Through the coronavirus pandemic, we have accumulated scientific explanations (pathogens, antigens) of infectious diseases and treatments (antibiotics, vaccines), and we have entered an era in which we can expect preventive and therapeutic effects on infectious diseases to a significant extent. However, it is unknown when a pandemic infectious disease such as coronavirus will strike humanity again. COVID-19, which broke out in the second half of 2019, has struck fear throughout the world and disrupted daily life. In this situation, we would like to find out what implications the spread of the concept of public healthcare has on medical and health policy and what role it can play in protecting the health of future community members if the spread of infectious diseases continues.
Health is by no means an individual task, but needs to be understood as the current result of human survival as a social being and the historical interaction with the social environment that humans have created. Health is confronting global and social structural challenges, and therefore there is a need to encompass a wide range of disciplines and reorganize it as a study of human survival. The current National Health Promotion Act has been enacted with core values such as health education, improved nutrition, and health management, but disease prevention is omitted. The concept of disease prevention must be included in the National Health Promotion Act.
Even today, in order to prevent the spread of serious infectious diseases - for example, viruses such as coronavirus or avian influenza - and to protect society, the state needs to isolate infected or suspected patients and restrict individual behavior, thereby protecting the ‘freedom’ of individuals or infringes on ‘privacy’. This coercion in relation to infectious disease control in public health is clearly an expression of power, and it remains the same today. However, what is implied in public health as a modern concept is more than the health of members of the public community; it is a society in which freedom and equality are vibrant, premised on the healthy survival of autonomous individuals with human dignity in modern civil society. At the same time, it contains the ideology of building a modern civil society.
The idea of modern public health is that hereditary hierarchical society is divided, an emerging class takes over the real power of society, and individuals are centrifugally disbanded from the community due to the expansion of civil freedom against the background of the idea of laissez-faire, leaving them defenseless. In the midst of this situation, the preservation of life, the maintenance of a hygienic environment that guarantees it, or the improvement of the system are rooted in the centripetal idea that politics and administration must take responsibility for the solution. The history of plague has reminded us that humanity, unable to avoid microscopic parasitism, is definitely part of the ecosystem, and the once terrifying experience of the American continent continues to teach us the same lesson today.
No matter how legal scholars classify the types of basic human rights in modern society, the basic concept of human rights that has been formed historically has universality that precedes any form of state as long as it is a modern civil society, and is sound as the most basic content that establishes the concept of human rights itself. There is a ‘right to life’ and a ‘right to health’ that must preserve the body and mind. Understanding the historical changes in the development of the concept of prevention derived from medicine and disease that has been given to human life is not only an answer to the question of what a disease is, but also a social understanding of health through life and death that we have acquired today. It is about carving the outline of a concept.
The idea of public health in modern times aims at new social values and moral codes, forming the background of social thought that brought about important changes in attitudes that define people’s lifestyles. Since the focus was on improving and preventing infectious diseases such as cholera and typhus, which were major causes of death for humans in the 18th and 19th centuries, and the sanitary environment that promotes them, public health was public hygiene, and through various historical processes, it has become what it is today. It also serves as the basis of social systems. By reviewing the historical development of public healthcare, we will be able to solidify the legal basis for infectious disease prevention.
Understanding the modern historical development of civil society and public health ideas is a very important research task in order to eliminate the concept of modern health that has been dwarfed by the physical health of isolated individuals. In particular, we must re-recognize that the idea of public health is an idea of social change for the sound survival and health of people. In other words, the modern idea of public health is that survival and health cannot be separated, and basic human rights are closely related to human survival, either directly or indirectly.
As long as human survival inevitably means healthy survival, the basic idea of public health is a concept that aims for the well-being and welfare of citizens against the background of the human right to survival and life created by the process of forming civil society. It is not only a work, but also a social ideology that serves as a basis for claiming basic human rights derived from the consciousness of the value of each individual's life, the desire for an equal social environment in survival, or political freedom to guarantee it. Against the background of these legal and philosophical arguments, it is possible to explain the state’s power over COVID-19 (forced vaccination, order to wear a mask, quarantine of confirmed cases, etc.).
The ideas of preventive medicine and public healthcare are closely related to the modern Enlightenment ideas centered on the 18th century, which forced political reforms in society. There are countless examples where pestilence has had an extremely important influence on the fate of societies or nations, and certainly on the rise or fall of civilization itself. Nevertheless, the reason many historians underestimate plague in the historical context may be because they believe that plague is a force majeure phenomenon that suddenly appears and not a phenomenon with humans as the agent. If we understand it this way, the current mutation of the coronavirus infection can also be fully explained.
In general, when a human encounters an inexperienced pathogen for the first time, that is, when the ‘pathogen’ is introduced into a society without immunity or in an environment where parasitic/symbiotic relationships are not established, there is a high possibility of causing enormous damage. From these historical facts, policy standards can be established to decide whether to block borders or ban foreigners from entering the country to prevent infectious diseases.
Since the Black Death in the Middle Ages, people have been thinking about death, calling it ‘Memento Mori’. It must have been a worldly mental preparation for the unexpected arrival of the Grim Reaper, but it was clear that death from war or plunder was none other than the work of humans in the human world. Many people thought that human life and its preservation as a gift to this world were the most important principles that everyone should follow. For today’s humanity, the concept of prevention is a key task for survival. Preventive medicine is an active strategy created by humans seeking a happy life, and is a modern-day conclusion about diseases and society that has accumulated in the historical process of fighting against disease.
The appearance of disease changes over time and across societies. When we say disease prevention, although we include individual outbreaks in prevention, it does not mean that it is achieved in the individual category. The number of people suffering from certain diseases is limited. However, there is a perception that the mechanism of disease is universal to humanity and that prevention from infection in particular can only be achieved collectively. This is the theoretical background of herd immunity.
Disease prevention has a social context as a survival strategy for humanity that threatens our individual lives, as in the case of unpredictable deaths due to vaccination. In this sense, the recognition that personal survival depends on others is not only culturally correct, but also biologically correct. The philosophy that explains the justification for nationwide vaccination is established here. The acquisition of the public nature of this structural hygiene ideology is due to the establishment of the overall concept of universal modern political thought that has been acquired historically, that the so-called ‘survival sovereign’ who must survive in society belongs to all people, not to a very small number of powerful people or classes. It relies on or has contributed to it. Medicine is a social science and anthropology in a broad sense, and its greatest duty is to create a healthy society based on physiology.