Testing Care and Morality: Everyday Testing During COVID-19 in Denmark

ABSTRACT COVID-testing was central to control the spread of infection in Denmark. Drawing on ethnographic fieldwork, we show that testing was not just a diagnostic sign; it was also a biosocial practice that enacted a public health morality, centered on responsibility, care, and belonging. We argue that testing led to a public healthicization of everyday life, as it moralized individual and collective behavior and created a moral divide between the tested and the untested. By attending to COVID-19 testing as a material-semiotic sign, we show how testing is embedded within a particular cultural and moral framework of the Danish welfare state.

COVID-19 among different population groups and nations in the Global North (Bevan et al. 2021;Christensen et al. 2021;McElfish et al. 2021;Street et al. 2022).They find that people are generally willing to accept personal burdens of testing to protect others and demonstrate solidarity, but they also indicate barriers such as economic costs, logistics, and stigma.These works highlight the need to explore COVID-19 testing as a social process, as it is inseparable from and embedded in everyday life and social relations.
In this article, we follow COVID-19 testing as a biosocial practice to explore how meaning is ascribed and transformed, as tests circulate through the medical system and into individual lives and social worlds.Drawing on ethnographic fieldwork, we show that people used testing to enact responsibility, care, and belonging in everyday life during the pandemic, and we argue that the testing regime led to a public healthicization, which moralized health behavior and created a moral divide between the tested and the untested.By attending to COVID-19 testing as a material-semiotic sign, we show that testing is embedded within a particular public health morality in the welfare state, where individual and collective health is experienced and articulated as a shared moral concern.

Testing Denmark
The first COVID-19 case in Denmark was registered in February 2020, but as of November 2023, there are more than 3 million confirmed cases and over 8000 deaths with a confirmed COVID-19 infection (Statens Serum Institut n.d.).The pandemic affected Denmark relatively mildly in terms of total deaths and hospital admissions compared to many other countries in the Global North, an outcome that is often attributed to high levels of trust in the government and the public health authorities (Nielsen and Lindvall 2021;Olagnier and Mogensen 2020;Power et al. 2023).In line with many other countries in Europe, Denmark introduced national lockdowns that temporarily closed public institutions, workplaces, schools, and non-acute medical services.Social distancing was strongly encouraged, but besides temporary bans on gatherings in public spaces, stay-at-home requirements were solely recommendations and thus neither officially mandated nor sanctioned (Mathieu et al. 2020).Although public attitudes toward the COVID-19 strategy fluctuated over time, for example with the introduction of face masks in autumn 2020, protests and demonstrations against pandemic management were minor compared to countries such as France, Austria, Belgium, and the Netherlands (BBC News 2021; The Guardian 2021).
Denmark introduced COVID-19 testing to manage and control the virus in spring 2020.Testing helped to find and isolate the infected, trace and quarantine their contacts, identify risk in different population groups, allocate medical resources and staff, and assess mitigation measures, so Denmark would not, as the WHO stated, "fight blindfolded."Today, more than 67 million PCR tests and 61 million antigen tests have been performed (Statens Serum Institut n.d..), and the fact that Denmark ranked among the top testing nations worldwide in terms of the total number of tests performed relative to the size of its population was underscored in several press briefings (Statsministeriet 2020a(Statsministeriet , 2020b)).The public health authorities adjusted the test strategy several times to accommodate new medical knowledge, infection trends, global supply issues, and political priorities.While the trajectory of the test strategy had its own temporality, it encompassed a general transition: from testing people with severe symptoms and GP referrals; to testing people with COVID-19-related symptoms; to offering free PCR and antigen testing to all citizens, regardless of symptoms; to introducing a national corona passport that regulated access to workplaces, educational institutions, and public spaces; to recommending self-testing.During the time periods April 2021-September 2021 and November 2021-February 2022, when the national corona passport was instated, people needed tests, not just to determine infection status but also to access everyday activities like going to work, hairdressers, gyms, restaurants, and indoor public spaces.Until the vaccines became available, a negative test result thus functioned as an admission ticket to society.
