The Politics and Perceptibility of Breath During the COVID-19 Pandemic

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The Politics and Perceptibility of Breath During The COVID-19 Pandemic

Vaibhavi Shah

Submitted to the Program in Science, Technology, and Society in Partial Fulfillment of the Requirements for the Degree of

Bachelor of Science

at the Massachusetts Institute of Technology

February 2021

The author hereby grants MIT permission to reproduce and to distribute publicly paper and electronic copies of this thesis document in whole or in part in any medium now known or hereafter created.

Signature of Author……………………………………………………………………………….... Program in Science, Technology, and Society Department of Biological Engineering January 15, 2021

Certified by……………………………………………………………………………………….... Robin Scheffler Associate Professor of Science, Technology, and Society Thesis Supervisor

Accepted by……………………………………………………………………………………….. Jennifer S. Light Department Head, Program in Science, Technology, and Society Bern Dibner Professor of History of Science and Technology Professor of Urban Studies and Planning 2

Introduction

I tie up my shoes and pick up my bag from the bench beside me, making sure my phone is securely zipped up. I put my earbuds in and head out the door, running for five minutes before realizing something was wrong. I was not out of breath yet. I quickly scanned to see if others were close by—were they more than 6 feet away? Could my dangerous breath make its way towards them? Would they throw disgusted scares at me? What if I was breathing in unclean air while I was stopped here lost in thought? Panicked, I turned around and ran back to my house, picking up a crucial component for my run that I forgot—my mask. Mask on, I continued on the run, feeling the reassuring shortness of breath that ironically reminded me that my ability to breathe was protected.

This stressful change in my average running routine is one example among many of how the

COVID-19 pandemic has reshaped the routine components of our lives in ways that are both profound and mundane. Anyone caught up in the events of the past year can attest to the host of adjustments that have been incorporated into their daily routines. Our workspaces have changed from organized cubicles to temporary setups on kitchen tables, grocery store visits are more dangerous than a simple errand should be, and lunch outings with friends are not the carefree rendezvous they once were. The adaptations that we, as individuals living through the pandemic, make to our lives center on protecting our breath and the air around us, in the present and for the future.

Naturally, this everyday experience and the approaches taken to make these routine adaptations differ across countries, cultures, and communities. Yet with all of the changes I both experienced

3 and noticed going on around me during the pandemic, I saw that there was one central consistency. A renewed focus on the air that we breathe. SARS-CoV-2 relies on breath for its transmission, and as the COVID-19 pandemic has spread, a conversation has spurred around the conscious consideration of breath. We have come to understand that SARS-CoV-2 spreads through our breath, and this awareness has made the simple action of inhale and exhale, an intensely scrutinized part of our everyday lives. The choices we make to wear masks around others, distance ourselves from our friends and strangers, and if need be, rely on a ventilator or piece of assistive technology are done to ultimately preserve this act of breathing. Around the world and in the United States, the importance of breathing, as well as the inherent right to breathe, has become a focus of social, political, and technical debate.

Breath is not an abstract concept. Air can be felt as we take breath, we can see it in some cases if it is cold enough, and we can resultantly generally understand what the consequences of its absence are. While breath can be measured through tests such as spirometry or pulse oximetry, documenting rates of inhalation/exhalation and oxygen saturation levels, these tests often confirm physical changes in our breathing patterns that are observable, such as a significant

1 shortness of breath for instance. If something is wrong with our breath, these tests confirm what we can already feel. And because of this, only in extenuating circumstances do we feel the true weight of its absence.

1 What Kind of Lung Function Tests Are There and What Do They Involve?, InformedHealth.Org [Internet] (Institute for Quality and Efficiency in Health Care (IQWiG), 2016), https://www.ncbi.nlm.nih.gov/books/NBK355303/.; “Pulse Oximetry | Johns Hopkins Medicine,” accessed January 9, 2021, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/pulse-oximetry.

The COVID-19 pandemic has transformed air and breath into a central player in the political, social, and economic response to the pandemic. This shift of breath, from an invisible and ubiquitous part of our lives to a centerpiece, comes with a corresponding shift in how we treat breath. This progression from an invisible to a tangible object, and the political and social consequences thereof, is something STS scholar Michelle Murphy has described through her concept of regimes of perceptibility. She defines these regimes as environments in which objects,

2 in this case breath, can be manipulated and further defined to meet certain goals. With the existence of the COVID-19 pandemic in the United States, our right to breathe has been treated as an object—a physical artifact—that can be regulated. This new understanding of breath has raised social and political debates, both old and new ranging from anti-mask movements to widespread denial of climate change and urban pollution. These debates have underlined the importance of access to clean air in the community, and they have been amplified by the spread of COVID-19. Instead of being an invisible process, something instinctual and otherwise unimportant, breathing has become a conscious action fraught with consequence.

Since COVID-19 is what brought me to this realization about breath, through this thesis I primarily aim to explore the progression of these debates more intimately in regard to this recent pandemic in the United States—how has breath and the ability to breathe clean air become an object subject to the influence of political, social, and economic considerations? While this conversation has become increasingly prevalent with the COVID-19 pandemic, it is by no means a unique issue in history. Breath has been a point of contention and of relevance in arguments surrounding past examples of social considerations and health, from pollution to racial justice

2 Michelle Murphy, Sick Building Syndrome and the Problem of Uncertainty : Environmental Politics, Technoscience, and Women Workers (Duke University Press, Durham, 2006), 24.

5 movements. My goal with this thesis is to explore the progression of breath in context of similar historical parallels where breath has also been at the forefront of relevant conversations, in addition to interspersed and separate discourse related to the COVID-19 pandemic itself. I hope to illustrate these parallels through a case study approach where I detail pertinent historical themes of breath shifting from a pure to a dangerous force, from an intangible to a tangible object of conversation, and from a communal to an individualized commodity. These themes will demonstrate how these shifts may have further contributed to breath becoming jeopardized due to external political, social, and economic forces.

The first case study will explore indoor spaces that have historically harbored “dangerous air” and how the treatment of these spaces has varied over time. This exploration will be done by detailing the application of miasma theory to residential spaces, the concerns about industrial workplace health with sick building syndrome, and the current work and study from home movement during the COVID-19 pandemic. The second section will explore the intertwined history of environmental justice and the civil rights movement and how urban pollution has contributed to racial inequities in health outcomes. This will be connected to the recent intersection of racial justice and breath, when breath became a stark political and social force with the “I Can’t Breathe” protests over the Summer of 2020. The last case study will be centered around the regulatory landscape surrounding secondhand smoke in the United States, and it will explore how the individualization of breath harnessed during the enactment of tobacco laws persisted during the anti-mask protests during the COVID-19 pandemic. These cases will be followed by a deep-dive into the COVID-19 pandemic that focuses on how breath has progressed with the transmission of SARS-CoV-2. The guiding questions that I anticipate exploring are:

What are historical parallels in terms of the politicization of breath? How has the concept of breath progressed over the duration of the COVID-19 pandemic in the United States? How have the various stages of the pandemic related to the concept of breath?

Case Study: Indoor Spaces with Bad Air

The onset of the pandemic helped establish a new priority for many: the reevaluation of the potential dangers of the workplace or schools from a ventilation, and more broadly, air circulation standpoint. Concerns arose about the compromise of individual health in these enclosed indoor spaces due to stagnant and bad air. These concerns create a divide between two types of workspaces: those that could be moved to a remote environment and those that could not. Thus, a flood of individuals was sent away from their respective “office” to work from home, except for workers whose occupations were deemed essential enough to warrant the significant health risk. For the vast majority of students and employees though, the workplace became a dangerous place—filled with compromised, sinister air. To preserve their right to breathe clean air, individuals stayed within their residences or in other private spaces, making their own clean, personal office space to escape the perils of the workplace.

The residential environment was renewed as a space with the comforts that a domestic space would traditionally contain, coupled with characteristic aspects of a working environment such as productivity and structure. This odd mix, while novel when compared to the modern widely accepted mindset of separating work and personal life and drawing a line between where serious and non-serious activities take place, is evident in past situations. The shift to a remote location, away from crowded spaces and urban centers, and thus a presumably safer office or work setting, is reminiscent of historical situations where air has been deemed as compromised in public spaces. Thus, this case study aims to explore the technical basis of unsafe air in enclosed spaces and how transmission of bad air in public settings has varied over time. Particularly, the goal of this section is to assess how the right to clean air in closed spaces has been subject to political

8 debates and how this bears similarity to our current scenario in light of the COVID-19 pandemic.

Specifically, is the concern around bad air accompanied with government intervention or is responsibility left to individuals? And does the change in composition of sinister air over history affect this relationship?

A Reassessment of Indoor Spaces Using Miasma Theory

The connection between the environment that one spends much of their time in with the quality of individual health is not an idea exclusive to modern times. Perhaps the most familiar example of the dangers of bad air from an infectious disease standpoint is the theory of miasma. Miasma is a theory that attributes contagious disease transmission to the prevalence of dust or particles

3 from rotting corpses and waste in the air. In miasma theory, the carrier of the dangerous particles is air itself, analogous to current airborne diseases that carry similar invisible agents such as viruses or pathogens through the air. The sinister air is composed of these dangerous particles that can contaminate indoor spaces and spread between locations, further enveloping these spaces in a veil of harmful substances. This foundational understanding of the spread of dangerous air defines miasma theory regardless of fluctuations in the theory over time. Despite the cloud of uncertainty surrounding the technical details of miasma, the overarching theory provided a means to reevaluate indoor spaces. The word miasma itself gave birth to the name of

4 malaria for instance, which directly translates to “bad air” in Italian. This shows how much of

3 John M., ed., A Dictionary of Public Health, A Dictionary of Public Health (Oxford University Press, 2007), https://www.oxfordreference.com/view/10.1093/acref/9780195160901.001.0001/acref-97801951 60901. 4 “Malaria | Definition of Malaria by Merriam-Webster,” accessed January 9, 2021, https://www.merriam-webster.com/dictionary/malaria.

9 the theory, setting aside its scientific validity, centers around the concept of air and transmission through air.

