PITTSBURGH, Pennsylvania: Stop calling the novel coronavirus outbreak the “Wuhan coronavirus”, and start getting comfortable with “COVID-19”. Thats the World Health Organizations recommended name for the disease.
While identifying a new disease by its place of origin seems intuitive, history demonstrates that doing so can harm the people who live there.
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Consequences can include economic distress as tourists withdraw, investment cools and solidarities between people weaken. Linking a specific disease with a specific place can lead to discrimination and stigmatisation and avoidance of a town or village.
READ: Commentary: Outbreaks of diseases make us exaggerate or under-estimate risks. The COVID-19 shows that
READ: Commentary: COVID-19 could redefine Singapores place in the global economy
A LONG TRADITION OF NAMING BY PLACE
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Tagging a place when identifying a disease has a long history.
In the 19th century, as global trade and mobility allowed cholera to spread worldwide from its origins in the Ganges Delta, the disease quickly became known as “the Asiatic cholera”.
That label persisted for decades, implicitly blaming an entire continent for a disease that can spread anywhere as a function of poor sanitation.
For Europeans and Americans of the time, Asia was an exotic, distant somewhere else. Distinguishing the disastrous illness of cholera as “Asiatic” fit with the racialised, imperial views that denigrated the intelligence and the cultures of non-white populations globally and justified colonial overrule.
A woman wearing a face mask passes a Public Health England sign warning passengers of a new coronavirus detected in Wuhan, at London Heathrow Airport, on Jan 28, 2020. (Photo: AFP/DANIEL LEAL-OLIVAS)
It also helped justify more stringent quarantine measures and travel restrictions for people read as “Asian” and not European. Muslim pilgrims en route to Mecca from southern Asia, for instance, were subject to different rules than European troop ships travelling the same routes.
Ideas about disease changed after the late 19th century, when scientists could use new laboratory techniques to link specific pathogens – bacteria, parasites, and later on, viruses – to specific diseases.
Sometimes, this gave a scientific name to an age-old problem, such as “consumption” becoming the medical entity tuberculosis.
But these new techniques also allowed researchers to correlate pathogens with particular locales. Naming an illness after a place quickly became the norm.
READ: Commentary: Dont forget the vulnerable in the fight against COVID-19
READ: Commentary: Fighting fear is key part in battling COVID-19
So Rift Valley Fever, caused by a virus in the Bunyaviridae family, got its name from an area of colonial Kenya where it was first reported.
The Hantaviruses are linked to the Hantan River area of South Korea where Dr Ho-Wang Lee first identified the virus.
Ebola virus disease (EVD) got its popular name from a river near the village in the modern nation of Democratic Republic of Congo (formerly Zaïre) where US and European scientists identified that pathogen.
Focusing on a specific place creates something particular from something that could have happened anywhere.
Theres nothing peculiarly distinctive about Lassa village in Nigeria, compared to any other village five or 50 miles away. Lassa was just the first place where a white missionarys death drew the attention of authorities.
And yet, in the aftermath of that moment, as “Lassa fever” came to identify a fearsome hemorrhagic fever, the town of Lassa became a shadow of its former self.
FOCUSING ON THE WRONG THINGS
In the short term, close associations between places and diseases can stigmatise the sick, as well as influence perceptions of risk for people both nearby and distant.
Passengers wearing masks leave cruise ship Diamond Princess at Daikoku Pier Cruise Terminal in Yokohama, south of Tokyo, Japan February 21, 2020. REUTERS/Athit Perawongmetha
An outbreak of a serious and deadly respiratory and hemorrhagic disease reported in the US Four Corners region in 1993 was tagged by the press as a “Navajo flu”. People in the area assumed incorrectly that the disease was directly contagious and highly localised to the Navajo Nation.
Associating this alarming new disease specifically with the Navajo Nation had a chilling effect on reporting illness to medical authorities because of fear of stigma.
In the end, officials named the new hantavirus that caused that particular outbreak Sin Nombre, which means “without a name” in Spanish.
READ: Commentary: Protecting public health is key in novel coronavirus fight but we must also tackle xenophobia
Understanding disease ecology and patterns of transmission at a point of origin are important for biologists and epidemiologists.
But permanently naming a disease for a specific place serves to keep public attention on the moment of origin – the “spillover” case or known outbreak of an epidemic.
Focusing on how an “emerging” disease originally reached human populations can come at the expense of clear messaging about who is at risk of infection or how to prevent the disease in an ongoing epidemic.
Whats more, that outbreak moment is often less relevant for a general public looking to stay healthy or public health practitioners trying to control a person-to-person epidemic.
BUILDING BLAME INTO A NAME
Affixing place to disease also puts a spotlight on specific people, which matters for how a wider public associates a populations perceived culture, foods or activities with a disease.
These kinds of stereotypes arose, for instance, around Ebola virus disease in 2014 to 2015, erroneously blaming some people for a wider problem.
FILE PHOTO: A woman wearing a mask walks past a quarantine notice about the outbreak of coronavirus in Wuhan, China at an arrival hall of Haneda airport in Tokyo, Japan, Jan 20, 2020. (Photo: REUTERS/Kim Kyung-Hoon/File Photo)
Early conversations about EVD, marked as particularly African with its name, focused on eating “bushmeat”, a term from the colonial era to describe meat that people hunt, rather than buy in a market.
Talking about “bushmeat” allowed people to characterise those suffering from EVD as primitive or exotic. It also implied that people were responsible for bringing this disease into circulation because of what they ate or how they lived.