Denmark invested heavily in testing, and the global shortages of testing kits and protective equipment only accentuated the state's achievement in procuring tests for its people, as the testing infrastructure evolved from a few white tents to a country-wide network of free testing facilities.A brief from the Ministry of Justice to the Danish Parliament revealed that the testing regime cost almost 270 million EUR per month in spring 2021 (Borre and Bloch 2021), and experts estimate that the testing expenses in 2021 alone amount to more than 1.3 billion EUR (Bech and Herløv 2022).Although there was generally popular support to the testing regime in Denmark, these revelations sparked heavy debate among both experts, politicians, and lay people about the merits and justifications for mass testing (Drivsholm and Elkjaer 2022;Elkjaer 2021;Rysgaard and Jensen 2021).

Ethnographic setting and methods
We conducted an ethnographic fieldwork on COVID-19 testing in Denmark from February 2021 to March 2022.The fieldwork explored testing in everyday life through ethnographic observations and conversations with people at COVID-19 testing facilities, and we conducted semi-structured interviews with 40 people who were recruited from various sites such as workplaces, educational institutions, and social networks.During fieldwork, we explored everyday test practices, including motivations and barriers to testing, attitudes to the national test strategy, and reflections on behavior and decision-making before, during, and after testing.These conversations and interviews helped us situate everyday experiences and investigate how people perceived COVID-19 testing over time.
The ethnographic material comprises extensive fieldnotes and verbatim interview transcripts that were analyzed thematically following the principles of abductive analysis (Timmermans and Tavory 2022).Due to personal and societal concerns about the risk of infection, the interviews were primarily conducted through digital communication platforms.Though some reservations persist toward online interviewing, pandemic experience and research show that the quality of online interviews is often equal to in-person interviews, with no loss of rapport or intimacy (Jenner and Myers 2019).We draw on this empirical material to explore central analytical themes, tracing how and what testing enacted as it moved into social and moral worlds.All participants were informed about our research interests and provided written and oral consent prior to participation in the project.In order to protect participant identities, the participants received pseudonyms, and all identifying details were removed or altered.On March 11, 2020, the Danish Prime Minister Mette Frederiksen held a press briefing and announced a national lockdown to control the spread of the coronavirus.She explained that adherence to restrictions and recommendations from the public health authorities was for the common good and that every citizen was obliged to uphold the welfare society and protect the vulnerable members of society, those most likely to suffer from a COVID-19 infection: "We have a very strong obligation to help especially the weakest in our society, those most vulnerable to diseases; people with chronic disease, cancer patients, and the elderly.For their sake, the infection must not spread" (Statsministeriet 2020a).The Prime Minister used evocations to "stand together by keeping distance" and "demonstrate community spirit," and thus she effectively established COVID-19 as a shared national task that conjured up a sense of moral responsibility and community spirit in the welfare state (Villadsen 2021).

Public health morality
During the pandemic, there was a widespread moralization of health practices across countries in the Western World, as specific practices such as physical distancing, testing, and vaccination took on moral properties (Bor et al. 2022;Gkinopoulos et al. 2022;Labbé et al. 2022).The process of moralization, which refers to the process by which certain behaviors, beliefs, or practices are imbued with moral significance and transformed into matters of right or wrong, good or bad, plays a crucial role in shaping social norms, regulating individual behavior, and maintaining social order within a community (Rozin 1997(Rozin , 1999)).The process is often guided by prevailing cultural norms, values, and beliefs, and societies usually enforce and reinforce moral codes through informal social mechanisms such as social approval or disapproval, praise or condemnation, and reward or punishment.Moralization is often involved in (public) health discourses, and many health behaviors and diseases such as AIDS, mental illness, and addiction have been subject to moralization, both historically and in the present day.The moralization of health behavior can have both positive and negative consequences for the individual and society, because while it can motivate people to change behavior and promote a sense of solidarity, it can also create stigma and undermine social cohesion by creating a divide between those conforming to and those deviating from the health norm (Täuber 2018).
