In 2009, at the height of the H1N1 pandemic, a group of researchers in the U.S. and Canada decided to test whether public-health interventions might limit disease-induced prejudice along with disease itself. In one part of the study, members of both vaccinated and unvaccinated groups were asked to read an article that amplified the threats of the pandemic, then complete a survey that assessed their attitudes toward immigrants. The vaccinated subjects, it turned out, exhibited less prejudice than their unvaccinated counterparts. In another part of the study, the researchers determined that defining vaccination in terms of contamination—“the seasonal flu vaccine involves injecting people with the seasonal flu virus”—increased prejudice in subjects concerned about disease, whereas defining it in terms of protection—“the seasonal flu vaccine protects people from the seasonal flu virus”—had no such effect. Initiatives that minimize disease, the researchers concluded, might also end up minimizing discrimination.
Eula Biss cites this imperfect but telling research in “On Immunity,” her mesmerizing book about vaccination, which observes that an innate wariness of perceived out-groups—immigrants, ethnic minorities, people with visible disabilities—amounts to an ancient disease-prevention mechanism. Evolutionary psychologists refer to a “behavioral immune system” that attunes humans to physical differences or unfamiliar behavior, even when it poses no risk. This tendency peaks at moments of particular vulnerability: one study, from 2007, suggests that pregnant women exhibit more xenophobia than usual during the early stages of gestation. Biss quotes Susan Sontag, who wrote that syphilis “was the ‘French Pox’ to the English, morbus Germanicus to the Parisians, the Naples sickness to the Florentines, the Chinese disease to the Japanese.” It is no help that popular perceptions of disease depend on metaphors of foreign infiltration. As the anthropologist Emily Martin writes in “Flexible Bodies,” textbooks and magazines tend to depict the body as a site of warfare between “ruthless invaders and determined offenders.”
It was only a matter of time before Donald Trump enlisted such language to serve his nativist agenda. Although COVID-19, the disease caused by the novel coronavirus, has killed more than twenty thousand people and affected countries around the world, Trump’s fixation on its origins in Wuhan, China, has encouraged a rash of anti-Asian bigotry in the United States. Acknowledging such harassment during a White House briefing on Monday night, Trump urged the public to “protect our Asian-American community.” But this paltry call for tolerance does not compensate for the prejudice that he and other figures on the right have helped foment. This month, Trump has taken to referring to COVID-19 as the “Chinese virus,” presenting the label as a corrective to Beijing officials’ claims that the American military was the source of the outbreak. Countering misinformation, though, is hardly the same thing as implicating an entire people. Last week, an Asian-American journalist reported that a member of the President’s staff called COVID-19 the “kung flu” to her face. This Wednesday, the Washington Post reported that representatives of the G-7 countries failed to agree on a joint statement about the pandemic, because the Trump Administration insisted on using the term “Wuhan virus.” “China is to blame, because the culture where people eat bats and snakes and dogs and things like that,” Senator John Cornyn, Republican of Texas, said in a recent videotaped interview, defending Trump’s label. “These viruses are transmitted from the animal to the people, and that’s why China has been the source of a lot of these viruses, like SARS, like MERS, the swine flu.”
Cornyn’s statement is startling in its ignorance—neither MERS, which stands for Middle East Respiratory Syndrome, nor the 2009 strain of H1N1, the official name of the swine flu, is thought to have originated in China—but he is not wrong to connect Trump’s fearmongering nickname for the novel coronavirus to the stories of pandemics past. The history of disease offers numerous examples of how ill-chosen names can instigate undue prejudice toward particular ethnic or religious communities. In 2015, the World Health Organization issued a set of best practices for naming new infectious diseases, in order to reduce the potential for stigma. Its recommendations discouraged basing nomenclature on geographic locations (Japanese encephalitis), proper names (Creutzfeldt-Jakob disease), species of animals and food (monkeypox), or cultural and occupational references (Legionnaires’ disease). (The W.H.O. also warned against certain terms—“unknown,” “fatal,” “epidemic”—that incite unnecessary fear.) “This may seem like a trivial issue to some, but disease names really do matter to the people who are directly affected,” Keiji Fukuda, at the time the organization’s assistant director-general for health security, said in a statement. (It took the W.H.O. weeks to land on the name COVID-19, which stands for “coronavirus disease 2019.”)
Much of the old nomenclature has turned out to be not only stigmatizing but inaccurate. The Ebola virus, for instance, gets its name from a river that sits about forty miles from Yambuku, the Congolese village where researchers first investigated the disease, in 1976. In his memoir, “No Time to Lose,” Peter Piot, the doctor whose team worked toward the discovery of the virus, admits that they made a hasty decision while in an “entirely fatigued state,” choosing a natural landmark as an eponym to avoid risking the reputation of an entire country. (Piot later learned that he had a bad map: the Ebola River is not even the closest river to Yambuku.) The Spanish flu, which coincided with the First World War, was so named because Spain, which remained a neutral power, had no qualms about covering its outbreak, whereas Germany, France, the U.K., and the U.S. suppressed accounts to preserve public morale. (Most evidence suggests that Spain was not the first country to witness an outbreak, nor was it the hardest hit.) During the 2009 outbreak of H1N1, which came to be called the swine flu because it resembled other viruses that commonly affected pigs, pork farmers reported huge losses in their industry. Though the illness was likely developed through a combination of animals, China and Russia banned pork imports, and health officials in Egypt ordered the widespread culling of hundreds of thousands of pigs, ravaging the livelihood of the country’s swine farmers, almost all of whom were among the Christian minority.
In the U.S., perhaps no disease better illustrates the perils of disease naming than AIDS, which, in its early days, was sometimes called “gay cancer.” Epidemiologists have argued that this label exacerbated the government’s disastrous response, allowing officials to recast the outbreak as a “niche liberal issue,” in the words of one study, rather than the epidemic that it remains today. The comparison between COVID-19 and AIDS is imperfect at best: for one thing, the American government delayed confronting the AIDS epidemic for years, not weeks. Still, it’s hard not to see a similarity between the recent reports of harassment against Asian-Americans and the stigmatization that gay people suffered in the wake of the AIDS outbreak. Carol Goldin, a researcher at Rutgers University, wrote, in 1994, that aligning any disease so closely with a single group “allows the rest of society to simultaneously assign blame, and, through contrast, define their own innocence.” This, she added, is not simply a civil-rights issue but “a serious health threat”: it allows those outside of the targeted group to consider themselves exempt from risk.
