Philosophers of medicine have formulated different accounts of the concept of disease. Which concept of disease one assumes has implications for what conditions count as diseases and, by extension, who may be regarded as having a disease (disease judgements) and for who may be accorded the social privileges and personal responsibilities associated with being sick (sickness judgements). In this article, we consider an ideal diagnostic test for coronavirus disease 2019 (COVID-19) infection with respect to four groups of people—positive and asymptomatic; positive and symptomatic; negative; and untested—and show how different concepts of disease impact on the disease and sickness judgements for these groups. The suggestion is that sickness judgements and social measures akin to those experienced during the current COVID-19 outbreak presuppose a concept of disease containing social (risk of) harm as a component. We indicate the problems that arise when adopting this kind of disease concept beyond a state of emergency.

医学哲学家对疾病的概念做出了不同的解释。一个人所假设的疾病概念会影响哪些疾病被视为疾病，以及从广义上讲，哪些人可能被视为患有疾病（疾病判断），以及哪些人可能会被赋予与疾病相关的社会特权和个人责任（疾病判断） ）。在本文中，我们考虑针对四组人群（阳性和无症状）对2019年冠状病毒病（COVID-19）感染进行理想的诊断测试; 积极而有症状的；消极的; 且未经测试-并展示了不同的疾病概念如何影响这些人群的疾病和疾病判断。建议是，与当前COVID-19爆发期间所经历的疾病判断和社会措施类似，其前提是疾病概念包含社会（危害）风险。我们指出了在紧急状态之外采用这种疾病概念时出现的问题。