The classic example of miasma theory that is related to the spread of a pandemic is the Black

Death. The Black Death was primarily transmitted by rats in trading ships that made their way to

5 the homes of working class merchants and other enclosed spaces in medieval Europe. This vector coincided with the presence of tiny and cramped homes, that were low on the scale of cleanliness, making this infectious disease a natural historical parallel to the way workplaces are

6 treated in light of the COVID-19 pandemic. These grimy and condensed living conditions contribute to the theory of miasma, and thus perpetuate beliefs that certain aspects of the

7 environment play a crucial role in creating “bad air”. These preexisting ideas that individuals harbor of what conditions can contribute to pandemic-like circumstances come into play with the

COVID-19 pandemic. This sets the stage for future arguments pertaining to how we, as average citizens, interact with our environment, and how this in turn impacts public health, especially as it relates to the workplace and common areas that are shared by many.

The gradual shift in the credibility of miasma theory is similar to the way individuals of society perceive and deal with the influx of scientific information during the COVID-19 pandemic.

Dating back to ancient Greece, miasma theory remained widely accepted and acknowledged into the wake of the 19th century, providing a relatively modern point of comparison for the current

5 Fernanda Ferreira, “Plagues of the Past,” Science in the News (blog), December 31, 2014, http://sitn.hms.harvard.edu/flash/special-edition-on-infectious-disease/2014/plagues-of-the-past/. 6 John Aberth, The Black Death: The Great Mortality of 1348-1350: A Brief History with Documents, The Bedford Series in History and Culture (Palgrave Macmillan US, 2005), https://doi.org/10.1007/978-1-137-10349-9. 7 Melanie A Kiechle, Smell Detectives: An Olfactory History of Nineteenth-Century Urban America, 2017, 53.

10 state around bad air and unpleasant spaces in the work environment. For instance, during the cholera epidemic in the United Kingdom, the tension between miasma and dissenting theories about disease transmission featured debates including scientific figures such as John Snow.

Snow challenged the existing political and social norms in place that allowed miasma theory to dictate widespread public health recommendations by asserting that contaminated water, rather

8 than contaminated air, was the primary danger. Since miasma theory was the status quo ideology of the time, individuals stuck to the breath centric lens of viewing the cholera epidemic, stunting the entry of new scientific information, such as the facts regarding water pipeline infrastructure that Snow presented that challenged these preexisting views. The opposing scientific ideas provided by Snow’s evidence surrounding contaminated water was neglected and not readily accepted by the majority, until the latter half of the 19th century when this theory gained more traction after the public health crisis had passed. The hesitancy to incorporate new scientific information into public consideration is a social consequence that has reemerged with the COVID-19 pandemic, with both early uncertainty around public health recommendations of mask wearing and distancing, continued doubt surrounding the transmission of the virus in enclosed spaces, and particularly the role of surface contact versus airborne transmission. This uncertainty then paves the way for popular dissent against imposed restrictions, shadowing scientific fact under a cloud of doubt.

Thus, even though the scientific basis of miasma is contestable over time, it was able to make a direct line connecting dirty, polluted spaces and increased prevalence of contagious disease. This connection stimulated an improvement of sanitary standards in sewage treatment, road

8 Stephen Halliday, “Death and Miasma in Victorian London: An Obstinate Belief,” BMJ : British Medical Journal 323, no. 7327 (December 22, 2001): 1469–71.

11 pavements, and general ventilation standards, setting precedents for how city dwellers regarded the treatment of clean spaces and spaces that might be compromised in terms of hygiene. In a sense it set the stage for these residents to imagine that a closed and tight place could foster infectious diseases and helped unwillingly guide cleaning standards for surfaces and air purification. It established a loose correlation between the conditions of a place to the potential health danger that it can bring. This change is marked by sweeping changes in infrastructure and other staples of urban planning such as architectural design, preserving these ideologies long

9 after the prevailing scientific debate of the time has passed out of the public eye. These guidelines for common or public spaces evolve with shifts in scientific debates, setting a precedent for how workspace construction can follow the flux of public health considerations.

Miasma set the stage for some of these infrastructural changes to take place and allowed buildings to be constructed with consideration of these aspects of air circulation in mind.

However, while it did upend poor hygienic practices and construction standards that were detrimental to health, this change was not fully encompassing. Later in history, the question of unsuitable building standards came up again with the concern around building construction in the

United States.

9 Dom Litter, “HOW CHANGING HYGIENE STANDARDS COULD SHAPE OFFICE DESIGN,” Designerati (blog), 2020, https://designerati.co.uk/how-changing-hygiene-standards-could-shape-office-design/, https://designerati.co.uk/how-changing-hygiene-standards-could-shape-office-design/.; Jordan W. Tappero and Robert V. Tauxe, “Lessons Learned during Public Health Response to Cholera Epidemic in Haiti and the Dominican Republic,” Emerging Infectious Diseases 17, no. 11 (November 2011): 2087–93, https://doi.org/10.3201/eid1711.110827.

Sick Buildings and Interior Air Health

The concept of enclosed common spaces and their containment of bad air was central when dealing with concerns around ventilation and building construction in the 1980s. Sick building syndrome encompasses any related health ailments that impact an individual that can be traced back to the construction and standards of a specific building that an individual resides and spends

10 time in, most commonly their workplace. This wave of “sick buildings” that negatively impacted health was brought about in part by the use of dangerous chemicals, synthetic materials, and other hazardous materials in building construction, causing a host of underlying

11 health issues for workers. This incited not only widespread protests, but also a persistent dissatisfaction with the workplace and the restricted space where workers were expected to spend much of their time at. This bears resemblance to the current situation with the COVID-19 pandemic, where there was a mass exit from the workplace and educational institutions out of fear of indoor spaces. This exit, while supported by science, was driven by an overwhelming feeling of panic among the general populace in the face of unknown dangers that the novel coronavirus could bring in these spaces.

The technical details underlying ventilation standards that are related to this feeling of overwhelming panic, are relatively straightforward. Inside air is replaced with outside air (which is presumed to be cleaner, although given areas of high pollution this is not necessarily always the case) at a fixed velocity that best accommodates the cleanliness standards of the workplace.

10 Sumedha M. Joshi, “The Sick Building Syndrome,” Indian Journal of Occupational and Environmental Medicine 12, no. 2 (August 2008): 61–64, https://doi.org/10.4103/0019-5278.43262. 11 Murphy, Sick Building Syndrome and the Problem of Uncertainty : Environmental Politics, Technoscience, and Women Workers, 3.

In the early 20th century, these buildings were regulated such that 15 cubic feet of outside air had to be filtered through the building per minute, replacing the indoor air. However, this standard was adjusted in the latter half of the century to 5 cubic feet per minute. This change, while quantitative and exact in nature, was not prompted by evolving scientific evidence or improved equipment. Rather, in the wake of the oil embargoes of the 1970’s, excessive energy use was

12 discouraged, and corporations were urged to preserve energy where they could. This push for wide scale energy conservation incited a host of changes that directly impaired indoor air quality in workspaces, including “air-tight” indoor spaces and open-floor plans that lacked appropriate ventilation between neighboring workstations.13

This shift in regulations shows how compromises in air quality and the cleanliness of the air one breathes becomes a tangible object that is subject to the back and forth of external political factors. This indoor ventilation standard was once again raised after pushback from parties concerned about the health and safety of workers, again subjecting regulations to social pressures

14 rather than concrete scientific information. The inherent fluidity of science in this situation and the willingness to adjust engineering standards according to political, economic, and social motives is a longstanding tradition in American history that continues through to current times with the COVID-19 pandemic.

12 “Indoor Air Fact No 4: Sick Building Syndrome” (United States Environmental Protection Agency, 1991), https://www.epa.gov/sites/production/files/2014-08/documents/sick_building_factsheet.pdf. 13 Guiseppe Ryan Passarelli, “Sick Building Syndrome: An Overview to Raise Awareness,” Journal of Building Appraisal 5, no. 1 (July 1, 2009): 55–66, https://doi.org/10.1057/jba.2009.20. 14 “Indoor Air Fact No 4: Sick Building Syndrome.”

In these 19th century New York City sick buildings, urban residents were increasingly put at risk due to the low sanitation and chemical use standards, as well as the foul odors present that quickly became associated with direct danger to one’s health. These sanitation arguments were built on a rudimentary understanding of how health was being compromised by the urban environment, but it was clear that some form of danger was present, causing public health

15 uproars in the city. In these situations, the contrast between the foul-smelling workplace and perhaps cleaner suburban or residential air was stark. The workplace was often constructed with synthetic carpets and furniture that accentuated these foul odors by the release of volatile organic compounds (VOC’s). In contrast to miasma theory, which defined bad air as air filled with rotting organic matter particles, with sick building the prominent contaminants have shifted primarily to chemical materials. These compounds combined with hydrogen sulfide, formaldehyde, and carbon monoxide in the air and served as the primary cause of noticeable foul

16 odors in enclosed spaces. This combination of chemicals circulating through the air created the pollutant that required a reevaluation of indoor air quality on a microscopic level.

Maintaining Pure Air During the COVID-19 Pandemic

While this distinction between clean and foul air may not be so obvious to the olfactory sense with the COVID-19 pandemic as it was for noxious chemical fumes in the 1980’s, the “foulness” of the air in workplaces, enclosed areas, and urban spaces lies on a more subtle, molecular level.

Here the definition of the invisible danger has shifted once again from rotting matter to chemical

15 Kiechle, Smell Detectives, 21–52. 16 Diana M. Ceballos and Gregory A. Burr, “Evaluating a Persistent Nuisance Odor in an Office Building,” Journal of Occupational and Environmental Hygiene 9, no. 1 (2012): D1–6, https://doi.org/10.1080/15459624.2012.635131.

15 reagents to finally biological viruses that can be transmitted swiftly through the air, polluting enclosed spaces despite the ventilation infrastructure in place.

