to the cognitive, methodological and institutional conditions under which they are constituted, in different epistemic fields. To grasp the complex roles of such conditions in producing knowledge about and responding to post-Covid, this project consists of five interrelated subprojects:

• Subproject 1 develops a meta-epistemological framework that examines how different epistemological perspectives and choices of methodologies impact on the understanding and production of a complex, emergent object of study such as post-Covid. It presents a framework for combined analyses to be used and fine-tuned in collaboration with subprojects 2-4. The framework is meta-epistemological in that it addresses practices of knowledge production and their underlying conditions of possibility.
• Subproject 2 examines post-Covid symptoms of fatigue with or without cognitive impairment through analyses that bring neuroscience perspectives (neurology, neuroradiology, neurobiology), rehabilitation medicine, and phenomenological philosophy into dialogue with each other. It specifically aims to understand experiences, characteristics, and pathophysiology of these symptoms.
• Subproject 3 examines post-Covid-19 syndrome as a diagnosis. It studies how this new diagnosis is made sense of by stake-holders such as patients and personnel in health care and at the Swedish Social Insurance Agency, with an eye for how clinical entities can be produced also by non-clinical institutions. It explores how patient rehabilitation needs change over time, and the possible recovery trajectory in post-Covid rehabilitation medicine – combining clinical, socio-cultural and philosophical analyses.
• Subproject 4 targets policy-work. It develops a novel model for the assessment of different kinds of knowledge production practices of relevance for health care policy-work, and applies it to post-Covid. It evaluates and fine-tunes this model together with people involved in policy-work who have agreed to test our model.
• Subproject 5 develops art-based research in collaboration with subprojects 1-4. Through art-based inquiry, it aims to contribute to the research process, visualises questions and results, brings them to a broad audience, and contributes to inventive research communication.

An Interdisciplinary Research Environment

The project is funded by the Swedish Research Council’s Research Environment Grant: Interdisciplinary Research, that aims to create opportunities for researchers to develop interdisciplinary research and research environments. This is crucial for the project: building on relatively new infrastructure through the Centre for Medical Humanities and Bioethics (established in 2020) at Linköping University, the research team engages in new interdisciplinary collaborations – that we see as much needed for the understanding of post-Covid.

The research team at Linköping University consists of researchers from four departments (two at the Faculty of Medicine and Health Sciences: the Department of Biomedical and Clincal Sciences, and the Department of Health, Medicine and Caring Sciences, and two at the Faculty of Arts and Sciences: the Department of Culture and Society, and the Department of Thematic Studies), and from Region Östergötland (the Department of Rehabilitation Medicine and the Department of Radiology).

The team also consists of colleagues at:

• Institute for Medical Humanities, Durham University (Professor Jane Macnaughton and Professor Angela Woods);
• l’Initiative Humanités Biomédicales, Sorbonne University;
• Dept of Medicine, Health and Society, Vanderbilt University,
• Dept. of Communication and Philosophy, Florida Gulf Coast University, and
• Dept of Social and Behavioral Sciences, the University of California, San Francisco.

Together with the Centre for Medical Humanities and Bioethics, the research team will develop an international Graduate School/Early Career Research Training. In this way, the research environment seeks to help strengthen and foster new generations in innovative, interdisciplinary health research.