The moralization of pandemic behavior assumed a particularly strong form in Denmark, as it was linked to notions of the welfare state as a moral community.Denmark is a small country which is known for its egalitarian and universal welfare model, where wealth is redistributed through taxes as the "broadest shoulders carry the heaviest burdens" (Esping-Andersen and Korpi 1987;Gulløv 2011;Jöhncke 2011).It is a society characterized by strong social cohesion, mutual trust, and solidarity, where people "believe they share the norm of not cheating each other" (Larsen 2013:11).In the welfare state, people have a moral responsibility to contribute what they can and only request what they need to protect the common resources and ensure the common good, and thus the relationship between the state and its citizens constitutes a particular local moral world with inherent rights and responsibilities (Offersen et al. 2017).During a public health crisis such as COVID-19, participation is not simply a right but a duty, and the boundary between the individual and the collective body fades, as the body does not just belong to the individual but to the community.Public health policies establish the moral norms that prescribe how to be a moral person and a good biocitizen, and these moral norms constitute a public health morality that moves into everyday life and social relations.
COVID-19 testing is a pandemic behavior that formed part of the public health morality of the Danish welfare state.In the following, we seek to show how testing takes on different meanings as it moves beyond the medical system and into social and moral worlds.We draw on material semiotics, which "treat everything in the social and natural worlds as a continuously generated effect of the webs of relations within which they are located" (Law 2009:141;Law and Singleton 2014), and praxiography, which takes practices as its core analytical unit (Bueger and Gadinger 2018;Mol 2002).Following Dutch philosopher and ethnographer Annemarie Mol (2000Mol ( , 2002)), we understand objects as multiple, variable, and unstable entities and explore how situated practices enact different versions of an object.In this article, however, we do not explore a particular object and the many practices through which that object is enacted, but instead turn the attention toward a particular practice and the many objects that it enacts.We focus on testing, which emerged as a key practice to people during the pandemic, and treat it as a socio-material practice that enacts notions of responsibility, care, and belonging in different, though partly overlapping, ways.The analytical attention to test practices as signs allows us to explore everyday enactments of public health morality and investigate how COVID-19 testing embodies "particular forms of ethical orientations and normative expectations" (Langer and Højlund 2011:1).In this way, we elucidate how testing is not just about the presence or absence of COVID-19 but about everyday performances of responsibility, care, and belonging that both shape and are shaped by a moral framework of collective responsibility and community spirit in the Danish welfare state.

Testing responsibility
The point isn't whether you feel like testing.It's just the responsible thing to do.(Fieldnote, young man at test center, May 2021) Medical testing is part of the health care system in all modern societies and occupies a central place in medical epistemologies, interventions, and practices.Testing became particularly significant during the pandemic because the invisible virus constituted a diffuse pathological picture that rendered everyday life uncertain and risky.Many people grew hyper-vigilant and worried so much about the risk of infection that they felt paralyzed and incapable of making decisions.They needed tests to navigate everyday life with the virus, and they repeatedly explained how testing was a key practice that helped them achieve peace of mind and make decisions, as Pauline described: When I know that it's negative, then I sort of feel that I can do more, or at least that I can do things in good conscience, without being worried.(. ..)I guess I modify my behavior and do more if you can put it that way.I meet people or go to work.I socialize.(Pauline, office employee, June 2021) The epistemological distinction between knowledge and belief in Western civilization means that medical tests are often perceived as reliable and objective tools that deliver diagnostic certainty and definitive risk assessments (Pienaar and Petersen 2022).The sociologist John Gardner explains that "one reason why we place so much faith in diagnostic technologies is because we think of them as providing us with an objective glimpse of the body and disease, free of the complexity of human emotion (Gardner 2014: 151)."Test results provide the experience of risk with a language of facts, "a language which can recontextualize risk experiences by transferring them from the domain of beliefs and uncertainty to the domain of knowledge and certainty" (Svendsen 2005:98).COVID-19 tests were good to think with, because they rendered the virus visible and reinforced the perception of the risk of infection as something concrete and controllable.However, although the test stands as a figure that deals with knowledge in an objective and unbiased way, technologies are not neutral and "get their meaning, and ultimate function, in the way they are put to use" (Pols 2017:2).