The uncertainty behind scientific information regarding the spread of COVID-19 further worsens the contamination of these indoor spaces. The Environmental Protection Agency suggests that the rate of ventilation (i.e velocity) should be directly proportional to the number of individuals

17 in a space. This need for excessive ventilation comes not only from the risk of COVID-19 particles in the air, but also the increase of heavy-grade sanitation products such as cleaning fluid

18 that can cause skin and respiratory irritation as well. While deep sanitation of surfaces was suggested in the early days of the pandemic, the Centers for Disease Control and Prevention

(CDC) in the United States reversed this stance and noted that the primary spread of

SARS-CoV-2 was through person to person aerosol transmission rather than contact with

19 contaminated surfaces. This shift in CDC guidelines shows the underlying uncertainty in many of the scientific details regarding the SARS-CoV-2 virus. This uncertainty makes it difficult for individuals to trust the changing scientific information, as many establishments and households are still focusing on sanitizing surfaces excessively despite evidence that suggests other measures are more effective. This obsession with sanitizing reflects many of the sentiments still left over from the times where miasma theory prevailed, when there was a particular emphasis on hygiene and visible cleanliness. The holistically increased risk, from both the virus and ironically the

17 “Ventilation and Coronavirus (COVID-19),” Collections and Lists, June 18, 2020, https://www.epa.gov/coronavirus/ventilation-and-coronavirus-covid-19. 18 “Cleaning Supplies and Household Chemicals,” accessed January 9, 2021, https://www.lung.org/clean-air/at-home/indoor-air-pollutants/cleaning-supplies-household-chem. 19 Mike Ives and Apoorva Mandavilli, “Covid Indoors: Scrubbing Surfaces Does Little to Mitigate Threat - The New York Times,” accessed January 9, 2021, https://www.nytimes.com/2020/11/18/world/asia/covid-cleaning.html.

16 agents that are used to combat the spread of the virus, carry potentially dangerous consequences for individuals in closed spaces characteristic of office and educational settings.

The potential dangers of the air contained in a working environment spurred the development of a mindset where individuals felt uncomfortable and endangered to remain as they were in the office. Instead of a personal, pristine location, the office space instead became a detached venue with lurking dangers (primarily the invisible viral particles at this point in time). While this has gradually transitioned to a more subdued and subtle danger in traditional office settings, especially compared to the noxious fumes of the past, it has still had a substantial hidden impact on human health with the COVID-19 pandemic. Although due to different hazards, in the past months the workplace has once again become a place of peril and danger. Now, the hidden toxin in these buildings is primarily the air that fills them—not old organic material, carpets, paint, or other physical elements. This air can carry virulent particles or may serve as a mediator for these particles to begin travelling through. In some cases, this risk has been deemed high enough for groups of workers and students to be sent home, and create a new working environment in a building and residence that is less sick. For others, this redefined sick building is deemed a necessary risk and workers are expected, either due to the gravity of their work or the specifications of their job requirement, to remain in this hazardous environment through the course of the pandemic.

As some individuals have transitioned their work environment to a home setting, the fundamentals of miasma theory subtly come back in the overarching ideas that are harbored when seeking out a safe space. In contrast to the perhaps more crowded and concentrated

17 workplace environment, normative home offices are likely sparsely populated (by only one individual or members of the same familial unit) and have a more open space. This new setting provides a space where the user controls the environment, enabling the creation of a safer indoor space, far from others and in isolation. This control, whether it takes the form of more sophisticated and safer ventilation systems or simply the ability and freedom to crack open a

20 window has created a new setting. This setting is marked by the productivity and tasks of an urban, office environment, mixed with the generally guaranteed clean air of a home environment.

This idealistic setting contrasts the archetypal examples that perpetuate “bad air”—cramped and crowded, made for functionality and not for comfort and safety. The emphasis on the circulation and sharing of dangerous air then becomes less of a concern.

Instead, the workplace has evolved beyond the constraints of the polluted walls they were once defined by, and have now assumed a variety of different settings, including the outdoor space, as is the case with the restaurant and entertainment industry. The relocation of workplace settings is somewhat unprecedented and goes to show the implications of dangers within buildings on the health of individuals. Now, the power of creating a workplace setting seems to be largely in the hands of the employee, where they can now dictate crucial factors related to their health. Factors such as sanitation and air quality are directly up to the individual, providing them a semblance of autonomy over the conditions they spend their time in. From purchasing HEPA (high-efficiency particulate air) filters that can capture at least 99.97% of airborne particles to obtaining variations of the famed N-95 respirators that can create a tight seal on the face, individuals can take

20 WHO’s Science in 5 on COVID-19 - Ventilation (World Health Organization, n.d.), https://www.youtube.com/watch?v=XJC1f7F4qtc&feature=youtu.be.

21 hospital-grade precautions in their personal environment. In a sense, this gives one direct modulation over the air they breathe, ensuring especially with a respiratory disease, that the air surrounding them is clean and safe. This creates the notion that because one has control over the air that only they are breathing, it is very much an individual right that is to be protected for oneself rather than a preserved common good. This individualization separates the community aspect of office spaces and buildings that are integral in the social sense, but in doing so it reduces a semblance of social and logistical dependency and allows individuals to control how

(and what) they breathe.

In contrast to the earlier debates surrounding miasma and indoor construction standards, which were subject to EPA standards and governmental regulations, work from home shifts responsibility from a central authority, such as an employer or landlord, to the individual. The contrast of personal control of one’s environment with earlier instances of miasma theory is directly related to the interplay of the shift to individual responsibility from a time of government regulation in urban health. Miasma theory and the fear of a noxious vapor bringing a host of diseases with it incited a series of government driven regulations, including better ventilation, aqueducts for sewage diversion, and even large scale landscape projects in urban areas to help

22 mitigate the risks that came with these foul clouds of air. This demonstrates how the concept of miasma, and the imminent fear of bad air that it brought about was characterized by a

21 Cory Stieg, “How Using an Air Purifier in Your Home Can and Can’t Prevent the Spread of Covid-19,” CNBC, October 4, 2020, https://www.cnbc.com/2020/10/04/do-portable-hepa-air-purifiers-protect-you-from-covid-19.ht ml ; “N95 Respirators, Surgical Masks, and Face Masks,” FDA, December 3, 2020, https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/n95-respir ators-surgical-masks-and-face-masks. 22 Christopher Klein, “How Pandemics Spurred Cities to Make More Green Space for People,” HISTORY, 2020, https://www.history.com/news/cholera-pandemic-new-york-city-london-paris-green-space.

19 government response that aimed to amend the root causes of poor urban health through infrastructural change.

As the new academic year approached amid the COVID-19 pandemic in the United States, the question of individual responsibility in occupational safety re-emerged surrounding the reopening of academic institutions. While scientific advice still suggested that remaining in a work from home setting was the safest option, individuals took it upon themselves to invoke social and economic arguments warranting a return to educational centers. Historically, the Open

Air School Movement bears resemblance to the reopening schools situation with the COVID-19 pandemic. In the early 20th century in Britain, individuals began raising concerns over the quality of air that students in industrial areas were breathing, particularly while in school. Social observations made by citizens such as which schools (urban or rural) had smarter students, attendance trends among students contracting infectious diseases, and other sanitary concerns inspired by miasma theory once again, drove a scientific assessment of air quality in these spaces and tangible changes that could be made. Key players at the time such as Dr. W. L. Mackenzie and Dr. Cantlie urged citizens to place an emphasis on clean air in educational spaces, inciting an improvement to ventilation standards in schools and motivating the Open Air School concept.23

This historical example of social pressures pushing infrastructural changes in education spaces is a concept that has been repeated with the COVID-19 pandemic. When the question of whether schools should reopen emerged, groups pushed for a large-scale reopening of institutions, citing social, political, and economic arguments. These pressures overtook the science of the time,

23 David Hughes, “Just a Breath of Fresh Air in an Industrial Landscape? The Preston Open Air School in 1926: A School Medical Service Insight,” Social History of Medicine 17, no. 3 (December 1, 2004): 446–48, https://doi.org/10.1093/shm/17.3.443.

20 which demonstrated that many schools, including two thirds of elementary schools in

Philadelphia, did not have the minimum viable ventilation systems in place to safely hold

24 classes. This provides a contrast to earlier instances described regarding occupational health in the workplace, where workers overwhelmingly resisted going back to work environments that lacked the 15 cubic feet per minute ventilation standard. This shows how the same technical details and scientific fact can be cited or ignored, to fit the prevailing agenda of the time.

A workplace or office setting is where individuals spend a large part of their day if their job requires it. If this space is found to be endangering the air that they breathe, some type of change is warranted. The manner by which this change has been made over time has surely been tied to political context, and evidently this has manifested itself in a shift of responsibility over time from government regulation and guidance to an individual level, especially with the COVID-19 pandemic. Initially, the theory of miasma served as motivation to improve urban conditions in light of the bad air that seemed to be rampant in crowded homes and indoor spaces. But gradually, as the popularity of miasma theory declined, indoor air began being evaluated in the context of new contaminants of interest aside from rotting organic matter, such as chemical hazards in sick buildings and biological hazards such as viruses. The way these contaminants are understood on a technical level allow for practical adjustments such as sanitation guidance, shifts in indoor organization, and regulatory measures. And while uncertainties in technical understanding can limit the efficacy of these changes, they are made with individual health in mind as a top priority.

24 Dale Mezzacappa, “Just One Third of Elementary Classrooms in Philly Meet Minimum Ventilation Standards,” WHYY (blog), 2020, https://whyy.org/articles/philly-parents-asked-to-make-school-return-decision-with-incomplete-c onfusing-info/.

Case Study: I Can’t Breathe, Pollution, & Racial Justice

The COVID-19 pandemic not only brought about respiratory considerations in the traditional sense, but also came with a resurgence of breath as it relates to political and racial justice during the summer months. George Floyd, a 46-year-old individual in Minnesota, was arrested after using a counterfeit bill at a convenience store. One of the police officers involved in the arrest,

Derek Chauvin, placed his knee on George Floyd’s neck for seven minutes and 46 seconds, until

25 Floyd could no longer breathe. Floyd’s death was an example of how breath can be unjustly snatched from someone. With the death of George Floyd, the phrase “I Can’t Breathe” underwent a tragic resurgence, becoming the rallying cry of a host of protests and conversations during the summer of 2020.

While the concept of preserving our breath and ensuring the air we breathe is clean has made a resurgence with the COVID-19 pandemic, the idea that breathing is a matter of racial justice has been discussed for the past generation with growing force. Particularly, I want to point out the restriction of breath as it relates to environmental pollution. Pollution and arguments about environmental justice throughout history have served as a launching pad for discussion on the restriction of civil rights, policing, and the systemic racial inequalities in healthcare accompanying COVID-19. With the COVID-19 pandemic, the inability of vulnerable populations to breathe due to pollution was compounded by not only respiratory distress from the novel coronavirus, but also instances of systemic racism. The racial inequities due to environmental pollution were thus further exacerbated by events surrounding police brutality

25 “George Floyd: What Happened in the Final Moments of His Life,” BBC News, July 16, 2020, sec. US & Canada, https://www.bbc.com/news/world-us-canada-52861726.

