Individualization and work in the context of COVID-19 pandemic in Brazil

The COVID-19 pandemic promoted a productive leap in global dimensions and, consequently, in Brazil, consolidating profound social changes. The process of flexibilization of work relations found, in the pandemic context, objective conditions for its expansion, in particular the increasing use of technical-informational and telecommunications solutions. Assuming this scenario, this essay discusses the individualized and individualizing forms and labor relations resulting from this process, as well as the intensification of the dynamics of social individualization. RESUMO pandemia Covid-19 salto dimensões globais e, por consequência, no Brasil, consolidando profundas alterações sociais. O processo de flexibilização relações trabalho encontrou, no contexto pandêmico, condições objetivas para sua expansão, especial, o crescente uso de meios técnico-informacionais e de telecomunicações. Pressupondo este cenário, discute-se neste ensaio as formas e as relações de trabalho individualizadas e individualizadoras decorrentes desse processo, bem como a intensificação da dinâmica de individualização social. social.


Introduction
The assumption of this article is that the COVID-19 pandemic promoted a productive leap in global dimensions and, consequently, in Brazil.
We will call here the productive leap the phenomenon of consolidation of profound changes in the capitalist production process, understanding that: Production is not only a private production: it always constitutes a social body, a social subject, which acts in an ensemble -vaster or less vast, richer or less rich -of production branches 1 (31) .
We argue that this process, which develops since the Fordist model in the 1970s, occurs basically around the flexibilization and fragmentation of the industrial production and the conversion of the productive structure into electronic, computational and telecommunications technologies. This productive model, adopted then especially by Japan, Germany and Northern European countries 2 , found in the context of the pandemic the objective conditions for this leap -its expansion, capilarization and global consolidation; it can be observed in two dimensions of the productive process: its forms and intensity.
These productive forms, then present or incipient in Brazilian economy, and that unfold in certain work relations, flexible, temporary, partial, uberized, by means of platforms and apps, in articulation with temporary unemployment, structural, and with the emergence of what Standing 3 named precariat, were raised, in a very short period of time, to economic and social prevalence. In the initial months of the pandemic, the then named economy of precarious, flexible, informal, temporary, part-time work, sub-employment etc., became the dominant and necessary form the socio-economic reproduction. There was an impact in the fact that the pandemic, which was at first perceived as a pullback factor of the productive process due to social distancing and lockdown, has paradoxically maintained a certain productive standard, with a much smaller fall than what had been expected, including in Brazil 4(B4) . The agile technical informational and telecommunications means, already installed and available in the ambit of the Brazilian socioeconomic structure, enabled this almost immediate productive conversion, altering and definitively consolidating new production relations in the country. However, as in any context of the development of productive forces, reproducing social inequalities in correspondence to those relations.
The intensity of this conversion results from the agility enabled by the technical informational means, characterized by dispersion, segmentation, and division in separate and discontinued unities, capable of being processed, selected and retrieved according to specific and individualized needs 5(49-50) . This introduced a radically new spatiotemporal landmark in relation to that of the modern industrial society, being increasingly characterized by the flexibility of goods and equipment, standardization of high-precision fabrication, modular production, and automated assembly 2(49) .
When discussing the acceleration of late modernity, Rosa 6(127) mentions the difference between the times for the purchase of goods and services, which can be made in a few seconds, and their consumption, which cannot be made in a few seconds. We agree with Rosa, however, we argue that this difference has been reduced in the context of the pandemic; the times have become more similar and, consequently, so has the intensity of the productive logic, remembering that there is a reciprocal dependence between production and consumption.
Production creates the matter for consumption, as an object that is external to the latter; consumption creates the need as an internal object, as the purpose of production. Without production there is no consumption; without consumption there is no production 1(43) .
It is this articulation -between productive technologies, social forms of work, and intensive spatiotemporal contraction between production and consumption -stimulated by the pandemic context that consolidated what we here denominate productive leap, configuring other social forms and relations.