The COVID-19 pandemic was an extraordinary event, but testing soon became an ordinary practice that descended into everyday life and social relations.People generally followed guidelines from public health authorities, testing when they had been in close contact with an infected person or experienced symptoms, and self-isolating if they tested positive (Lindholt and Petersen 2021).Participants often elaborated on the countermeasures they had taken to reduce the risk of infection and testing often configured in these narratives alongside words like "responsible," "sensible," and "the right thing to do."The belief in a shared moral community was thus inherent in everyday life through actions and decisions, as testing implied that a person had taken responsibility and done what he or she could to avoid infecting others, as the office employee Jacob explained: We've just taken it as something that you just do, because it's sort of standard good behavior to make sure that you're tested.It's part of being prepared in present-day Denmark; that you've done as well as you could to not put others in danger.(Jacob, office employee, June 2021) Testing was instrumental in determining if people could visit grandparents, attend a party, or send children to school with a runny nose.Participants explained that they would usually await test results before making decisions or turn down social invitations if they could not get tested or receive the result in time.Test results allowed people to return to everyday life and reduced worries about infecting others, and the statement "I have just been tested" paved the way to social interaction and everyday life, as the university student Abby elaborated: It means that I've sort of gotten the stamp from above that says: "It's OK.You don't have to think about it right now.You've been told you haven't got it."And then I'm with my friends and go to parties like before.Well, like . . . .Yes, then I just live my life [laughs].Then I don't think about it.(Abby, university student, July 2021) During interviews, participants occasionally voiced concerns about test accuracy and quality, especially in relation to antigen tests, which were severely criticized by the public health authorities in the early stages of the pandemic.However, they also conceded that they always downplayed these uncertainties and trusted the test results, as Daniel proclaimed: We haven't actually had the discussion about whether tests were reliable enough.The, what do you say, the quantitative part of it.(. ..)There's been a broad agreement that a test is a test, and then you're clean.Then you've paid your indulgence and may enter Heaven [laughs].(Daniel, engineer, June 2021) Although test results always involved a degree of uncertainty, knowing a recent test result was better than not knowing anything.People wanted to regain control and manage the uncertainty that the virus produced, and testing suggested that people took responsibility for their lives instead of leaving life to fate.COVID-19 testing thus emerged as a key practice to demonstrate and enact responsibility, because it suggested that people tried to actively control the risk of infection and not put others at risk.However, the status of the tested body was always temporary and transitory.Test results provided a snapshot, a momentary infection status, and thus the limited validity period and risky activities such as dancing, hugging, or socializing without distance effectively reverted the status to untested, as Leah contemplated: It's a feeling I remember clearly from when I first started to get tested (. ..), it was the same cycle every time; that I had my test and then it would keep my spirit up for a few days, but then every time I kind of had my negativeness [test result] contaminated by seeing some friends.(Leah, unemployed, June 2021) Leah perceived the status of untested as "contaminated" or "unclean," which brings to mind the classical work on purity and danger by anthropologist Mary Douglas (1966).The untested body was neither infected nor not-infected, risky nor not-risky, but emerged as matter out of place in the moral community, where citizens were obliged to act and deal with the risk of infection for the common good.The lack of knowledge of infection status was a problem because it resided between two categories and demanded clarification, that is, testing.The transient nature of the status as "tested" thus left people with a continual and unceasing responsibility to monitor their infection status through further testing, if they wanted to carry on as good biological citizens (Petryna 2013;Rose and Novas 2005).As we elaborate below, this responsibility was also closely tied to notions of care and community spirit.

Testing care
You know, it isn't something I do for myself.It's something I do for others.(Fieldnote, woman at test center, April 2021) Humans are inherently social beings, but our social nature generates the perfect living conditions for the virus and makes us vulnerable during a pandemic.The fact that the virus thrives on our socialness reveals its biosocial nature, and lockdowns, hygiene practices, and social distancing measures all highlight how the biological entangles with the social and cultural lives of humans (Ingold and Palsson 2013;Seeberg et al. 2020).
Many people sacrificed socializing to show care and keep each other safe during the pandemic.However, although everybody was simultaneously "at risk" for infection and "a risk" to others, interview participants repeatedly explained that they were not worried about catching the virus.Instead, they worried incessantly about infecting others, especially the elderly, expectant mothers, and people with chronic conditions.They perceived themselves as "a risk" rather than "at risk," and thus they would regularly test to ensure that social interactions could resume and that they did not inadvertently infect others.People often voiced concerns in the form of "what if" narratives that accentuated personal responsibility; "what if I infected my grandmother and she died?" or "what if I infected my friend, who suffers from cancer, and she became seriously ill?"These statements suggest that it was not just about the risk of infection but also about the moral responsibility to manage risk and limit the potential to harm others.The personal burdens of testing in terms of time, resources, and discomfort were thus "necessary evils" to safeguard others, and the social obligation to test was a recurring theme in our interviews.