22 during the summer of 2020. This in turn sparked a wave of counter protests which harnessed breath related arguments from an All Lives Matter and anti-mask standpoint. The objective of this section is to trace the phrase “I Can’t Breathe” in context of a history of environmental justice and pollution, the death of George Floyd, and anti-mask protests during the COVID-19 pandemic.

Environmental Justice and Racial Equality

With the consistent increase in industrialization through the 20th century, pollution levels worsened, endangering lives, and particularly those lives concentrated in urban areas. As mentioned in the discussion on miasma theory in the prior section, this urban pollution focuses the brunt of negative environmental impact on vulnerable populations in city centers, which can often correlate to individuals of a particular socioeconomic status or racial identity. Because of the disproportionate impact of climate change and pollution on minorities, the relationship between racial justice and environmental justice as social movements has been deeply intertwined. Prominent figures such as Representative John Lewis, referred to the close relationship of environmental justice and civil rights, as a means to guarantee clean air as a “right

26 of all, not a privilege for a few”. This quote shows how the ability to breathe safely is treated as a benefit rather than a guaranteed right. This differentiation allows for inequities due to environmental conditions to perpetuate, causing certain racial groups to be particularly vulnerable to environmental dangers. This contributes to the larger concept of environmental

26 Luke Cole and Sheila Foster, From the Ground Up: Environmental Racism and the Rise of the Environmental Justice Movement (New York University Press, 2001), 21, https://jasonwmoore.com/wp-content/uploads/2018/07/Cole-and-Foster-From-the-Ground-Up_- Environmental-Racism-and-the-Rise-of-the-Environmental-Justice-Movement-2001-NYU-Press. pdf.

23 racism, where social and structural patterns place particular racial groups at a higher risk for receiving the negative impact of air pollution and climate-induced health perils.27

The intersection between climate activism and racial justice, extended to religious spheres as well, particularly with the United Church of Christ. The Commission for Racial Justice of the

United Church of Christ, a Christian civil rights activist group, released an environmental report

28 in 1987 detailing the effects of environmental racism. This further connection shows how deeply entrenched the history of environmental justice is with other social and religious activist groups involved in the civil rights movement, demonstrating that the race-based health inequities related to breath are by no means a new phenomenon.

The collaborative effort between the environmental justice and civil rights movements constructively led to policy changes in both domains. The rapid decline of environmental conditions was somewhat stunted by the passage of the Clean Air Act in 1970 which, informed

29 by scientific and technical details, was able to mitigate regions of especially dense smog. In this instance, government-level action was able to induce change across the nation, serving as a mandate to protect individuals, irrespective of their personal identity or background. Here, policy change directly impacts whether the air an individual breathes is clean. Thus, the ability to maintain clean air and the right of one to breathe this clean air was inherently politicized due to

27 Cole and Foster, 54. 28 Courtney Bernhardt, Keene Kelderman, and Ben Kunstman, “‘Breath to the People’ Sacred Air and Toxic Pollution: A Report Prepared for the United Church of Christ on 100 Super Polluters in Populated Areas across the U.S.” (United Church of Christ, n.d.), https://d3n8a8pro7vhmx.cloudfront.net/unitedchurchofchrist/pages/24840/attachments/original/1 582721312/FINAL_BreathToThePeople_2.26.2020.pdf?1582721312. 29 OAR US EPA, “Clean Air Act Requirements and History,” Overviews and Factsheets, US EPA, May 27, 2015, https://www.epa.gov/clean-air-act-overview/clean-air-act-requirements-and-history.

24 this government act. The Clean Air Act made something non-political (the science surrounding climate change and environmental pollution) an object to be regulated by political players. Since the science of environmental pollution is tied to the quality of the air that we can breathe, it has made breath an object that can be targeted along partisan lines, convoluting straightforward scientific facts. This type of sweeping high-level environmental regulation has continued to be subject to political influences, with concerns about divesting away from fossil fuels or even acknowledging human contributions to air pollution as a legitimate concern, being significantly

30 divided along partisan lines. This divide shows how maintaining clean air is an endeavor that is subject to political and economic pressures rather than resolute scientific fact. The readiness of

American politicians to deny clean air in the environment to groups from disproportionately

Black and other minority communities reiterates the argument that Representative John Lewis made that breath is indeed a privilege.

The contention that environmental protection and pollution reduction is a political rather than factual argument also politicizes the right to breathe, considering that in this case clean air is not treated as a baseline to be preserved but rather as an amenity to be earned. Pollution has hampered the ability of individuals to breathe clean air over the years, and often the same science-denying politicians prominent during the COVID-19 pandemic were the ones that have been ignoring the effect that pollution has had on human health. Letting human contributions towards pollution and its effect on public health become a political issue has disproportionately affected select populations, with studies showing that poor communities and communities of

30 Riley E. Dunlap, Aaron M. McCright, and Jerrod H. Yarosh, “The Political Divide on Climate Change: Partisan Polarization Widens in the U.S.,” Environment: Science and Policy for Sustainable Development 58, no. 5 (September 2, 2016): 4–23, https://doi.org/10.1080/00139157.2016.1208995.

31 color are the most susceptible to negative impact from air pollution. Black Americans are 52%

32 more likely to live in regions with high-risk pollutants. This structural inequity brings new meaning to the phrase “I Can’t Breathe”. These individuals that live in industrial centers, rather than suburban communities, are constantly surrounded by high levels of dirt and traffic, both of

33 which contribute to unhealthy air quality. This constant exposure detracts from the quality of air these groups are able to breathe, and inherently drives a wedge between these individuals and groups in less polluted regions. The air they breathe is different, not as pure as the air more privileged groups have access to, making these populations inherently unequal. These inequities breed the creation of the preexisting conditions that allow the COVID-19 pandemic to affect

34 certain populations more than others. The invisible killer (SARS-CoV-2) joins other existing invisible killers in the air such as particulate matter and dust from factories. These existing pollutants together cause higher rates of respiratory and cardiovascular complications, leading to comorbidities and preexisting conditions that have been in turn linked to poorer outcomes after contracting COVID-19.35

31 Isabelle Chapman and Drew Kann, “For Some Environmentalists, ‘I Can’t Breathe’ Is about More than Police Brutality,” CNN, accessed January 9, 2021, https://www.cnn.com/2020/06/27/us/environmental-racism-explainer-trnd/index.html. 32 Luis Magana, “Environmental Activism Has a Racial Blind Spot. The Science Shows the Fallout.,” NBC News, 2020, https://www.nbcnews.com/science/environment/why-i-can-t-breathe-resonating-environmental-j ustice-activists-n1228561. 33 Laura Pulido, “Rethinking Environmental Racism: White Privilege and Urban Development in Southern California,” Annals of the Association of American Geographers 90, no. 1 (March 1, 2000): 32, https://doi.org/10.1111/0004-5608.00182. 34 Nancy Krieger, “ENOUGH: COVID-19, Structural Racism, Police Brutality, Plutocracy, Climate Change—and Time for Health Justice, Democratic Governance, and an Equitable, Sustainable Future,” American Journal of Public Health, no. 110 (2020): 1620–23, https://doi.org/10.2105/AJPH.2020.305886. 35 Jonathan Lambert, “Study Finds Racial Gap Between Who Causes Air Pollution And Who Breathes It,” NPR.org, 2019, https://www.npr.org/sections/health-shots/2019/03/11/702348935/study-finds-racial-gap-betwee n-who-causes-air-pollution-and-who-breathes-it.

Thus while the COVID-19 pandemic is an issue specific to this past year, vulnerabilities relevant to the pandemic have been established for years with the silent, persistent poisoning of air pollutants. Instead of working to dismantle these pollution-induced risks to COVID-19, the administration of President Donald J. Trump has politicized the issue and is actively working to dismantle protections in place to lessen the impact of environmental hazards. Regulations around

PM 2.5—industrial particles that have been shown to worsen lung performance—have been maintained at their current level instead of being improved, inadvertently accelerating the decline of respiratory health of vulnerable populations. Rather than protect the individuals facing the dire impact of pollution and the pandemic, the Environmental Protection Agency is instead bolstering the fossil fuel industry, favoring economic ties over both racial justice and scientific

36 information. Once again, these political and economic motivations come at odds with both scientific and social evidence surrounding pollution and racial inequities, respectively.

The pandemic came as a shock to many Americans, who free from the especially salient effects of pollution, had yet to see an attack on one’s respiratory system that was as ubiquitous as the

COVID-19 pandemic. The raging wildfires, predominantly in the state of California, were perhaps the closest parallel to such a non-discriminatory widespread attack that could inflame

37 one’s airway or attack one’s immune system with pneumonia. Yet for the vulnerable populations of color, located in urban centers and near industrial areas, the COVID-19 pandemic

36 Coral Davenport, “Trump Administration Declines to Tighten Soot Rules, Despite Link to Covid Deaths - The New York Times,” New York Times, 2020, https://www.nytimes.com/2020/12/07/climate/trump-epa-soot-covid.html?referringSource=articl eShare. 37 Nina Bai, “What to Know About Wildfire Smoke and COVID-19,” What to Know About Wildfire Smoke and COVID-19 | UC San Francisco, 2020, https://www.ucsf.edu/news/2020/08/418276/what-know-about-wildfire-smoke-and-covid-19.

27 or even the recent wildfires are simply an extension of the longstanding attack on one’s right to breathe. “I Can’t Breathe” is an all too familiar phrase for these groups, as it relates to both pollution and racial justice. Ironically, the pandemic represented a period of time where one breath-related plague was somewhat replaced by another. In light of the stay-at-home order in early March, air quality finally improved, with statistically significant reductions in nitrogen

38 dioxide and fine particulate matter in urban counties. With the onset of the COVID-19 pandemic, there was hope that at least one of the attacks on breath would lessen or cease

(pollution). In a way, this reduction in pollution caused a considerable improvement in quality of life and respiratory health for those living in these urban areas, when looking exclusively at air

39 quality as a result of pollution. But this improvement was made obsolete by the other attack of one's respiration with the pandemic. This duality demonstrates the constant peril the vulnerable populations in many urban counties face, where one evil is replaced by an equivalent.

