When it comes to the popular naming of infectious diseases, xenophobia has long played a prominent role.DuKai

In President Donald Trump’s Oval Office address yesterday about the threats of the novel coronavirus, he went out of his way to label it a “foreign virus.”

“This is the most aggressive and comprehensive effort to confront a foreign virus in modern history,” Trump said, in words that betrayed the isolationist leanings of his chief speechwriter, Stephen Miller. The speech took a typically Miller-esque approach to the coronavirus pandemic: Blame foreigners, and close up U.S. borders.

The “foreign virus” line drew immediate criticism, including from CNN’s Jim Acosta, who told Chris Cuomo following the address, “I think it is going to come across to a lot of Americans as smacking of xenophobia to use that kind of term in this speech.” This comes on the heels of a number of Republican politicians, including Secretary of State Mike Pompeo and House Minority Leader Kevin McCarthy, making a point of referring to the “Wuhan virus” or “Chinese coronavirus.” The World Health Organization, in officially giving the disease caused by the virus the name COVID-19, sought to avoid just this type of geographic stigmatization.

When it comes to the popular naming of infectious diseases, xenophobia has long played a prominent role. Susan Sontag, in her 1988 work, AIDS and Its Metaphors (a follow-up to her extended essay from a decade earlier, Illness as Metaphor), observed that “there is a link between imagining disease and imagining foreignness. It lies perhaps in the very concept of wrong, which is archaically identical with the non-us, the alien.”

Syphilis, which ravaged Europe beginning in the late 15th century, is a famous case of what Sontag calls “the need to make a dreaded disease foreign.” “It was the ‘French pox’ to the English, morbus Germanicus to the Parisians, the Naples sickness to the Florentines, the Chinese disease to the Japanese,” she wrote. (The name “syphilis” originated in an epic Latin poem written in 1530 by the Italian physician Girolamo Fracastoro, about a shepherd boy named Syphilis cursed with the disease by the god Apollo. The poem was called Syphilis sive morbus Gallicus, “Syphilis or the French Disease.”)

A similar pattern of blaming foreign powers emerged in naming influenza pandemics. Writing in 1922, the British epidemiologist Francis Graham Crookshank noted that “no epidemic disease has been ascribed so frequently, in respect of particular prevalences, to neighbouring, or antipathetic regions as influenza.” A pandemic that struck in 1889–90 earned the label “Russian flu” in English, German, Italian, and French. That geographic naming style set the template for the global outbreak of 1918, or the “Spanish flu” as it became commonly known.

As the science journalist Laura Spinney details in her 2017 book, Pale Rider: The Spanish Flu of 1918 and How It Changed the World, Spain ended up taking the blame not because the pandemic actually originated there, nor because its outbreak was any more severe. Rather, it happened because while Europe was at war, Spain remained neutral and did not censor its press. Spinney explains that the major combatants in World War I kept their outbreaks under wraps to avoid damaging morale, with French military doctors cryptically referring to maladie onze, or “disease eleven.” When influenza hit Spain hard in May 1918, it lit up the international news, and the French, British, and Americans began calling it “Spanish influenza.”

With Spain serving as a convenient scapegoat, reports of the disease’s spread followed the old xenophobic tropes. For instance, in July 1918, the Fort Worth Record picked up a wire report about a Spanish passenger liner arriving at an unnamed Atlantic port and being “thoroughly fumigated and those on board thoroughly examined by federal and state health officers.” The article carried the headline “Spanish Influenza Is an Undesirable,” conflating the disease with the foreign “undesirables” blamed for spreading it. The irony, in retrospect, is that the leading theory for the origin of the so-called Spanish flu places it right here in the United States. In early 1918, the first wave of the pandemic started at Camp Funston, an Army training camp in Fort Riley, Kansas, before it spread to other military camps and traveled overseas.

Even when a geographic label for a disease is more accurate in pinpointing its origin, such names can be quickly outgrown. The Ebola virus was named for the Ebola River in the Democratic Republic of Congo in central Africa, where it was first identified, but the 2014 epidemic took place far away in western Africa. Similarly, the Zika virus was named for a forest in Uganda where it was first isolated in 1947, but the outbreak that began in 2015 started in Brazil and spread throughout the Americas.

More recently, world health officials have tried to be more sensitive in naming diseases by avoiding geographic references that may seem to assign blame to a particular region. Sometimes names can have unexpected connotations, however. As Spinney notes in her book, the acronym for “severe acute respiratory syndrome,” SARS, seems innocuous enough, but it created problems in Hong Kong when the disease reached epidemic levels in East Asia in 2003. Some in Hong Kong found the designation offensive because the official name of the country in English includes the phrase “special administrative region,” which is abbreviated as “SAR.”

Cognizant of how geographic labels have been unfairly used in the past, the WHO introduced a new set of best practices for naming infectious diseases, in 2015. Geographic names are to be avoided in order to “avoid causing offense,” though the WHO did not insist that already established names like Middle East Respiratory Syndrome, or MERS, should be retroactively changed.

When the WHO director-general, Tedros Adhanom Ghebreyesus, announced last month that the new coronavirus disease would be called COVID-19, he referred to the 2015 guidelines to explain why the name did not refer to Wuhan, the city in central China where the virus is thought to have originated. “Having a name matters to prevent the use of other names that can be inaccurate or stigmatizing,” he said, adding, “It also gives us a standard format to use for any future coronavirus outbreaks.”

When conservative figures such as Pompeo and McCarthy continually refer to the “Wuhan virus” or “Chinese coronavirus,” even after the WHO announcement, it’s clear they’re doing it to make a point. The purpose may be to combat what they see as political correctness in avoiding references to the geographic origin of the virus. Or, as a State Department official told The New York Times when asked about Pompeo’s use of “Wuhan virus,” the point may be to combat Chinese Communist Party propaganda that has suggested the virus did not originate in China after all. But when Trump, with the help of Miller, calls it a “foreign virus,” the calculus is much simpler: “foreign” = “bad.” The coronavirus, of course, doesn’t care what it’s called and, like all contagions, will continue to spread regardless of any jingoistic posturing.

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