Esther, a retired woman in her 70s, was not worried about catching COVID-19, even though her age placed her firmly within the official risk group.She was, however, worried about bringing it home to her husband, whose Chronic Obstructive Pulmonary Disease (COPD) and history of heart failure made him particularly vulnerable to respiratory infections.The risk of infection was widely debated in the family, and the two children, Lars and Marianne, were both worried about infecting their father.They decided to manage it quite differently, however, because while Lars decided that he and his family would not visit his parents before they were vaccinated, Marianne decided to manage the risk through regular testing.When asked about her daughter's testing strategy, Esther said: It means so infinitely much to us.Are you crazy?It means so VERY . . .[pauses to compose herself], and I'm so GRATEFUL.Sometimes when we went over there, then I sat at the end of the table -we sat there, Gunnar and me -and said: "I just have to say thank you to all of you, because" . . .[voice breaks up and eyes wet].I'm getting all emotional now, right?"Because you've tested yourselves for our sake."I think it was fantastic [sobs loudly and wipes tears from behind her glasses] that they would do that . . . .What if we hadn't been able to see them either?It would have been terrible, right?Terrible!(Esther, retiree, June 2021) Esther explained that her daughter used testing to safeguard her and her husband during visits.Although the family practiced social distancing, sitting at opposite ends of the table, Marianne used testing to allow the family to come together safely.Lars did not see eye to eye with his sister and upheld his decision not to visit.These different strategies demonstrate different moral reasonings about how best to care for their parents during the pandemic.While Lars avoided visits to keep his parents safe, Marianne used testing to manage the risk because she, like her mother, attached great importance to in-person visits.Esther interpreted the repeated testing before every social encounter as a "gift" to her and her husband, and the fact that Esther did not even have to ask for it only accentuated the love and affection that testing symbolized.
The notion of testing for others was not, however, reserved for the close family.In Denmark, testing was also part of a community spirit and solidarity narrative, and testing for others was framed as a moral obligation to protect fellow citizens, upholding the idea of the imagined community (Anderson 2016).People often referred to community spirit when asked about their motivations for testing, and Abby described the social engagement of testing the following way: It's as if there's a general consensus that we should look after each other, and we get tested.That is, that it's a good thing.Then we're safe and look after each other.And this is sort of the way it generally is.And it's also there among my friends and me.It's this sort of thing; we just do it.And it's not for my own sake.And I think also I say civic duty, because it's not for my own sake I get tested.It's for my friends' sake and for those in their social circles.(Abby, university student, July 2021) Abby explained that there was an unspoken societal consensus about caring for others through testing.She was not worried about catching COVID-19, but she still stood in line at the test center several times a week to get tested.These tests were, as she explained, enactments of care for others.Several interviews echoed these reflections, as participants repeatedly described testing as a social obligation and a civic duty.Accordingly, refusing or forgetting to test was also expressed as a lack of care for others, and a few participants explained that testing had caused disputes in the family or among friends when a person or side of the family refused to test.As an example, a woman tearfully recounted that testing disputes had divided her family and that they were no longer meeting or talking.She worried how the falling-out would affect the family, not only now, but also in the future.