Fighting for The Right to Breathe—George Floyd and Anti-Maskers

The predicament of never-ending attacks on breath eventually brings us to the widely publicized position in recent history with the initial COVID-19 mask mandates and their relation to politicized arguments about our breath and our right to breathe. As discussions of mask mandates suggest, public health responses to the pandemic have emphasized the ability that citizens have to protect their breath and their right to breathe, despite the invisible “killer” circulating around us. This agency became a central consideration of many government and private decisions made

38 Jesse D. Berman and Keita Ebisu, “Changes in U.S. Air Pollution during the COVID-19 Pandemic,” Science of The Total Environment 739 (October 15, 2020): 139864, https://doi.org/10.1016/j.scitotenv.2020.139864. 39 Quirin Schiermeier, “Why Pollution Is Plummeting in Some Cities — but Not Others,” Nature 580, no. 7803 (April 9, 2020): 313–313, https://doi.org/10.1038/d41586-020-01049-6.

28 in the United States during the pandemic, and this discourse around breath took on a new meaning when it merged with ongoing protests against police brutality, where activists renewed the protest slogan, “I Can’t Breathe.” The buzz around wearing masks, social distancing, working from home, avoiding visiting your loved ones—all in the name of preserving breath—seemed to be futile when one’s right to breath was so utterly disregarded in the case of

George Floyd.

The death of George Floyd at the hands of the Minneapolis Police Department in June brought activists into the streets, protesting that their nation’s designated law and order didn’t do the one thing it promised to do—protect its citizens, pandemic or otherwise. This irony was put on center stage; the irony that while an institution may claim to care about its people in the wake of perhaps one of the deadliest pandemics of recent years, the true testaments of how it stands for the protection of its people’s breath and air crumbled with this scenario. These protests and calls for action and justice for Floyd, and those before him that faced a similarly tragic fate, were marked as political movements. In these cases, an individual’s right to breathe, and not have this breath maliciously taken from them was seen as political. With this “political” designation, these instances were brushed aside along partisan lines, rather than taking it as it is—a fundamental violation of human rights. And hence, the death of George Floyd was perhaps the most stark example in these COVID-19 months, of breath being politicized. It bears resemblance to other scenarios surrounding the violation of breath and air in history, such as the previously outlined dire health effects of polluted air on individuals in the United States.

Setting aside the debate of whether these protests against police brutality or the Black Lives

Matter movement are characterized as a political issue or not, they did nevertheless bring about a host of breath related arguments, that were then in turn divided along political lines. The medical aspects of George Floyd’s murder were scrutinized, highlighting the host of respiratory contributors and coincidents of his death—a positive SARS-CoV-2 diagnosis, hypertension, and

40 asphyxiation from applied force during the incident. These factors are so intimately intertwined with breath, and were factors that impacted the ability of Floyd to take sustained breaths. These aspects sparked a conversation surrounding one’s “access” to air, and what could impair one’s ability to continue breathing.

“Anti-maskers”, the colloquial term for individuals who refuse to wear or don’t believe in the efficacy of a mask during the COVID-19 pandemic, began to harness the phrase, “I Can’t

Breathe” as a means to fight for their own right to continue breathing in the way they want to.

Individuals part of the anti-mask movement began asserting their own “right to breathe” in response to minority groups that asserted a similar right in the Black Lives Matter movement, but in a different context. Even influential council members holding public office, such as Guy

Phillips of Scottsdale, Arizona, compared the discomfort of wearing a mask to the inability to

41 breathe. Almost in a counter-protest like manner to the racial justice movements of the time,

40 Scott Neuman, “Medical Examiner’s Autopsy Reveals George Floyd Had Positive Test For Coronavirus,” NPR.org, 2020, https://www.npr.org/sections/live-updates-protests-for-racial-justice/2020/06/04/869278494/med ical-examiners-autopsy-reveals-george-floyd-had-positive-test-for-coronavirus. 41 FOX10 Phoenix Tweet: Scottsdale Councilman Guy Phillips..., 2020, https://twitter.com/FOX10Phoenix/status/1275939140710866945?ref_src=twsrc%5Etfw%7Ctwc amp%5Etweetembed%7Ctwterm%5E1275939140710866945%7Ctwgr%5Eshare_3&ref_url=htt ps%3A%2F%2Fwww.cnn.com%2F2020%2F06%2F25%2Fpolitics%2Fguy-phillips-arizona-mas k-protest-i-cant-breathe-trnd%2Findex.html.

Phillips and many other individuals began to express their frustration with masks or face coverings, claiming that it restricted their breath.

Phrases like “give me liberty or give me death” or “my body, my choice”, previously associated as progressive messages for their respective time periods have been adopted as slogans to describe the unwillingness to wear masks or to assert that wearing a mask is indeed a personal

42 choice. This adaptation of historical phrases that have been used to advocate and inspire positive change in the realms of social justice for instead a cause that directly violates public health guidelines shows a deep contrast in the nation regarding the access to clean air and the right to breathe. The unwillingness to wear masks is an issue that is divided along partisan lines, with more Republicans expressing discomfort in abiding by these public health guidelines.43 Inherently, this divide shows how a mask, an object that protects one’s breath and communal air, is politicized. This politicization in turn jeopardizes individual lives, making the slogan “I Can’t

Breathe” increasingly relevant when describing the effects the general populace feels as a result of the pandemic as well.

The individuals appropriating the phrase “I Can’t Breathe” for the anti-mask movement hence were empowered to say in return to activists that they literally could not breathe as well, claiming they were also the victims of injustice. On a technical level, the wearing of masks does

42 Reggie Jackson, “‘Give Me Liberty, And Give Me Death!’ What the Anti-Mask Messages Really Say,” The Milwaukee Independent (blog), July 10, 2020, http://www.milwaukeeindependent.com/reggie-jackson/give-liberty-give-death-anti-mask-messa ges-really-say/. 43 “Republicans, Democrats Move Even Further Apart in Coronavirus Concerns,” Pew Research Center - U.S. Politics & Policy (blog), June 25, 2020, https://www.pewresearch.org/politics/2020/06/25/republicans-democrats-move-even-further-apa rt-in-coronavirus-concerns/.

31 not indeed lead to a restriction of breath, in regard to both carbon dioxide buildup and oxygen access. A study done at Miami VA Medical Center and the University of Miami Hospital and

Clinics compared military veterans with compromised lung function to individuals with healthy lungs and found that both groups had no significant differences in oxygen and carbon dioxide

44 intake levels. So while it may feel like their breath is restricted by wearing a mask, while running or simply going to the grocery store, this physical feeling is not supported by scientific facts. This creates an internal conflict between the way that we can feel breath, as something tangible accompanied with noticeable changes when we put on or take off a mask, and scientific information that contradicts this physical feeling. This contradiction allows for regimes of perceptibility to take hold among the general public, where breath and the physical effects of masks can be contested both politically and socially.

Thus, the equating of two different circumstances—the active taking away of breath and ending one’s life with physical force to the slight restriction felt by wearing a face covering to protect yourself and those around you—shows the politicization of breath during the pandemic. Along with being politicized, the argument is grounded in physical feelings rather than technical fact, highlighting the prioritization of freedom-oriented discourse over science. Scientific evidence is pushed aside in favor of political and personal opinion, demonstrating the fragility of breath with these arguments. Additionally, given that various types of masks, especially home-made fabric masks, have differing ‘breathability’ ratings, demonstrates how a sweeping statement that masks

44 Erika Edwards, “Breathe Easy: Masks Don’t Hurt Lung Function or Cause CO2 Buildup,” NBC News, October 2, 2020, https://www.nbcnews.com/health/health-news/mask-myth-debunked-face-coverings-don-t-hurt-l ung-function-n1241721.

45 can restrict breath is difficult, if not impossible to concretely make. As with the alteration of indoor ventilation standards due to political pressure, the science surrounding mask efficacy and the relationship between masks and oxygen intake was bent to fulfill the political agenda of certain individuals.

This politicization not only arises from the leaders and people in positions of power that exploit this phrase, but also the inherent translation of mandated masks orders as an infringement on one’s liberty and freedom. Viewing the masks as a force that takes away these rights, rather than a necessary protection, allows breath to become politicized and utilized for one’s own motives.

Anti-maskers aligned themselves to political movements and personas that seemed to accept and validate their feelings, from All Lives Matter organizers to individuals in higher office with the ability to enact policy-based change. Simple key words such as “liberty” and “choice” or overarching concepts like “masks make it difficult to breathe” allow political groups to frame the argument effectively. Providing only snippets of information help make the argument

46 convincing, without the need to include evidence or scientific fact. It seems to boil down to the concept of everyone protecting their version of breath, harnessing political means and arguments if they need to, during these times.

45 Sheila Kaplan, “How Effective Is the Mask You’re Wearing? You May Know Soon - The New York Times,” December 16, 2020, https://www.nytimes.com/2020/12/16/health/covid-masks-effectiveness.html?referringSource=ar ticleShare. 46 George Lakoff, Don’t Think of an Elephant! : Know Your Values and Frame the Debate : The Essential Guide for Progressives., Don’t Think of an Elephant! : Know Your Values and Frame the Debate : The Essential Guide for Progressives / George Lakoff ; Foreword by Howard Dean ; Introduction by Don Hazen. (Chelsea Green Publishing, 2004), 24, https://lib.mit.edu/record/cat00916a/mit.001501450.

Nuances surrounding how exactly these fundamental rights and priorities change between groups comes with this overarching protection of breath. The main distinction seems to be whether breath is seen as a life force or breath is instead a marker of livelihood and wellbeing along more emotional lines. On the one hand there are anti-maskers, that claim that by shutting down businesses to prevent workers and customers alike from contracting the virus, a fundamental

47 freedom is lost in this regard due to a restriction of daily activities and proceedings. Here breath is synonymized with livelihood: the ability to go to bars, get haircuts, watch a movie in a theater, or dine inside of a restaurant. When it comes to the right to freely worship, for example, a practice that is protected by the Constitution, the closure of religious institutions seems to incite a

48 series of hotly contested debates. In this particular situation, it may seem that masks and public health orders directly undermine this Constitutional right. The debate of freedoms to be protected seems to come at odds with the view that breath is an essential lifeforce and rather than these extraneous factors, the binary distinction between life and death becomes the focus of the conversation.

In the middle of a respiratory disease, the slogan “I Can’t Breathe” continues to be ignored by individuals in power, deepening the relationship between politics and fundamental human rights.