By assuming this scenario, that of a productive leap stimulated and consolidated by COVID-19 pandemic, we will discuss in this article the resulting individualized and individualizing forms and relations of work in the Brazilian context. The argument is that the form of work that is consolidated in the context and unfolding of the pandemic, still in course, also consolidates and stimulates the processes of social individualization. This argument will be presented and discussed in this empirical-theoretical essay by means of three topics. In the first topic, we approach the conceptual-theoretical aspects on individualization and work in the contemporary world. In the second, we present some of the social forms of individualization in the processes of work developed in the pandemic context in Brazil, specifically remote work and telemedicine. In the third, we present the final considerations with some unfoldment of this phenomenon and the process of social individualization through health.
Considering that this is an essay, which allows for a more open methodological configuration, in the first topic and in the final considerations, we have adopted authors who have been working on the theme of individualization, more specifically in the field of contemporary sociology. The empirical data that inform the problematization exposed in the second topic correspond to a free search, though directed and intentional, in databases of scientific articles and news from printed and electronic media, using terms such as COVID-19 pandemic, telework, remote work and home office, use of apps and telemedicine.
Essay, in this paper, refers to the idea that the problem under study, i.e., the "social situations and trends" "cannot be adequately described without reference to theoretical factors" 7(223) . It also refers to the idea of "judgement formation" 8(191) , i.e., to some propositions that derive from experience, directly expressed, or those formed from the analysis of the subject-concept, both developing the formal argumentation.

Individualization and work
The process of individualization in the contemporary society has been a recurrent theme in the ambit of social theory. Here we will draw on the analysis of Bauman 9 , Beck 10 and Castells 11 , which despite being different, understand individualization as a process of social constitution, in which the individual is the central reference of social actions and processes, as a reference of/to herself/himself. In this context, the individuals become increasingly the expression of their own choices.
The choice, as a process of liberation of subjects from the shackles of modern society's traditions, promoted a double effect: culpability and insecurity. The first one refers to the effects of freedom itself. At the same time that the individual feels free to follow their own path and build their own biography, she/he is held responsible for their own choices. Individuals believe and behave as if they are responsible, culpable, for their own problems 10 . In the disease, they are held responsible or culpable for not having healthy habits; in unemployment, for not having been hardworking or not being adequately skilled. In this sense, the individuals become producers and active protagonists of their lives. The second effect refers to the loss of traditional securities, which promotes the weakening of belonging to a collective in the detriment of the individual, generating the sentiment of constant insecurity 9, 10 . The process of individualization becomes even clearer in the face of the transformations of the world of work, with the end of employment in the form of modern industrialization 9-11 . When referring to the Fordism industrial model, Bauman 9 states that the strong relationship between capital and work enabled the rise of a long-term mentality, in which the one who sells her/his work and the one who buys it constituted a long-term union. Capital and work were face-to-face, physically installed in industrial territories, and represented a long-term contractual relationship. This means that capital was as tied to the place as the worker. By means of a specific organization and management model, the factory as a physical and fixed territory enabled the creation of a cultural identity environment, i.e., it constructed and defined the worker's identity. In this sense, Bauman 9,12 , Beck 10 and Castells 11 highlight the centrality of work as a means of collective social insertion of the individual into modernity.
Bauman 9 uses the metaphor of camping to characterize the dynamics of work in the light capitalism, of liquid modernity. The metaphor of the camping/caravan site demonstrates that the flexibility of work does not offer security and conditions for the workers to develop long-term projects. Besides, flexibilization brought to workers the need to be always open to new changes and possibilities. It is the practice of always leaving the camping, not staying fixed, not having a lasting relationship similar to Fordism.
If in the first modernity the collectivized work was central in the construction of identity and the individual's social insertion, the present flexible work inflicts on the individual a sensation of imminent risk, both by the possible unemployment and the by possible professional failure. In this sense, presently work no longer represents a safe axis to fix identities and life projects; its structuring function of life planning is dissolved 9 .