Testing was generally performed as a symbolic practice that signified consideration and care for others, but a few participants also described testing as a form of self-care, as Leah explained: I think I would've perished in a society where you couldn't get tested.I would've quit a LONG time ago and just laid in my bed and given up.(Leah, unemployed, June 2021) Leah was afraid that she might infect others, and she was grateful for the open invitation to test whenever she felt anxious about symptoms, often several times a week.In a way, Leah used testing as a form of self-care to gain peace of mind and calm herself.However, the constant risk of infection and the wide availability of tests also reinforced her anxiety because she felt responsible for always knowing her infection status.Leah's story echoes the words of sociologist Deborah Lupton, when she explains that "risk meanings and strategies are attempts to tame uncertainty, but often have the paradoxical effect of increasing anxiety about risk through the intensity of their focus and concern" (Lupton 1999:13).When asked about testing needs, Leah and several participants voiced concerns about misusing or over-using the health care system.They wanted to "test in time" but they also worried that others might accuse them of "wasting test capacity," as Leah elaborated: I've got these sorts of hypochondriac tendencies, so it's really been GOOD for me that you could get tested.Except that I felt REALLY guilty about getting tested in the beginning, about sort of STEALING test capacity.It also became somewhat of a joke in my family: "Oh, Leah is always getting tested".(. ..)I needed those tests.I needed to get tested, when I had symptoms, because I was so afraid that I might infect others.But at the same time, I felt that I stole something that didn't belong to me.(Leah, unemployed, June 2021) In the Danish welfare state, there is a delicate balancing of rights and responsibilities in relation to the shared resources.Leah perceived test capacity as a shared resource and worried about "misusing" or "stealing" test capacity, as this would indicate a lack of care for the imagined moral community.Leah's worries about under-and over-using test capacity were echoed among several interview participants, highlighting the conflicting moral stakes of complying with public health guidelines to seek out health care in time while simultaneously avoiding misuse of the health care system in the welfare state (Offersen et al. 2017).People strived to enact good biological citizenship (Petryna 2013;Rose and Novas 2005), but as we elaborate below, it was difficult to navigate the new moral landscape of everyday life during COVID-19.

Testing belonging
I think it [testing] makes you think a little bit about what kind of person you are.Am I the kind of person who takes care of others or am I more a selfish jerk who does whatever I want?(Fieldnote, young woman at test center, February 2021) In Denmark, testing was generally presented as a voluntary practice, and people were keen to participate in the fight against the virus.They followed the official testing etiquette and trusted others to take measures to reduce the risk of infection through testing, but many participants also conceded that they felt obligated to test, because testing was considered the "right thing to do."The anthropologist Barbara Koenig explains that when a technology becomes routine practice, it often becomes a technological imperative, meaning there is an inherent obligation to use it (Koenig 1988).She argues that "the experience of a technological imperative becomes a moral imperative for action" (Koenig 1988:486), and the technology thus constitutes a new moral landscape, as people use it to define what is morally good or bad.COVID-19 testing quickly became a technological imperative, moving from an extraordinary event to a routine practice that was taken as a matter of course.Testing became the morally acknowledged way of managing risk and uncertainty, and thus everyday practices and decision-making were often determined by or structured around testing.
The wide availability of testing contributed to its presence as a technological imperative, but although it was difficult to refuse, social dramas and personal dilemmas occasionally led people to circumvent or avoid testing.People worried about testing positive because they did not want to lose access to work, travels, or public spaces, and these worries often manifested in their test practices.For example, a few participants hesitantly recounted that they had skipped testing to participate in social events because they wanted to keep their possibilities open, while a woman explained that her family avoided testing altogether, because they did not want to invalidate their corona passports and jeopardize a holiday to Austria.These decisions did, however, often trigger ambivalent feelings of shame or guilt for putting others at risk, and they usually kept these "faux pas" secret.
The moral obligations toward the community and fellow citizens carried profound weight, and the idea of testing positive and infecting others produced fears and worries about stigma and moral judgment for many people.A few participants explained that they worried so much about conflicts and social exclusion that they had refrained from telling others that they were waiting for test results or had tested positive.Leah, a young unemployed woman, stumbled on this dilemma while sharing an apartment with a young couple.After experiencing symptoms for a few days, Leah had decided to take a PCR test, although she assumed the symptoms were probably a result of her worries about COVID-19 in general.During the evening, Leah bumped into the young couple in their shared kitchen: And then they ask if I'd like to have dinner with them.And then it's sort of like, I can't say no without telling them I had a PCR test.But if I tell them I had the test, then she'll probably take offense at me using the kitchen.So, there I actually ended up saying I'd like to join, and then just took the chance and hoped it was negative, because I PRESUMED it'd be.Precisely because I didn't know anybody who was infected, but it was a bit of a dilemma where I ended up doing something -normally, I'm not the type that keeps things hidden, so it was quite unpleasant for me -but because I was afraid of the stigmatization and that she'd be angry with me for using the kitchen.(. ..)And then I had already figured out a plan, where IF it turned out to be positive, then I'd tell them that I'd been tested in the morning because I had woken up with symptoms.(Leah, unemployed, June 2021) Leah explained that she had a "strained relationship" with the young couple, particularly the woman, who constantly pestered her about social distancing.While Leah had no reason to assume she was infected, the fact that she had knowingly exposed them to potential infection was so embarrassing that she had already devised a plan to manage the situation.While the young couple might be frustrated by the potentiality of infection, it was unlikely they would blame her, if she did not have symptoms during the encounter.The ways people manage and work their way through crises or dilemmas demonstrate moral values and reasonings (Mattingly 2014).Although it is not always obvious that there is a moral crisis or dilemma at stake, ordinary moments and routines activities are "taut with moments of worldmaking and world-annihilating encounters" (Das 2015:54), and events can reveal or create moral dilemmas that cause new moral reasonings and subjective ways to position oneself (Howell 1997).Leah's moral reasoning enabled her to maintain her self-image as a responsible and moral person that belonged in the moral community.Normally, she would not willingly expose others, but although she felt guilty about her actions, she defended the decision by referencing that she had not spent time with an infected person.As Leah's dilemma demonstrates, it is hard work to establish oneself as a moral person during a pandemic because the individual is constantly in a position where they must (re) consider and determine when, how, and why their test practices constitute the morally correct way to manage the situation.
