Call It COVID-19  

by Alexandra Brewis and Amber Wutich

At a recent news conference, the Director-General of the World Health Organization asked people to stop using the terms “Wuhan Virus” or “Asian Virus” to refer to COVID-19. He has explained that this was a form of stigma, and “more dangerous than the virus itself.” He declared the mis-naming as “the most dangerous enemy."

This may seem to some an extreme way to talk about something like a disease name, when people are so worried about the disease itself. After all, most prior major influenza epidemics have become widely known by their point of origin, like the Spanish flu (1918), the Asian flu (1957), and the Hong Kong flu (1968). But global health experts consider casual use of such labels to be extremely dangerous, based on what we have seen in the past.

Why does (mis)naming a disease for a group of people create stigma? Stigma is best viewed as a process rather than a thing. Through the process of being stigmatized, people become socially stained and discredited because they hold a characteristic that is classified as unacceptable or undesirable. They then become a target for mistreatment or abuse. Some of the most damaging and powerful stigmas are generated around infectious disease epidemics, because they are associated with very high levels of public fear. By naming a new transmissible, unavoidable, and scary disease by association with a group of people or a place, stigma can be generated toward that group very readily. COVID-19 (“co” stands for Corona, “vi” for virus and “d” for disease, 19 for the year it emerged) was so-named precisely to avoid generating new or additional stigma.

So why does (mis)naming it as the “Chinese Virus” represent a particularly "dangerous enemy"? Immediately, people who feel stigmatized (such as Asian-Americans have reported being recently) are less likely to seek testing or treatment or disclose infection because they are aware they may be targeted for abuse or receive worse care. Whole communities may become unwilling to work in concert with public health efforts, because stigma erodes needed trust. In terms of government responses, naming a disease for its association with outsiders – like “Asian coronavirus” – can lead to dangerous missteps. For example, it can lead to devastating delays to respond locally because the assumption is that the risk is overseas or at the border. And, as epidemics progress, it can hide what is really going on. In the extremely deadly 1918 influenza pandemic, labeled the “Spanish flu,” the vast majority of deaths were probably in India. Stigmatizing disease labeling can act as a form of dangerous misinformation and censorship, because it turns focused attention onto one group, and at the same time meaning it isn’t being focused on others who might be at much greater risk.

Stigma is created by words as much as actions, and it matters for how we can respond in a pandemic crisis. Calling this new coronavirus COVID-19 is a small but very important way all of us can help fight the spread of infection.