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What’s in a disease name, anyway? Everything.

Jay Wong
Conditions
April 14, 2020
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Spanish Flu. Japanese Encephalitis. Middle Eastern Respiratory Syndrome. West Nile Virus. Wuhan Virus (and lately, the “Chinese Virus” as many have begun calling the pathogen that causes COVID-19: SARS-CoV-2).

What do these names all have in common, you might ask? Well, for one thing, they were constructed not by a strict scientific nomenclature, but by an aspect of the virus or disease that is inextricably linked to a facet of one’s ethnicity or geography. But more importantly, the nexus of commonality is their potential risk of fomenting stigmatization (or amplifying pre-existing stigma) towards the people or region associated with the pathogen and illness, an admonition that came straight from the World Health Organization.

In recent weeks, there has been a witnessing of public reproach against the current president’s reference to SARS-CoV-2 as the “Chinese Virus,” many concerned that it is an insidious dog whistle for his political base aimed at stoking the flames of xenophobia and deepening the Sino-American schism that is currently at the peak of political fragility. When the World Health Organization asserted that viruses like SARS-CoV-2 know no borders and do not care about our ethnicities, the president of the United States doubled down on his actions, justifying the phrase’s use on the grounds that he was merely stating an unassailable truth: that the novel coronavirus of 2019 originated from China. This then led to a second wave of public censure denouncing his, what many believed to be, coded us-vs-them rhetoric.

What is interesting though is that not long after this latest salvo of condemnation was launched against the president, a phalanx of his supporters from across the internet came out in a recriminatory fashion, staunchly declaring hypocrisy by citing a myriad of historical instances where viruses and diseases were named based on the location of its putative genesis or discovery, or named after a group of people it primarily afflicted without having ever received similar degrees of widespread excoriation in its aftermath, as in the cases mentioned at the beginning of this article and many others (e.g., Lyme Disease [named after a small coastal town in Connecticut called “Old Lyme”], Zika Virus [named after the Zika Forest in Uganda], and Ebola [named after the Ebola River in the Democratic Republic of Congo]). To many of his supporters, they saw an inconsistency here.

And just like that, the bloody war of names had erupted.

It occurred to me then to inquire more deeply, “What exactly about the phrase ‘Chinese Virus’ is racist?” Is it rooted in a subconsciously-driven uncharitable appraisal of the current president’s intentions based on the perception that he could only have a nefarious motivation to use this phrase due to his controversial track record and perceived personal character? Alternatively, is it the idiosyncratic synergy of the multi-racial/multi-ethnic composition of this country, the historically discriminatory treatment of Chinese populations in America, and the current acrimony-laced relations between the U.S. and China that makes a phrase like “Chinese Virus” contextually unpalatable, culturally tone-deaf, and racially insensitive? Or perhaps is it that the social landscape and cultural contours of our time have shifted and evolved in such a way that any ascription of a scourge such as a disease, illness, or microbial pathogen, even, to any location or group of people has become ineluctably linked to stigma transference to all associated person(s) as a matter of course? And to avoid a false trichotomy, is it all-together something else?

What exactly is the diagnostic calculus deployed then for determining whether a particular phrase or name ought to be amended due to its potentially detrimental impact on a society? And how can we more aptly explain to those who simply cannot see or understand how “Chinese Virus” can be precarious and stigmatizing when there are countless other extant examples that, to many, suggest this latest national outcry is all just part of a larger political subterfuge manufactured by the president’s adversaries to besmirch his character and stymie his re-election?

Given that a nuanced, all-encompassing discussion of this contentious topic would likely yield a panoply of opinions with multiple gradations of complexity and subjectivity, and that ultimately there would still likely remain a subset of the population who are immutable in their conviction that eponymous naming does not inherently carry any stigma or deleterious ramification, I propose a solution that may have the ability to put an end to this internecine semantics warfare once and for all.

The proposed solution? Obliterate the use of eponymous naming (past, present, and future) for all diseases, illnesses, and microbial pathogens, and instead, substitute in an equivalent counterpart constructed from an internationally standardized nomenclature that is entirely sterile (e.g., using medical terminology, dates, letters, numbers, etc.) and neutral (e.g., not referring to people, places, animals, food, plants, or anything that could be linked to a person’s identity such as culture, ethnicity, race, nationality, gender, sexual orientation, religion, physical appearance, age, disability, social status, etc.). Furthermore, perhaps we can redact current medical texts and as many eponymously named diseases and pathogens already in existence to reflect this change. This way, the precedent of eponymous naming can no longer be used as a justification by those who are not sympathetic to the plight of communities who are and have been harmed by such naming traditions. Additionally, it would further impugn the supposed benign intentions of proponents of eponymous naming by prompting us to ask them, “what is the compelling reason such that you absolutely must opt-in and elect eponymous naming when a very clear alternative with incontrovertible impartiality and objectivity exists?” which could more readily inculpate an ill-intentioned person feigning innocence in a crime of malicious will.

I do not suggest that such a solution (and an imperfect one at that) can happen overnight. But I do believe seemingly logistically complicated and initially unpopular changes like this one are, in fact, possible, if enough professionals in the medical community recognize its value and significance.

What’s in a name, anyway? Apparently … everything.

Jay Wong is a medical student. He received his undergraduate degree in molecular, cellular, and developmental biology from Yale University. He can be reached at his self-titled site, Jay Wong, and on Twitter @JayWongMedicine.

Image credit: Shutterstock.com

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What’s in a disease name, anyway? Everything.
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