The strong moralization of testing in society made it difficult to assume critical and divergent attitudes toward the COVID-19 management.Consequently, people who were critical of the COVID-19 management explained that they were often shamed or socially excluded, when they criticized the government or the public health authorities.For these people, testing became a way to maintain their social standing in the community and guard themselves against allegations or shaming, as the yoga instructor Hailey explained: It's not because I really believe that I've got more or less corona.It's more that then I can at least tell people afterwards -if I had corona -then I can say: "Well, but I was tested."I also think that it's about shaming.It's about the fact that for a long time, there's been a sort of smear campaign against people that have been just a little bit critical.So that is why you constantly try to guard yourself against being shamed.After all, it's your worst fear to suddenly be pushed out of the community.And it's actually a really smart strategy to make people do things; if you don't do it, we'll shame you.Then you'll be excluded from this community.So, you're constantly trying to make sure that you're not left out, that you have a clear conscience, that you're not irresponsible.(Hailey, yoga instructor, August 2021) When people tested, they could say that they had done what they could within the range of technical and moral possibilities.Although Hailey considered testing "unnecessary" and a "bloody waste of time," she was concerned to manage the risk of infection in ways that would not jeopardize her social standing or relationships with others.Avoiding testing would be a sign of non-commitment to her social relations and to society, so although it went against her better judgment to test "for no reason," she subjected herself to the common testing etiquette and adjusted her test practice to accommodate others and avoid shaming.
The moral is a communal enterprise, and no person is independent of her community and its virtues (Mattingly 2014).During the pandemic, the responsibility to take up testing, not only individually but also in relation to others, constituted a moral landscape, which posited moral judgment on the untested and those who performed "risky behavior."People perceived actions like arriving at work with symptoms, refusing to follow testing guidelines, or withholding information about infection status as self-serving and a violation of a social norm.The failure to act for the good of others was described as a betrayal of community spirit and good biological citizenship (Petryna 2013;Rose and Novas 2005).Participants used words like "selfish," "reckless," "disloyal," and "dangerous" to describe these individuals, and testing thus emerged as a moral practice that distinguished the "responsible" from the "irresponsible" citizens and established a moral divide between the tested and the untested.It became a concrete sign of belonging, signifying people's status as good or bad citizens, as insiders or outsiders to the moral community.

Public healthicization in the welfare state
The moralization of pandemic behavior aligns with political currents around new public health policies in the Western World, where the main focus has shifted from disease treatment to health promotion and lifestyle prevention (Knudsen and Triantafillou 2021;Larsen 2012;Lucivero and Prainsack 2015).Behaviors, beliefs, and practices are increasingly moralized in these new public health policies, and "judgments of morality in the practice of citizenship involves caring for the self and others" (Petersen and Lupton 1997:64).However, as the responsibility has also shifted from the state to the public itself, individual citizens now have a moral responsibility and a societal obligation to make healthy lifestyle choices and engage in lifelong surveillance practices such as healthy dieting, exercising, and preventive testing to protect themselves, the community, and the common resources in the public health care system (Armstrong 1995;Frumer et al. 2021;Heinsen et al. 2022;Petersen et al. 2010).