One would assume that given the gravity of the situation, breath would not be a commodity, but an essential right. It’s value and importance should in theory be untouchable, due to its dominance of headlines and conversations alike. Yet, the national, heavily publicized resurgence of this movement in May 2020 made it clear that breath is a political force. The ability to hold

47 Chad and JT Go Deep, Solving the Mask Shortage in Huntington Beach, 2020, https://www.youtube.com/watch?v=3Q3PSISAZL8. 48 Richard Luscombe, “The US Churches and Pastors Ignoring ‘stay-at-Home’ Orders,” the Guardian, April 5, 2020, http://www.theguardian.com/world/2020/apr/05/coronavirus-churches-florida-social-distancing.

34 breath over one’s head and be in the position of power to take it away is one enabled by political motives and forces, as we see with all too common examples of police brutality. For instance, with the protests that persisted through the summer, police forces threw tear gas into the crowds,

49 which can cause coughing, tightness of breath, and irritation of the respiratory tract. Individuals participating in these protests were wearing homemade masks, contrasting starkly with the military-grade masks that police forces were equipped with. These homemade fabric masks can often have penetration levels between 40 and 90 percent, highlighting their relative uselessness

50 in these situations. These citizens were doing what they could to protect themselves from the other force in addition to the virus that was trying to take away their breath—in this case the police carrying tear gas, further highlighting the cruelty of the situation. According to the

American Thoracic Society, if tear gas use is coincided with a positive COVID-19 diagnosis, individuals can be especially susceptible to negative effects from the chemical since they might not be able to smell the chemical hazard and may subsequently inhale large quantities of it

51 instead of vacating a highly concentrated area. Additionally, tear gas fumes can accelerate the spread of COVID-19 by taking up and carrying viral particles through the air. The effects of the tear gas can also leave one to be especially vulnerable if they do end up contracting the virus,

52 compounding the respiratory dangers linked to protests during the pandemic. Here, multiple

49 KARE 11, Protesters Chant “I Can’t Breathe” before Police Fire Tear Gas, 2020, https://www.youtube.com/watch?v=NTKG5JuldDg. 50 Harvery V. Fineberg, “Rapid Expert Consultation on the Effectiveness of Fabric Masks for the COVID-19 Pandemic (April 8, 2020)” at NAP.Edu, 2020, https://doi.org/10.17226/25776. 51 “Tear Gas Use During COVID-19 Pandemic Irresponsible; Moratorium Needed, Says American Thoracic Society,” accessed January 10, 2021, https://www.thoracic.org/about/newsroom/press-releases/journal/2020/tear-gas-use-during-covid -19-pandemic-irresponsible-moratorium-needed,-says-american-thoracic-society.php. 52 Will Stone, “Tear-Gassing Protesters During An Infectious Outbreak Called ‘A Recipe For Disaster,’” NPR.org, June 5, 2020, https://www.npr.org/sections/health-shots/2020/06/05/870144402/tear-gassing-protesters-during- an-infectious-outbreak-called-a-recipe-for-disast.

35 agents are working towards restricting one’s right to breathe throughout the entire timeline of the situation, from the initial chokehold placed on George Floyd to crowd-control weapons at protests to eventual hospitalizations that may result from the spread of COVID-19 at these events.

In this particular situation, breath is exploited and threatened through the acts of these police forces, who use tear gas as a means to further ameliorate the threat of the pandemic. The gas masks are certainly not the masks that one would expect to be donned during the pandemic, and it puts the United States in a unique position concerning the lack of funds or resources to obtain personal protective equipment (PPE) for healthcare providers, while certain groups such as the

53 police are seemingly well prepared. Financial resources and logistical efforts are devoted into ensuring police and national guard members have gas masks, which serves as a counter to the lack of conviction shown for providing PPE to state and local governments during the early

54 stages of the pandemic. Perhaps this was a way to show the priorities of the nation, and to note which and whose breath is protected in these circumstances.

The statement “I Can’t Breathe” has been used in the context of preserving one’s right to breathe, by environmental activists, protestors of police brutality, and social opposers to mask mandates. With environmental justice, “I Can’t Breathe” is tied to the deterioration of air quality in urban centers, which negatively affects minorities that are more likely to live in these larger

53 Daniel Joseph Finkensadt, Robert Handfield, and Peter Guinto, “Why the U.S. Still Has a Severe Shortage of Medical Supplies,” Harvard Business Review, September 17, 2020, https://hbr.org/2020/09/why-the-u-s-still-has-a-severe-shortage-of-medical-supplies. 54 “‘Kettling’ Protesters in the Bronx,” Human Rights Watch, September 30, 2020, https://www.hrw.org/report/2020/09/30/kettling-protesters-bronx/systemic-police-brutality-and-it s-costs-united-states.

36 city-like conditions. Of course, with protests against police brutality, the implications of the phrase “I Can’t Breathe” becomes increasingly relevant with the manner of the death of George

Floyd in 2020. And with social pushback against mask wearing, the phrase was appropriated to fit the political leanings of those that felt masks restricted breath. The relevance of this phrase through history and settings, highlights the central role that breath plays in each of these situations and unifies different threads of activism and political discourse.

Case Study: Secondhand Smoke, Masks, and Protecting

Others

If one contracts COVID-19, their breath is compromised and the air around them becomes similarly impure. So, while it is true that SARS-CoV-2 attacks its host’s breath, it also attacks the clean air surrounding this individual, harming many more in the process. Thus, as much as

American culture emphasizes individualization, with the COVID-19 pandemic this stance is misleading. Now, one person’s breath can impact countless other individuals that may be in contact with them or in close proximity, making this pandemic a community issue. So, how do we hold someone responsible for unknowingly harming others in their community with the air they breathe?

Whether breath is considered a baseline human right or not (i.e. regardless of one’s position, they should be able to breathe) is an ongoing debate. With the COVID-19 pandemic this debate has reemerged. If breath is considered a baseline right, it seems to follow that taking away one’s breath should be classified as some type of grave crime on the level of a human rights violation.

The act of actively murdering someone by any means, since it takes away their breath, is an example of this extreme crime. Yet, when this violation of one’s breath is not as immediate as it may be during an active murder, it is not seen as a grave crime. For the COVID-19 pandemic, the act of seizing one’s breath through actions such as not wearing a mask or interacting with others while infected, has consequences that are distributed over a period of time—the results are not as immediate as a murder per se.

Legally, there are laws in place to prevent the emergence of nuisances—acts or conditions that

55 disturb some core tenet in society, in this case public and individual health. But even as the name nuisance suggests, such a “disturbance” is portrayed to be not as severe compared to other more intense crimes. For instance, through a nuisance such as smoking and spreading secondhand smoke to those around you, you could in turn be taking away their right to live and breathe through a long-term cascade of health repercussions such as the onset of lung cancer or respiratory damage.

Through these nuisances, whether this be secondhand smoke discussion or COVID-19, breath can be analogized to an object in a tragedy of the commons type of scenario. In the tragedy of the commons analogy, an individual that puts their own needs above the community when using

56 communal resources inevitably causes some type of damage to these communal resources. In this instance, the communal pool of clean air is being protected by some and polluted by others through individual actions, leading to a system that affects those that have no original connection to the toxin of interest (either the secondhand smoke or the virus). This tragedy of the commons enables the dangerous element to affect other community members, even if they may end up having no repercussions on the individual that began exploiting the communal pool of air.

In contrast to the COVID-19 pandemic, which may have consequences within weeks with the rapid spread of the virus, secondhand smoke acts over an even longer time scale of many years.

But because both secondhand smoke and the spread of the COVID-19 pandemic are not

55 Kathleen Hoke, “Overview of Nuisance Law” (Partnership for Public Health Law, n.d.), https://www.apha.org/-/media/files/pdf/factsheets/overview_of_nuisance_law_factsheet.ashx?la= en&hash=0351A061DD2754C8802BB67515BB9C9FDB524B38. 56 Garrett Hardin, “The Tragedy of the Commons,” Science 162, no. 3859 (December 13, 1968): 1243–48, https://doi.org/10.1126/science.162.3859.1243.

39 immediate acts in the moment where the offender can be easily held accountable, the consequences are in turn also spread out over time and labelled as merely a temporary nuisance.

Even though the COVID-19 pandemic is on a shorter time scale and measures like contact tracing hold some degree of accountability, legal arguments are still difficult to make. The factor of uncertainty around whether these health repercussions will actually occur and the idea that a death sentence is not guaranteed with certainty by something like secondhand smoke or a

COVID-19 diagnosis, further alleviates this responsibility.

Smoking Regulations and Communal Health

Secondhand smoke has been the subject of activism and campaigns to improve smoking regulations in public spaces for decades in the United States. These campaigns incited a transition from a landscape with no restrictions set in place to gradually tighter guidelines about where one could smoke with the introduction of designated smoking areas. These regulations represented a shift towards acknowledging communal health consequences of individual behavior, from a legal and policy standpoint. While some states quickly moved to ban smoking in public spaces, other states such as Michigan only recently passed widespread restrictions—in

2010, smoking was finally prohibited in all indoor workplaces, restaurants, and bars.57 Meanwhile, many other states such as Texas, Alabama, Georgia, and West Virginia still lack strong restrictions, allowing many of these violations of public health and disregard for the air

58 quality of others to continue. While these laws and policies are scientifically advised by acting

57 “Smokefree Policies Reduce Secondhand Smoke Exposure,” Centers for Disease Control and Prevention, August 4, 2020, https://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/protection/shs_expo sure/index.htm. 58 “Smokefree Air Laws,” American Lung Association, March 10, 2020, /policy-advocacy/tobacco/smokefree-environments/smokefree-air-laws.

40 officials such as the U.S. Surgeon General or the Centers for Disease Control and Prevention

(CDC), their ultimate enactment lies in the hands of politicians, making the concern around clean air a largely political, rather than scientific, endeavor. The connection between secondhand smoke and cancer, among other respiratory complications, is a well-established scientific fact.

Yet, these laws and regulations face political resistance in their passage, causing the science to be overshadowed again by political and economic motivations.

The political motivations opposing stronger public smoking regulations branch off from the idea of viewing the ability to breathe clean air as a concrete right, as established earlier in this section.