In the context of contemporary individualization, Beck 10 also analyses the de-standardization of employment, stating that flexible work, sub-occupation and unemployment substitute full-time occupation. The right to work and labor rights, the defined place and time of the working journey, which were the pillars of this traditional world of work, does no longer exist as such. In this context of uncertainty, the objective, psychic and health risks are privatized to the worker her/himself, who is individually held responsible. The individual must self-reproduce, including with regard to social protection and working conditions. The characteristics of this contemporary worker is to constitute a kind of multiuse, in a way that the own existence is marked by constant insecurity. According to Beck 10 , the more the relations, conditions and market are de-regulated and flexibilized, the faster and efficiently the society of work becomes a society of risk.
Like these authors, Castells 11 states that the end of the industrial society implies a new production system, in which productivity and competitiveness constitute the main factors, with the first originating from innovation and the second from flexibilization. Firms, regions, countries, and economic unities organize their relations of production to maximize innovation and flexibilization. Information technology and the cultural capacity to use it are crucial for the performance of these new productive functions. Furthermore, a new type of organization and administration, aiming at adaptability and simultaneous coordination, becomes the base of the operational system, exemplified in what the author names network enterprise 11 .
In this new context, the workforce is redefined, with the emergence of two types of workers, named by the author as generic workers and self-programmable workers; what differentiates them are the educational capacity and the incorporation of information. These differences, used in self-programmable workforce, enable the worker to have the "capacity of constant redefinition of the necessary skills to perform a given task" 11(417) . On the other hand, generic workforce, without access to education, "receive a given task with no reprogramming resource and no presupposition of information and knowledge incorporation beyond the capacity to receive and execute signals" 11(417) , being easily substituted by machines or less valued workforce. Therefore, the end of the industrial society, in Castells, configures a new productive system of uncertainties and flexibilization.
Bauman 9 considers that even in the previous phase of the industrial society, uncertainty has always been present for workers; however, in the contemporary society it acquires the character of a powerful individualizing force that, instead of uniting, divides. For this author, there is the loss of the cohesiveness capacity historically attributed to work, as well as its identity function of configuration of cohesive social classes. The long-term work is substituted by the volatility of the workforce. Also for Beck 10 , unemployment and flexibilization of work coincide with an individualization that lacks class bonds. For these three authors, these aspects constitute the first effect of the process of individualization in the world of work: insecurity.
This new form of work needs a polyvalent worker, capable of dealing with the most varied technologies, available 24 hours, apt to learning new forms of (self-)management, approaching the own subjectivity, no longer being an employee but rather a collaborator, able to redefine the solidarity relationship of factory workers toward the individualization of relations and processes of production and wages; an individualized worker, an entrepreneur, always keen to permanent training/ capacitation and held responsible for the own choices and career.
Drawing on the notion of fitting and refitting, Beck 10 states that the individual disconnects from the life style characterized by the long-term work of the industrial society and enters the way of life in which the individuals must build themselves their biography in a continuously individualized and individualizing process. In face of a globalized, technological, fast, informational world, the worker finds her/himself immersed in the increasing need to qualify, reinvent and update her/himself.
With the disintegration of certainties constructed by the industrial society, Beck 10 sees that the worker inserted in the process of radicalized individualization will always be held responsible and culpable for not being able to follow the necessary professional update.
This new context of the world of work radicalizes even further the existing social inequality, privileging those who have the possibility to be constantly qualified, those who can or are apt to better incorporate new technologies, and being even more perverse by making the individual be responsible for the hindrances of labor insertion 9,10, 13 .