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PITTSBURGH, Pennsylvania: Stop calling the novel coronavirus outbreak the “Wuhan coronavirus”, and start getting comfortable with “COVID-19”. Thats the World Health Organizations recommended name for the disease.
While identifying a new disease by its place of origin seems intuitive, history demonstrates that doing so can harm the people who live there.
Advertisement
Advertisement
Consequences can include economic distress as tourists withdraw, investment cools and solidarities between people weaken. Linking a specific disease with a specific place can lead to discrimination and stigmatisation and avoidance of a town or village.
READ: Commentary: Outbreaks of diseases make us exaggerate or under-estimate risks. The COVID-19 shows that
READ: Commentary: COVID-19 could redefine Singapores place in the global economy
A LONG TRADITION OF NAMING BY PLACE
Advertisement
Advertisement
Tagging a place when identifying a disease has a long history.
In the 19th century, as global trade and mobility allowed cholera to spread worldwide from its origins in the Ganges Delta, the disease quickly became known as “the Asiatic cholera”.
That label persisted for decades, implicitly blaming an entire continent for a disease that can spread anywhere as a function of poor sanitation.
For Europeans and Americans of the time, Asia was an exotic, distant somewhere else. Distinguishing the disastrous illness of cholera as “Asiatic” fit with the racialised, imperial views that denigrated the intelligence and the cultures of non-white populations globally and justified colonial overrule.
A woman wearing a face mask passes a Public Health England sign warning passengers of a new coronavirus detected in Wuhan, at London Heathrow Airport, on Jan 28, 2020. (Photo: AFP/DANIEL LEAL-OLIVAS)
It also helped justify more stringent quarantine measures and travel restrictions for people read as “Asian” and not European. Muslim pilgrims en route to Mecca from southern Asia, for instance, were subject to different rules than European troop ships travelling the same routes.
Ideas about disease changed after the late 19th century, when scientists could use new laboratory techniques to link specific pathogens – bacteria, parasites, and later on, viruses – to specific diseases.
Sometimes, this gave a scientific name to an age-old problem, such as “consumption” becoming the medical entity tuberculosis.
But these new techniques also allowed researchers to correlate pathogens with particular locales. Naming an illness after a place quickly became the norm.
READ: Commentary: Dont forget the vulnerable in the fight against COVID-19
READ: Commentary: Fighting fear is key part in battling COVID-19
So Rift Valley Fever, caused by a virus in the Bunyaviridae family, got its name from an area of colonial Kenya where it was first reported.
The Hantaviruses are linked to the Hantan River area of South Korea where Dr Ho-Wang Lee first identified the virus.
Ebola virus disease (EVD) got its popular name from a river near the village in the modern nation of Democratic Republic of Congo (formerly Zaïre) where US and European scientists identified that pathogen.
Focusing on a specific place creates something particular from something that could have happened anywhere.
Theres nothing peculiarly distinctive about Lassa village in Nigeria, compared to any other village five or 50 miles away. Lassa was just the first place where a white missionarys death drew the attention of authorities.
And yet, in the aftermath of that moment, as “Lassa fever” came to identify a fearsome hemorrhagic fever, the town of Lassa became a shadow of its former self.
FOCUSING ON THE WRONG THINGS
In the short term, close associations between places and diseases can stigmatise the sick, as well as influence perceptions of risk for people both nearby and distant.
Passengers wearing masks leave cruise ship Diamond Princess at Daikoku Pier Cruise Terminal in Yokohama, south of Tokyo, Japan February 21, 2020. REUTERS/Athit Perawongmetha
An outbreak of a serious and deadly respiratory and hemorrhagic disease reported in the US Four Corners region in 1993 was tagged by the press as a “Navajo flu”. People in the area assumed incorrectly that the disease was directly contagious and highly localised to the Navajo Nation.
Associating this alarming new disease specifically with the Navajo Nation had a chilling effect on reporting illness to medical authorities because of fear of stigma.
In the end, officials named the new hantavirus that caused that particular outbreak Sin Nombre, which means “without a name” in Spanish.
READ: Commentary: Protecting public health is key in novel coronavirus fight but we must also tackle xenophobia
Understanding disease ecology and patterns of transmission at a point of origin are important for biologists and epidemiologists.
But permanently naming a disease for a specific place serves to keep public attention on the moment of origin – the “spillover” case or known outbreak of an epidemic.
Focusing on how an “emerging” disease originally reached human populations can come at the expense of clear messaging about who is at risk of infection or how to prevent the disease in an ongoing epidemic.
Whats more, that outbreak moment is often less relevant for a general public looking to stay healthy or public health practitioners trying to control a person-to-person epidemic.
BUILDING BLAME INTO A NAME
Affixing place to disease also puts a spotlight on specific people, which matters for how a wider public associates a populations perceived culture, foods or activities with a disease.
These kinds of stereotypes arose, for instance, around Ebola virus disease in 2014 to 2015, erroneously blaming some people for a wider problem.
FILE PHOTO: A woman wearing a mask walks past a quarantine notice about the outbreak of coronavirus in Wuhan, China at an arrival hall of Haneda airport in Tokyo, Japan, Jan 20, 2020. (Photo: REUTERS/Kim Kyung-Hoon/File Photo)
Early conversations about EVD, marked as particularly African with its name, focused on eating “bushmeat”, a term from the colonial era to describe meat that people hunt, rather than buy in a market.
Talking about “bushmeat” allowed people to characterise those suffering from EVD as primitive or exotic. It also implied that people were responsible for bringing this disease into circulation because of what they ate or how they lived.