Sarah Milov describes in her book, The Cigarette: A Political History, how the same rhetoric

59 around breath as an incontestable right plays out from the smoker’s perspective. The smoker asserts that it is their right to smoke in a public space and restricting this would be an infringement upon one’s freedom. Here, the scientific evidence such as the public health effects of cigarette smoke and disproportionate impact racial minorities and individuals from low socioeconomic statuses face are set aside in favor of political inclinations and debates around personal liberties. This argument is further explored in Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming, where the scientific basis of secondhand smoke is manipulated such that it instead becomes a conversation surrounding individual liberties. Scientists like Frederich Setiz asserted that tobacco smoking

60 was a liberty, a right, to be protected. Similar to the mask wearing argument from before, the apparent right to not breathe is what is under scrutiny, as it is deemed to be as critical as the right to preserving clean air for others. Again, this motivation to adjust science such that it fits

59 Sarah Milov, The Cigarette: A Political History (Harvard University Press, 2019), 161, https://www.hup.harvard.edu/catalog.php?content=bios&isbn=9780674241213. 60 Erik Conway and Naomi Oreskes, Merchants of Doubt (Bloomsbury Press, 2010), 164.

41 political and economic motives, is a continuity over time, harnessed to protect varying definitions of personal liberties.

This individualization of breath as it relates to personal liberties shows the lack of regard for communal access to clean air. Advocates of smoking bans claimed that this individualization of breath endangered communities in which the smoker was situated. The actions of the smoker were a danger to communal health, in addition to the obvious effects on the individual. From being in the same car as one’s children while smoking to smoking on a crowded beach boardwalk with strangers, this harmful act is oddly targeted to those within a specified radius.

Specifically for children, their lungs are underdeveloped compared to healthy controls and they

61 have higher frequencies of severe asthma attacks. The argument regarding individual liberties becomes contentious when considering these children, given their inherent vulnerability in society, are subject to the dangers of these individual decisions made by smoking adults. When smoking was permissible in airplanes, a largely enclosed space with neighbors that are unable to

62 simply get up and walk away from the smoker, this act becomes more than a mere nuisance. In these instances, it is a targeted act where the danger that is brought upon others is direct and intentional, all in the name of preserving the right that one has to enact this danger if they please.

The lack of emphasis on the ability to take away other’s breath with smoking further accentuates how tobacco advertisements tend to focus on the individual’s circumstances rather than larger communal impact. In the United States, Surgeon General warnings center on the negative effects

61 “Health Effects of Secondhand Smoke,” Centers for Disease Control and Prevention, February 27, 2020, https://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/health_effects/index .htm. 62 Milov, The Cigarette: A Political History, 167.

42 of tobacco smoking on the individual directly smoking the cigarette, such as lung cancer and

63 heart disease. Aside from warnings regarding use during pregnancy and the impact smoking can have on a fetus, the effect of smoking on others is often ignored on cigarette packaging and during marketing maneuvers. This portrayal thus teases apart the effects of secondhand smoke from tobacco warnings to the consumer, deemphasizing the importance of public health concerns when creating warnings and health alerts. This creates a cultural environment where the individual is deemed to be more important than the community, allowing arguments about protecting individual freedoms to gain traction for the tobacco regulation space.

This cloud of emotional and social debate serves to cover up the scientific basis of secondhand smoke transmission. As is the case with the transmission of the COVID-19 virus, the dangers of tobacco smoke rely heavily on a variety of technical details such as location (indoors/outdoors), distance between the toxin and an individual, and concentration of tobacco in the smoke.

Naturally, outdoor locations are better for ventilation of secondhand smoke, providing an easier method by which the harmful toxins can be distributed and redirected away from individuals.

Similarly, it is noted that the odor and effects of secondhand smoke can be felt up to 23 feet away from the source, creating a semblance of distancing guidelines that can be put into place

64 for secondhand smoke restrictions. Additionally the concentration of suspended particles in the smoke can also vary across a wide range of 24 to 1947 micrograms per meter cubed, vastly impacting the dangers present in secondhand smoke depending on the situation and proximity to

63 “2000 Surgeon General’s Report Highlights: Warning Labels | Smoking & Tobacco Use | CDC,” Centers for Disease Control and Prevention, June 19, 2019, https://www.cdc.gov/tobacco/data_statistics/sgr/2000/highlights/labels/index.htm. 64 “Outdoor Exposure to Secondhand Smoke: What’s the Danger?” (Tobacco Free Youth Recreation, n.d.), http://www.tobaccofreeparks.org/fckfiles/Outdoor%20Air%20ETS%20Factsheet.pdf.

65 others. While these recommendations are backed by scientific facts, they can become overshadowed and questioned by the emotionally driven language used by individuals on both sides of the debate. Even petitions made to impose more smoking guidelines by activists were accompanied by emotional stories, sweeping claims about emotional disturbances caused by tobacco, and other speculative arguments, highlighting the willingness to set aside these

66 technical details to accomplish a given agenda. This concept makes a reappearance with the guidelines surrounding mask wearing, airborne and surface transmission of SARS-CoV-2, and the 6 feet social distancing rule during the COVID-19 pandemic, which although were informed by science, were often manipulated with emotional and political debates on both sides.

The Individualization of Mask-Wearing

These technical factors thus can’t always be taken at face value, given they carry some semblance of uncertainty and opinion interspersed with them, whether this be in regard to secondhand smoke or the COVID-19 pandemic. For both instances, the uncertainty around whether the danger in question—tobacco smoke or the virus—is fatal down the line or if the effects are negligible, allows for these technical details to be pushed aside. For the COVID-19 pandemic, factors such as indoor versus outdoor settings, distancing between friends and family, or asymptomatic versus symptomatic transmission make the guidelines of what exactly is a

“dangerous interaction” blurrier, and in the process reduce the sense of responsibility that an individual feels.

65 Composition, Exposure and Regulations, Tobacco Smoke and Involuntary Smoking (International Agency for Research on Cancer, 2004), https://www.ncbi.nlm.nih.gov/books/NBK316410/. 66 Milov, The Cigarette: A Political History, 160–66.

Since both the effects of secondhand smoke and COVID-19 transmission are not seen immediately after exposure, it is particularly difficult to discern these scenarios as active acts of taking away each other’s breath. In the case of the COVID-19 pandemic, the idea of assuming responsibility for the health and safety of those around you is reflected with the idea of wearing masks (or choosing not to wear them). Masks are primarily worn to protect those around an individual, particularly in preventing contaminated respiratory droplets spreading between

67 individuals. However, instead of focusing on this communal aspect of air, the focus is instead placed on the individual with the portrayal of mask use in the United States, where the importance of protecting yourself is highly emphasized rather than the need to wear a mask to

68 protect those around you in the community. This individual-oriented language clashes with the scientific basis of how masks work and the role they place in stopping a community spread.

Again, this demonstrates the willingness to ignore scientific details to accomplish an agenda—in this case, getting the average American citizen to abide by mask mandates.

Yet despite this construction of mask wearing arguments, certain military-grade visualizations have been popularized that depict the transfer of “macroscopic” viral particles and show how infected individuals not wearing a mask could direct droplets containing SARS-CoV-2 towards

69 those in close contact with themselves. These visualizations take a different approach and aim 67 Nina Bai, “Still Confused About Masks? Here’s the Science Behind How Face Masks Prevent Coronavirus,” Still Confused About Masks? Here’s the Science Behind How Face Masks Prevent Coronavirus | UC San Francisco, June 26, 2020, https://www.ucsf.edu/news/2020/06/417906/still-confused-about-masks-heres-science-behind-ho w-face-masks-prevent. 68 Uri Friedman, “What the U.S. Can Learn From East Asia About Face Masks - The Atlantic,” April 2, 2020, https://www.theatlantic.com/politics/archive/2020/04/america-asia-face-mask-coronavirus/60928 3/. 69 Dalton Bennett, Sarah Cahlan, and Daron Taylor, “Military-Grade Camera Shows Risks of Airborne Coronavirus Spread,” Washington Post, December 11, 2020,

45 to instead advance the communal argument of mask-wearing, visually showing how the virus is far from an entity that is isolated to one individual. These videos show breath as a tangible and visible object, further supporting Murphy’s regime of perceptibility concept, where these objects

70 can be manipulated to advance scientific and social debates. The use of language such as “military-grade” when publicizing these visualizations to the general populace adds to this constructed regime, by subconsciously adding confidence in the visualizations by associating them with a robust system and infrastructure like the military. This combination of making breath a tangible object and surrounding it with technological credibility allows for scientific fact to be more convincing. These visualizations therefore show that when individuals refuse to wear masks, or intentionally enter crowded or indoor venues without a mask, they are actively hurting those around them, taking away their breath, albeit in a more indirect manner.

As is the case with smoking in public venues or around compromised and vulnerable individuals, the refusal to wear masks in the midst of the COVID-19 pandemic represents a lack of regard for the health and wellbeing surrounding oneself. The ability to consciously acknowledge the harm one could cause by refusing to curb smoking habits around others or refusing to wear a mask in public spaces rests upon a tenet of universal respect for others. Unfortunately, this has been a contested topic over history, showing the willingness of individuals to politicize the right to breathe and leave concerns of public health and safety up to opinion.

https://www.washingtonpost.com/investigations/2020/12/11/coronavirus-airborne-video-infrared -spread/. 70 Murphy, Sick Building Syndrome and the Problem of Uncertainty : Environmental Politics, Technoscience, and Women Workers.

A central principle of both the pandemic and secondhand smoke health concerns is based upon an ability to accomplish communal protection in public spaces, whether this be through natural consideration or regulation-induced coercion. Distancing oneself, avoiding frequent outings for the protection of others, and wearing masks are common responsibilities that fall on the individual in the interest of largely protecting others, from bystanders to essential workers. The way the idea of wearing masks is framed shows how the concept of individual rights is manipulated on both sides (those who support masks and those who don’t) to advance their own debate. Individualization is used to hide the communal effects of the virus, to convince skeptics that they should care for their own health, if not the health of others. A violation of this basic consideration for others is what leads to a depletion of communal breath and clean air, a trend that is seen with both the COVID-19 pandemic and secondhand smoke. This semblance of respect, for those around us and ourselves to some extent, falters with these historical parallels in the United States, in part due to political, social, and economic considerations.

COVID-19 Pandemic The previous sections of this paper show how breath and clean air have been an object subject to political, social, and economic motivations across historical settings. The idea of treating breath as an object to regulate and contest through debates has shown the resulting lack of regard given to protect the right to breathe clean air with the support of scientific and technical fact. Instead, these considerations have been pushed aside, allowing for inequities among community members to develop. With the COVID-19 pandemic, the politicization of breath is clear from a higher level as well as when considering specific stages of the pandemic chronologically in the United

States. Additionally, within each of these stages, the way that breath and air is treated also follows a gradual evolution through the course of the disease inside an individual itself.