In place of the protection ensured by the Fordism work, today prevails the liberal discourse of entrepreneurship that forcefully pushes the responsibility of the individual for the own professional and social destiny and success. Furthermore, the flexible employment regime prevents the creation of the individual's lasting bonds with work, deepening the loss of collective and socializing references, sense of belonging, social support and construction of a modern traditional identity. It is in this way that the work processes are articulated to those of individualization, and vice-versa, weakening the worker's bonds and protection support 10 .
The major consensuses among the authors Castells, Bauman and Beck highlight the transformation of the contemporary world of work, the concern with the individual's responsibility, and how each one must learn to live with the own anxieties and worries in an individualized way 13 .
In synthesis, contemporary work is mainly characterized by non-regulated contracts, part-time work, fixed-term employment, outsourcing, the so-called productive relations and informal contracts that encompass selfemployment, sub-employment and structural unemployment. Its product is the flexibilization of work and production relations. This does not mean the loss of centrality of work in society; on the contrary, this centrality is maintained as one of the important vectors of the organization of societies, in the social relations between individuals and groups. However, it is reconfigured by the individualized form, weakening the construction of collective identities and cohesion typical of the industrial society and ascribing to workers the sentiments of insecurity and culpability 9-11 .

Remote work
"With COVID-19, the world lived in a few months the equivalent to ten years of digitalization" 14 . It is recognized that "one of the consensuses around the pandemic is that the circumstances contributed to the acceleration of digital transformation of Brazilian enterprises and homes" 15 , a productive form that articulates in one network the social, study and work world, thus breaking the barriers that were previously clearly established.
However, there are some paradoxes. Data from the Solidary Research Network 16 and the National Household Sample Survey PNAD-COVID-19 17(B7) show the differences and social inequalities of the phenomenon of digitalization. They indicate that in Brazil the profile of the remote worker is mainly white, with higher education and female, predominantly linked to the sector of service, of higher education and management and administrative positions of the agroindustrial sector. This is a highly unequal situation in relation to the majority of the working population, black, with lower education level, whose work remained presential or was lost due to the crisis in the production floor. The pandemic caused a "retreat [that] produces a sudden stop of the economic activity, since many firms shut down and people stay at home" 18(1) .
With more people at home, amid the sanitary recommendation of social distancing, there was a growing number of delivery orders, but also of bank services, businesses, health, fitness and education 19 , reaching a 15% increase. In 2020, Brazil represented almost half (48.77%) of the delivery orders in all Latin America 20 . This fact, added to unemployment in the country, previously significant and aggravated by the pandemic, made the use of apps become an alternative to those who sought work, even creating a waiting list to gain access to these platforms of services, which became a source of income to many families 21 .
Even though social inequality linked to work is maintained or is reproduced in the Brazilian society, the form of work mediated by Information and Communication Technologies (ICT) is anchored in an individualized and individualizing dynamics that broadens its standardization in the pandemic context. Socio-economic inequality with technical informational similarity. The paradox confirms the trend that the 'productive leap' fulfils itself: from an industrial economy to an informational economy, one of platform, techno-electronic-telematics.
At this juncture, what has been taken as informal, incipient, flexible, de-territorialized, became the principal productive process, making social life feasible in a context of epidemic risk. Social distancing was fulfilled by the economy of platforms, sub-employment, informal and temporary employment, part-time and fractured workday, and unemployment. According to the Apps Flyer 22 , since the beginning of the pandemic, installations and the use of apps had an accelerated growth in Brazil, where in some states the increase was close to 50%, as in the state of São Paulo. This is attributed to the fact the country is the second in the ranking of nations with the greatest growth of the smartphones market, after Indonesia 23 ; this may be an important component that boosts greater portability and individualized practices.
In this sense, social distancing, home office, unemployment and its flexible forms, the economy of platforms and the use of applications, intensely articulated in the context of the pandemic, have deeply transformed the social context.