Several social scientists have described the role of health and illness in society through the concepts of medicalization and healthicization (Clarke et al. 2010;Conrad 2007Conrad , 1992;;Conrad and Schneider 1992;Illich 1975;Zola 1972).The sociologist Peter Conrad (1992) explains that while medicalization refers to the process by which non-medical problems or aspects of life become defined and treated as medical issues that require biomedical intervention, healthicization is about health promotion and proposes lifestyle and behavioral causes or interventions for events that were previously defined as biomedical problems.Morality plays a significant role in processes of both medicalization and healthicization, as it influences perceptions, debates, and decisions about how to define and address health and illness within society.The moral responsibility and obligations of individuals, institutions, and policymakers differ significantly in these processes, however, because while medicalization exonerates people from moral responsibility, healthicization extends into all aspects of life and offers "no absolution from individual responsibility, accountability, and moral judgement" (Zola 1972:492).During the pandemic, we witnessed elements of both medicalization and healthicization in everyday life, but none of these concepts fully capture the emerging role of new public health policy and the shift from health at the level of the individual to that of the population.Consequently, we propose the concept public healthicization to describe the multifaceted processes through which public health permeates everyday life and social relations beyond traditional health care.The concept delineates how the individual and the public merge, often reaching a point where individual actions and societal interests appear inseparable, and how public health policies and interventions establish moral norms about which behaviors, beliefs, and practices are deemed acceptable, healthy, and normal.
During the COVID-19 pandemic, public healthicization manifested itself through a collection of semiotic signs, including hand sanitizer, physical distancing, face masks, testing, and vaccines.Among these, mass testing constitutes a particularly illustrative example of public healthicization in Denmark, as it forced public health into everyday life and regulated access to society and social interaction.The government and the public health authorities embedded testing in a public health morality, where monitoring infection status and taking measures to reduce the risk of infection through testing became a moral responsibility and a societal obligation.Testing was not just a matter of protecting yourself; it was about protecting society, and the tested bodies thus constituted the good and responsible biocitizens, while the untested bodies posed both a physical and a symbolic threat to the moral community.Although COVID-19 testing is only a singular case, it highlights the pervasive role of diagnostic signs in the public healthicization of everyday life.COVID-19 testing effectively embodied the public health morality of the welfare state, and everyday enactments of testing as signs of responsibility, care, and belonging established individual and public health as a shared moral concern.
National leaders and public health authorities play an important role in instructing and advising citizens on proper and responsible behavior during (inter)national health crises.The Danish Prime Minister's mobilization of the welfare state to moralize health behavior encouraged adherence to restrictions and limited the adoption of conspiracy theories (Bor et al. 2022;Gkinopoulos et al. 2022), but it also led to an intolerance toward norm violators and created a moral divide between the tested and the untested -and later the vaccinated and the unvaccinated.The strong narrative around COVID-19 as a nationalist project, tied to notions of personal responsibility and societal obligation toward the moral community, was so effective that it left little room for critical and diverging attitudes, neither within the government nor among social relations.In a democratic society, there should always be room for discussions and divergent opinions, and the moralization of testing thus raises important questions about the freedom of the individual and where to draw the line when protecting and leading the collective body through a health crisis.There is no doubt that the belief in a shared moral community constitutes a form of resilience in relation to pandemics or natural disasters, but it is important to find a balance between public healthicization and individual freedom, as the moralization of health behavior may backfire and reduce the social and institutional trust that is so fundamental to Denmark and the welfare society.

Conclusion
COVID-19 testing holds profound significance as a diagnostic sign in public health management when determining the presence or absence of SARS-Cov-2, but it also takes on new and extended meanings when it enters social and moral worlds.In this article, we traced testing as a biosocial practice and a materialsemiotic sign that achieves a special moral weight and symbolic density in everyday life, as people use it to enact responsibility, care, and belonging in the welfare state.We showed that testing was embedded in a public health morality that framed the risk of infection as a moral responsibility and a societal obligation, which created a moral divide between the tested and the untested.Finally, we argued that testing led to a public healthicization, as it forced public health into everyday life and regulated access to society and social interaction.Testing embodied the public health morality of the welfare state, and everyday enactments of testing as signs of responsibility, care, and belonging established both individual and public health as a shared moral concern.
This is important.It's about more than yourself.It's about society.(Prime Minster Mette Frederiksen, press briefing, March 2020)