In the early stages of the pandemic in March of 2020, the United States lacked a federal plan for stay-at-home orders, causing certain state and local authorities to place economic concerns before health and safety concerns. Businesses and large corporations were hesitant to shut down, because with the lack of a federal mandate, they could place economic incentives to keep their

71 business running above public health concerns. When a group of individuals worldwide were polled, it was found that the public in March was more worried about the long term economic

72 impact of the pandemic rather than the immediate health impact. This shows how even on an individual level, concerns about secondary factors like financial security take precedence over

71 Patricia Cohen and Jim Tankersley, “America’s Economy Begins to Shut Down as Pandemic Measures Take Hold - The New York Times,” March 16, 2020, https://www.nytimes.com/2020/03/16/business/economy/coronavirus-us-economy-shutdown.ht ml. 72 Laura Oliver, “Most People See COVID-19 as an Economic Crisis First, Health Risk Second,” World Economic Forum, March 18, 2020, https://www.weforum.org/agenda/2020/03/covid-19-public-perception-economic-health-crisis-co ronavirus-pandemic-ipsos/.

48 concerns about breath, inevitably causing breath to be brushed aside as a less important entity to protect. From the onset of the pandemic, given the SARS-CoV-2 virus’s origin in China, the question of how this would impact the U.S.-China relations was a major concern. While of course public health measures were discussed and remained of great importance in the early days of the pandemic, much of the discourse was focused on how the intertwined United States and

73 China economies would react. These economic arguments compounded with the political rhetoric that focused on blaming individuals of Chinese descent, or even other Asian American individuals. This diverted American’s focus away from the public health crisis and ongoing jeopardization of breath and instead abroad towards political and economic debates related to

China. This type of language dominated the early days of the pandemic, with influential individuals in political office using this as a means to distract from the imminent threat to breath.

After the initial lockdown period from roughly March through May of 2020, states began reopening their economies again. The reopening of various states, such as Texas and Utah,

74 happened despite increasing numbers of cases in these locations. This contradiction of public health recommendations shows how the sanctity of breath was compromised to cater to social and economic pressures. Certain groups were hesitant to return to this temporary normal way of life, and the choice to either abide by or ignore COVID-19 prevention guidance became a largely

75 partisan issue. Wearing a mask emerged as a political symbol rather than a measure to protect 73 Trefor Moss, “Pandemic Makes U.S.-China Economic Breakup More Likely, U.S. Businesses in China Say - WSJ,” The Wall Street Journal, April 17, 2020, https://www.wsj.com/articles/pandemic-makes-u-s-china-economic-breakup-more-likely-u-s-bus inesses-in-china-say-11587113926. 74 Julie Bosman and Mitch Smith, “Coronavirus Cases Spike Across Sun Belt as Economy Lurches into Motion - The New York Times,” June 14, 2020, https://www.nytimes.com/2020/06/14/us/coronavirus-united-states.html. 75 Amelia Thomson-Deveaux and Anna Weiderkehr, “Republicans And Democrats See COVID-19 Very Differently. Is That Making People Sick? | FiveThirtyEight,” FiveThirtyEight,

49 the communal pool of clean air, showing how breath was directly politicized during this period and the months following.

In each of these stages, breath played an instrumental role throughout the course of the

COVID-19 disease itself, from prevention to infection. During the lockdown and stay at home order, there was a return to spaces with clean air as illustrated in the first section of this paper: workplaces and educational institutions were abandoned in favor of residential spaces with limited amounts of people. Here, clean air was available in the comfort of one’s home or personal space, and as long as interactions with others and outings were minimized, the right to breathe was preserved. Breath was confined to personal spaces and areas, but the actual act of breathing in these personal spaces was unrestricted (no masks or personal protective equipment was mandated). As public spaces began to reopen, individuals in most venues were required to wear masks. Masks serve as a compromise to restrict one’s breath in the present to protect it in the future, by avoiding contraction of the virus and the further spread of the pandemic. This trade-off shows how breath has emerged as a sacred object to protect with the COVID-19 pandemic and how all the preventative measures in place, precautions, and necessary risks interplay with one’s ability to breathe in the present and in the future. The last step of this cycle of breath on an individual scale occurs when one actually contracts the virus and potentially faces a drastic deterioration of their respiratory health. Symptoms such as shortness of breath after contracting SARS-CoV-2 highlight the physical attack on breath that is brought about by this pandemic. This attack on breath comes full circle if an individual is placed on a ventilator, a machinery that takes over the task of breathing. Here, the machine becomes the holder of breath

July 23, 2020, https://fivethirtyeight.com/features/republicans-and-democrats-see-covid-19-very-differently-is-t hat-making-people-sick/.

76 and the individual remains powerless. The ventilator has full power over the individual’s ability to breathe. The autonomy over one’s breath and the individualization of breath previously seen by electing to stay at home, choosing to wear a mask, and distancing from others is no longer evident in this situation.

The start and continued progression of the COVID-19 pandemic in the United States brings about a variety of important considerations surrounding breath. The pandemic has illustrated, as is the case with other historical examples, that breath is subject to external factors such as political, social, and economic pressures. These pressures were seen during both the initial stage of the pandemic in the United States as well as the later stages of the pandemic from Summer

2020 and beyond. Additionally, this progression of breath chronologically through the course of the pandemic was accompanied by a similar progression on the individual level.

76 Harris Solomon, “Living on Borrowed Breath: Respiratory Distress, Social Breathing, and the Vital Movement of Ventilators,” Medical Anthropology Quarterly, August 18, 2020, https://doi.org/10.1111/maq.12603.

Conclusion The COVID-19 pandemic has brought about a series of changes in the daily routine of

Americans—the introduction of face masks, social distancing measures, bans on crowded events, and work from home movements are just a few of these obvious shifts. However, what is uniquely interesting about COVID-19 is the heavy emphasis it has placed on breath and the right to breathe clean air. SARS-CoV-2 uses air as its medium of transmission to harm the breath that individuals take, demonstrating how intertwined the concepts of breath and air are with the current public health landscape. All the public health measures and guidelines are enacted to protect our breath and the breath of others, highlighting how relevant these discussions have become.

COVID-19 has brought about a renewed interest in the air that we breathe, connecting it to longstanding discussions about access to healthy air. The pandemic took an integral but overlooked part of our lives, the act of breathing and the air around us, and made it into an object that we debate, discuss, regulate, and monitor. COVID-19 has brought about a renewed interest in the air that we breathe, connecting it to longstanding discussions about access to healthy air.

Breath became intertwined with a landscape of political, social, and economic questions. The transition of breath as one of these objects in a regime of perceptibility is evident in the current discourse we see during the pandemic, whether this be protests against mask mandates or partisan debates on the impact of urban pollution. In these historical parallels, the importance of breath has been used to guide policy, scientific, and social change.

The case studies explored in this thesis connected instances where breath and air have been of paramount importance over history. The first case study included a discussion on indoor spaces with compromised or sinister air, with leading concepts such as miasma theory and sick building syndrome harnessed as a means to understand what compromises bad air. This evaluation of dangerous indoor spaces was extended to the work from home movement that upended traditional workplaces and educational institutions during the COVID-19 pandemic. The second section detailed the history of breath-limiting factors in social justice movements of the past, namely the environmental justice movement, that highlights the disproportionate impact that urban pollution has on the air that certain racial groups breathe and how breath unified concerns over health inequities, civil rights, and the environment through the the “I Can’t Breathe” movement and the accompanying protests. Lastly, the third case study explored the regulation of secondhand smoke and the language used to describe its health effects on the community. These communal health considerations were evident in the anti-mask protests during the surge of the

COVID-19 pandemic. These historical parallels emphasized the shift of breath from a pure to a dangerous force, from an intangible to a tangible object, and from a communal to an individualized resource.

The COVID-19 pandemic has shown us the integral role breath can play in American society, and it has revealed how we deal with imminent threats to breath. All of the measures to protect the purity of the air we breathe, from preventing the spread of the virus, treating the virus, and even combatting the virus within our bodies, has elevated the status of breath. Breathing has become a protected action at the center of regulatory bodies, social discussion, and economic considerations. A natural question to raise would be: was this same spotlight on breath, and

53 related political discourse, evident in other nations during the COVID-19 pandemic? And if so, does this vary between traditional western and eastern countries, between developing and industrialized economies, or between democratic and non-democratic regions? Exploring the interplay between the same themes raised in this thesis in other national contexts could provide an even larger subset of historical and COVID-19 era parallels to the present discussion. Having these additional cases could provide an expansion of the “society” in question when exploring science, technology, and society.

Biographical Note Vaibhavi Shah has attended the Massachusetts Institute of Technology (MIT) from 2017 to 2021 as a Bachelor’s student in Biological Engineering and Science, Technology, and Society. She is a member of the Tau Beta Pi Engineering Honors Society, and she was acknowledged as a United States Presidential Scholar, Goldwater Scholar, Coca-Cola Scholar, Astronaut Scholar, and a Rhodes Scholar Finalist. While at MIT, Vaibhavi has served as a Co-Director of StartLabs, a premier entrepreneurship group, the Editor-in-Chief of the MIT Undergraduate Research Journal, and the Innovation Chair for the Society of Women Engineers. Vaibhavi has previously conducted research in big data in medicine, neural engineering, clinical neurosurgery, and health inequities, and she intends to use this background to inform her future career as a physician-scientist.

Acknowledgements

I would like to take the time to express my thanks and great appreciation to the individuals who played an instrumental role in the production of this thesis and supported me throughout my time at MIT.

Thank you to the Science, Technology, and Society (STS) department for exposing me to a whole new world of knowledge. Particularly, thank you to my incredible thesis adviser, Professor Robin Scheffler, for supporting me throughout the research process and providing invaluable insight. Thank you to Karen Gardner and Professor Dwai Banerjee for making me feel at home within the STS department and encouraging me to pursue the major. And an immense thank you to Professor Kenneth Manning and Professor Héctor Beltrán for teaching me so much through your courses.

And of course, all of my love to my family and friends who were by my side throughout the MIT journey. To my mom, Varsha, thank you for always pushing me to be better and for always being there, whether that be through countless video calls or sitting right next to me while I type away on my laptop. To my dad, Bhaviesh, thank you for encouraging my ambitious dreams. And to my sister, Shivani, thank you for being my inspiration and my motivation, and for being the best big sister I could ask for.

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