Living spaces have changed. Houses and buildings have now space for home office and co-working. From this, new apps unfold, such as the office pass or on demand, which enable to book a working place in any region of the city, at any day and time 24 . The newspaper 'O Estado de São Paulo' published a report in which 66% of people consulted wished to maintain hybrid work in the post-pandemic time: co-working spaces are closed due to home office; co-working spaces are opened in districts away from the center of the city 24 . The productive plan in general and that of cities is altered, with the emergence of other and/or new 'satellite regions' of production.
This process is perceived optimistically as innovation. A research of the Latin American platform Workana published on the news portal G1 25 shows that over 80% of the interviewed entrepreneurs intend to maintain remote work after the pandemic and over 90% of the interviewed employees say they wish to continue with remote work after the pandemic. This is mainly justified by the flexibility of time and focus on results. However, only slightly over 20% of the firms offered digital tools and/or computers to employees in remote work 25 and few firms subsidized home expenses with internet and electric power 26 .
Uberized, domiciled, self-sustained and self-produced work, by home office or individual entrepreneur, combine with modern traditional formal, extra-domiciled, under contract, temporally and spatially configured work. In this sense, home office and work by apps anchored on ICT, further than being a spatiotemporal and contractual variation, carry a new modality of productive, individualized and individualizing activity, organizing and transforming the contemporary society. Therefore, it is a social process that consolidates globally, permeated by a series of contradictions and the coexistence of new and traditional structures.
One example is the discussion about the best way to measure work and the working day. Previously, firms made use of 'presenteeism', i.e., the amount of hours that the employee stayed physically at the office performing activities under the sight of the boss and other workers. However, with the need of social distancing due to the pandemic and, consequently, with the shift of work into the home, physical presence can no longer be an adequate marker to evaluate the worker.
In fact, during the pandemic, the number of worked hours worldwide increased, rather than decreased. In 2020, the average number of daily hours worked increased in more than half an hour in average. The thought is that if everyone is online, I must be online too. [...] Many bosses only perceive the most visible persons, so they presume that those are the most productive employees 27(1) .
In the context of this new organization of work, the production still linked to presenteeism remains as a managerial instrument to assess the performance of the employee. Even if this compulsion for production emerges not as formal measure, in the sense of a new guidance formalized by the firm, but as a 'spontaneous' movement, in a certain way it becomes institutionalized, precisely through the individual movement of each employee, from the pressure of delivering results and, especially, from the attempt to make oneself 'present' in the virtual context.

Health work: telemedicine
In the health sector, the phenomenon of telework was also intensified during the pandemic. The main 'tele' tool is teleconsultation, which is remotely performed by means of software or apps that mediate the contact of the health professional with the patient. In this context, due to the recommendation of social distancing, added to the increasing demand for clinical care, teleconsultation became a key element.
The pandemic context forced a change in the traditional model of health care services. Health organizations have been abdicating presential care and are investing in technological solutions to perform clinical follow-up of users. Therefore, health professionals face a double challenge: to advance in the knowledge of the new disease, COVID-19, and to adapt to a new way of delivering care in the distance format.
Telemedicine understood as medical practice mediated by ICT is not a new activity, but it was strongly boosted in the pandemic context and this pressed the regulation of teleconsultation by means of a Directive of the Ministry of Health 28 and a temporary federal law 29 , already at the beginning of the pandemic.
In the ambit of the Unified Health System (SUS), there was already the National Program 'Telessaúde Brasil Redes' [Tele-health Brazil Networks], created in 2007 and expanded in 2011, which operates as a tool of permanent education and support for health professionals, providing services of tele-consultancy, tele-diagnosis, second formative opinion, and tele-education 30 . Despite the hindrances for the expansion of the program in such a large country, with huge inequalities regarding the availability of technological equipment and internet access, the strategy was positively evaluated by the Pan-American Health Organization (PAHO) for having satisfactorily managed to articulate different points of the health networks, reducing waiting lines and being resolutive in a large number of cases 31 . Based on this, Haddad and Temporão 31 now defend the teleconsultation, considering that its authorization would have the potential to expand access and strengthen the management of health networks of SUS.
