As I write this, the G7 group of the world’s wealthiest nations are in a stalemate over their combined response to the COVID-19 epidemic. The rising numbers of people who have died from the disease, along with the science of epidemiology has made the need for such a response clear. The stalemate is not based on science. It is based on a name. Mike Pompeo, the Secretary of State for the United States holds the presidency of the group and in the text he circulated he referred to the virus that causes COVID-19 as the “Wuhan virus”. To the other members of the group this was a “red line” they were not willing to cross.
On February 11th, 2020, the World Health Organization announced a name for the novel coronavirus that had been first identified in Wuhan, China at the end of December 2020. They called in SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). At the same time, they named the disease caused by the virus COVID-19 – a name nobody knew and now almost everyone knows. The Director-General of the W.H.O., Dr. Tedros Adhanom Ghebreyesus, made some remarks to contextualize the naming. “We had to find a name that did not refer to a geographical location, an animal, an individual or group of people, and which is also pronouncable and related to the disease. Having a name matters to prevent the use of other names that can be inaccurate or stigmatizing. It also gives us a standard format to use for any future coronavirus outbreaks.” The statement by the Director-General underlines the important of bringing a whole range of knowledges and imaginations to the current situation. Science is key, but so are the specific skills of humanists and interpretive social scientists. Clearly the power of naming is important. The good work of the W.H.O. recognized this.
The names declared on February 11th need to be understood in relation to a history of naming diseases after places – a history that the officials at the W.H.O. were clearly aware of. The history of pandemics in the 20th century was a history of place name based diseases. Most famously, perhaps, the influenza pandemic of 1918-1920, that killed from 17-50 million people and infected a quarter of the world’s population, was called the “Spanish Flu”, mainly due to the fact that it was only Spanish journalists who were reporting on it. Later pandemics were called the Asian Flu (1957) and Hong Kong Flu (1968). Other outbreaks have been named after particular animals (Swine Flu, Bird Flu). Other diseases, that did not reach the status of pandemic, have also been given “other” place names. This was notably the case with syphilis in the late 15th and early 16th Centuries. The army of King Charles VIII of France collapsed from a mystery illness during an invasion of Naples. The disease spread quickly through Europe and North Africa and was given different names depending on where you lived. In Italy, it was the French disease and in France it was the Italian disease. Russians called it the Polish disease, Poles called it the German disease, Arabs called in the Christian disease. In Japan, they called it the Tang sore – a reference to China. It is certainly the case that human mobilities, of one kind or another, form part of the historical geography of syphilis. It was the marches of King Charles’ army on Naples that brought the disease to light in Europe. The disease became particularly notable in port cities – the Chinese called it the ‘ulcer of Canton’ after the port city that formed their major contact point with the west. It was in the English port of Bristol that syphilis was named the Bordeaux sickness (after another noted port with particular ties through the wine trade to Bristol). Syphilis was not just connected to “other places” but to mobility in general. Early attempts to account for its sudden appearance in Europe looked to nomadic groups such as the Moors and the Beggards. More recently scientists have explored the long-held notion that the disease came back from the Americas with the Columbus expedition as a kind of reversal of the well-known movements of Small Pox.
Clearly it is the case that viruses, and the diseases they cause, travel. Virus’s move from one host to another. In the case of COVID-19 this appears to predominantly be through the air in droplets and in aerosol form as we cough. In order to become a pandemic though, the virus relies on infected human bodies moving over much larger distances from one place to another, both within cities and across national borders. We can see this visualized in any number of exercises in data visualization that have appeared in recent weeks – but perhaps most notably in a moving map produced by the New York Times and based on tracked cell phones. The map shows clusters of red dots (infected human bodies) around the wet market in Wuhan suddenly expanding and mingling with streams of non-infected people (blue dots) as 175,000 people moved across China to celebrate Chinese New Year. These streams become international as human bodies board airplanes and travel across the world – including the first known case outside of China in Bangkok. These dots become more real when we know something of the people involved. One of the early accounts in the United Kingdom was of businessman Steve Walsh who had attended a conference in Singapore before taking a skiing holiday in the French Alps. He was subsequently labelled with the unhelpful term “superspreader” after it was confirmed that (through no fault of his own) 11 British citizens had caught the virus from him.
The facts of a virus’s mobilities have no necessary relationship to the stories that this leads to. As Susan Sontag made clear in both Illness and Metaphor, and AIDS and its Metaphors accounts of illness are rarely innocent scientific accounts. Some of the most pervasive narratives we have involved the movement of meaning between disease and society. Diseases are punishments. Carriers of disease are morally dubious as well as medically infected. We already have the leaders of the USA and UK invoking metaphors of war. It is almost as though they have taken Sontag as a how-to guide and missed her point entirely. The production of meanings attached to illness matter. On February 24th, 2020, a Singaporean student. Jonathan Mok, was walking on Oxford Street in central London when he was viciously attacked by four young boys, one of whom said “I don’t want your coronavirus in my country”. Mok was so badly beaten he needed facial surgery. This seemingly extreme event is but one example of racist actions that are ill-informed by supposed associations between Chineseness and COVID-19. The list is so long it has its own Wikipedia page. Instants range from people eating less Chinese food, to further instances of bodily violence, to national and local newspapers using racist headlines – such as Sydney’s Daily Telegraph headline of “China kids stay home”.