Today, the Basic Health Units (Unidades Básicas de Saúde -UBS) of SUS installed in indigenous villages in the Médio Xingu region, state of Pará, receive teleconference equipment and internet access. The purpose of the strategy is that these UBS shall provide distance consultation to 2,400 indigenous persons, by specialized medical professionals from other localities; the project is funded by a private concessionaire of Belo Monte hydroelectric plant 32 .
Still in the ambit of SUS, Celuppi et al. 33 verified that several state administrations in Brazil have included telehealth and telemedicine tools in their contingency plans in the pandemic. Virtual tools are included for assistance, communication, professional training, as well as self-evaluation by the user.
In the private sector, telemedicine is a rapidly expanding trend. Since the beginning of the pandemic, in 12 months, private health insurance providers registered more than 2.5 million virtual consultations, with a resolution rate of 90%, according to a survey conducted by the Brazilian Association of Health Insurance (Associação Brasileira de Planos de Saúde -Abramge) 34 . Private health services are offering virtual consultation packs at low cost, a strategy that is adopted not only by popular clinics but also by traditional hospitals that serve the upper class, such as the Albert Einstein Hospital, in São Paulo 35 .
In this sector, with the emergence of services directed to telemedicine, there is a transformation in health work: doctors have been autonomously registering at digital platforms, without necessarily having an employment bond with the firm in which they have registered, counting solely on the Federal Council of Medicine (Conselho Federal de Medicina -CFM) as a regulatory medical activities agency. As pointed out by Costa, Sola and Garcia 36 , medical services have become characterized by: […] de-localization of delivery, homogenization of services, administration of surplus labor through precarious bonds and control of local institutional management by intermediation firms 36(74) .
These authors state that with the emergence of telemedicine, medical doctors occupied the position not only of workers, but also of consumers, since they use a platform that has precisely the purpose of capturing them; hence, in the same way as the patients, they are also the final users of the digital service.
In this aspect, it becomes evident that there is a certain vulnerability of the professional in relation to the bond with telemedicine firms, in some measure similarly to the relation patient/ consumer: The medical doctor also has a relatively vulnerable position in face of these systems, because she/he does not share with the platforms' managers the economic capacity and expertise to administer not only informatics systems, but also sophisticated structures of networks potentiation to dominate market 36(78) .
Thus, while the health professional loses the own centrality, the firms that intermediate the encounter between doctor and patient gain larger space and, especially, confidence, because it is the platform that has the information about the professional: The system does not allow the consumer to choose the service provider; as in the case of the Uber system, in which instead of trusting the public authority for the certification of private drivers (in the case of taxis, the license is a municipal competence), the user trusts the platform and, after entering the network, but less importantly, the evaluation of other users about a certain driver/service provider 36(81) .
In fact, in this model of telework via digital platforms, the doctor gains autonomy and flexibility to manage the own agenda and working hours; however, employment bonds become increasingly more fragile, which corroborates the loss of centrality in the relationship with patients. However, even if the working bond is fragile, professionals must follow the guidance of the firm to which they are linked, and they could be faced with going against legal medical conduct, i.e., be contrary to CFM's norms.
In synthesis, the advance of telemedicine in Brazil is a fact, but it still encounters regulatory dilemmas, since the activity is not fully regulated and is supported by provisional law. Here we wish to highlight an issue that refers to the autonomy of the medical doctor. The main Brazilian medical institutions -the aforementioned CFM and the Brazilian Medical Association (Associação Médica Brasileira -AMB) -diverge about the first consultation being obligatorily presential. While the CFM defends that the first consultation should be presential, the AMB understands that the doctor "should determine whether there is the need for a presential consultation or not" 37(1) . In an interview to the newspaper Folha de São Paulo, the president of AMB said: It is the doctor's decision, the doctor's autonomy. If the doctor adventures into making a therapeutic proposition without having all the necessary elements, she/he will be held accountable for this. It does not attenuate the doctor's responsibility if he/she makes a presential consultation or a teleconsultation 37(1) .