The history of association between disease and immigrant populations is littered with examples from American history. In Alan M. Kraut’s Silent Travelers: Germs, Genes and the Immigrant Menace he traces these links through the various responses of public health officials to disease and immigration. He charts how “medicalization of preexisting nativist prejudices” leads to calls for the exclusion of whole groups of “other” people. His book includes the association of Irish and cholera (1830s), Chinese and bubonic plague (1900), and Italians with polio (1916). Another disease forever intertwined with racism is AIDS. In 1982 AIDS began to be associated with Haitians in addition of gay men, heroin users and people who had blood transfusions. The disease had been identified among Haitians fleeing the dictatorship of Jean-Claude “Baby Doc” Duvalier as well as in people identified as Haitian in several cities across the United States. One immediate supposition was that this disease may have been imported by an immigrant group – a notion that was later dispelled as it was shown that Haitians caught the disease in the same ways as everyone else. The doctor who proved this, the Haitian doctor Jean William Pape, suggested that “he believes the doctors were seeing cases in other nationalities at the same time, but reported only on the Haitians because they did not see them as having the same privacy rights – because they were poor, black refugees”. The link drawn between AIDS and Haiti, including by the US Center for Disease Control (CDC), had immediate impacts including the collapse of the Haitian tourist industry. The association between AIDS and Haiti effectively stigmatized all Haitians. In his book AIDS and Accusation: Haiti and the Geography of Blame, Paul Farmer writes “in the United States and other wealthy postslavery societies of the Americas, the stigma of AIDS combined with inveterate racism to ensure the victims of the disease would bear the blame for their own misfortune. Moveover, not only sufferers from HIV but all Haitians were branded as AIDS carriers” and further “Racism was central to the early international responses to AIDS, too, and remains a problem today, as AIDS takes its greatest toll on the continent of Africa, where the heritage of colonialism and racism weighs heavily.” It should come as no surprise that the same President who deliberately started referring to the “Chinese virus” is reported by the New York Times to have previously declared that Haitians “all have AIDS” in an Oval Office meeting.
Beyond associations between disease and foreign “others” on the one hand, and disease and general anxieties about mobility on the other there is a very specific connection in the west between disease and ideas about Chineseness. This includes various diseases such as Cholera around 1900 in the United States but also regulatory constructs that linked race to hygiene, sanitation and public health. In geographer Kay Anderson’s book Vancouver’s Chinatown she charts how the idea of the Chinese as a race was constructed in the Canadian case through the identification of a specific place in Vancouver as “Chinatown”. Part of this process was to place Chinatown affairs under the authority of the municipal sanitary officer alongside disease, water, and sewage. Similar connections were made in efforts to define and defend racially coded borders at Angel Island in San Francisco bay during the period of the Chinese Exclusion Acts 1910-1940. Part of the justification for the immigration detention center was the fear of small pox and bubonic plague. Chinese detainees were often subjected to invasive and arduous medical exams. Sociologist Renisa Mawani has shown how similar connections between race, disease, and sanitation were made at D’Arcy Island off the coast of Vancouver Island between 1891 and 1924 where Chinese people suffering from leprosy were detained. Indeed, leprosy was known on the west coast of Canada as the “Chinese disease”.
The association between foreigners and disease is a common one. It rests on a wider set of narratives of foreign others as dirty and polluting. As the anthropologist, Mary Douglas, reminded us in her book Purity and Danger, when we see references to dirt we are seeing references to matter out of place. Dirt, pollution, is defined by moral geographies – ideas about what and who belongs where and when. Similarly, references to immigrants or foreigners as dirty, polluted, or diseased is a symptom of moral geographies. This is why it matters whether we talk about SARS-CoV-2 as a virus that originated in China or as a Chinese (or Wuhan) virus. The first is simply a statement of the facts as we know them, the second is an attempt to give a virus implied national characteristics that draws on a racist history. It was perhaps no surprise, therefore, that President Trump, on the 17th March, in sharp contrast with the experts of the W.H.O., made the deliberate decision to refer to the virus in exactly these terms. Since then, both Trunp and Pompeo have alternately used the terms “Chinese virus” and “Wuhan virus” – a practice that is both racist and unhelpful for a coordinated global response to the pandemic.
Ogilvie Professor of Geography
University of Edinburgh