Final considerations
The analysis of work as a social phenomenon requires special attention. According to Linhart 38 , in consonance with Castells 11 , Bauman 9 and Beck 10 , the transformations in the world of work, especially from the 1980s, with the intensive incorporation of ICT, obliged sociology to develop new analyses, since the analytical categories applied up to then by this field of studies no longer represented the new context. Nowadays, one no longer refers to factory workers, but to operators, installation pilots, line conductors; no longer to qualifications, but to competences, missions, roles; no longer to groups, but to cells, elementary units, zones, islands; no longer to bosses, but animators; no longer to direction, but to managers 38 (25) .
The sociology of the landmark of modernity understood work as a "militant" form, as a "battlefield with its attacks and counter-attacks" 38 (24) , i.e., work explained by the capital/ work conflict. Workers as a class, over which falls the intensified exploitation, but which detains -at least potentially -the capacity of a collective organization (and unionist representation) and response (fight).
Since "there are no more certainties" 38(24) , the field of sociology has split into those who believed that the new technical-productive transformations could valorize subjectivities and strengthen the worker's autonomy, and those who understood that modernization could be even more coercive, reinforcing a threatening and "unbearable pressure" on the worker. This dissensus is due to the fact that the new reality is ambivalent and in it coexist contradictory tendencies, with two fundamental phenomena that characterize the new world of work as an object of sociological analysis: individualization and contradiction 38 (26)(27) . It can be said that the pandemic exacerbated these two phenomena in the context of the productive leap.
If, on the one hand, work mediated by telecommunication and informational technologies represents an innovation, on the other hand, it produces new risks. Specifically, concerning work by means of platforms and apps -the best-known example is uberization, a term due to the company named Uber -by including the cyberspace dimension and the transnationalization of the world of work, it challenges the typical state regulation of the first modernity, based on the geographic national delimitation and on the territorialized collectivity of labor force, characteristically modern. It also challenges the very reproduction of the workforce, now conditioned to the "management of its own survival, [which] becomes the core of the social reproduction of workers 39(115-116) , incorporated and managed by means and in the process of work.
Regarding medical work, the relation flexibilization and individualization is even more complex, because this work is anchored on the idea of medical autonomy, a social phenomenon according to Donnangelo 40 . Taking Foucault's classical analysis of the clinic, Donnangelo stresses that its great transformation in modern society was due not only to the technical-scientific incorporation but mostly to the "spatial and temporal reorientation of the medical act" 40 (32) . It means there was a notably liberal historical-social, political and economic structure that characterized the clinic: "an ideology of work -the medical liberalism -, a specific relation of exchange of this work for income in a free market" 40 (33) .
In this sense, medical autonomy -a central issue in the public debate on COVID-19 therapeutics, for example, as well as in the advance of telemedicine in the pandemic context -presupposes its modern liberal, traditional heritage, though objectively mixing with the flexibilization of contemporary work. In this viewpoint, the path of health care in the digital format is not in the origin, but reinforces the individualized care and weakens the precepts of health in its modern collective dimension. The apps of self-diagnosis, for example, transfer this responsibility, which was previously of the medical professional, to the patient. Bauman 9 , Beck 10 and Castells 11 , here in dialogue with Donnangelo 40 , highlight the profound changes in the world of work, now shaped in consequence of the pandemic event. A change of the collective paradigm to the individual. This ascertainment may be one of the keys to the understanding of the processes of individualization, both in the world of work and in the social world.
The exercise of this essay was to articulate the idea of a productive leap with the processes of individualization, not only in relation to the world of work but also to social individualization, both processes stimulated and exponentiated by a phenomenon in health-disease: the emergence of the COVID-19 pandemic. The pandemic as a catalyst phenomenon of profound social metamorphosis.