On Dec. 31, medical personnel in the Chinese city of Wuhan identified a new strain of coronavirus, a viral family that infects the respiratory system. Since then, 6,000 people in China have been confirmed infected and at least 130 have died. By Jan. 23, 11 million people in Wuhan were quarantined and with other travel networks and large gatherings restricted, the lives and livelihoods of about 25 million people in China were constrained.

As #CoronavirusOutbreak tops Twitter’s trending topics, sensationalized videos of East Asian people eating live rats, bats and frogs populate social media feeds alongside images of long lines and conflict in Chinese hospitals. Echoing the public discourse of recent Ebola virus outbreaks in West Africa, a sense of chaos, fear and even disgust permeates Western discussions of coronavirus.

While addressing the outbreak will take a global public health effort, the U.S. Centers for Disease Control and Prevention has declared the current risk to the American public is low. If 21st-century outbreaks like SARS, MERS and Ebola virus are any indication, it is likely American fear of contracting coronavirus — and the xenophobic, racist assumptions that drive it — carries a risk far greater to most people in this country than the virus itself. Historically, infectious disease has generated racist discourse that blames victim populations for the perceived threat, justifying political responses that threatened human rights.

Discourses about disease, contagion and otherness go back centuries, and have often been motivated by the mobility of people and goods between settlements, states and continents. They have a prominent history in the United States, where, for example, officials began using public health to excuse the protracted detainment of Hispanic people at the southern border in the 1840s. In another case, Civil War-era federal officials argued that an outbreak of smallpox among freed people was a direct consequence of emancipation, a logic they used to excuse their failure to respond with any public health effort. In another smallpox epidemic that hit North America in 1898, all indigenous people in Oklahoma were banned from boarding trains or leaving their reservations based on the unfounded belief that they were responsible for the disease’s spread.

But Chinese and Chinese American people have served as scapegoats for infectious disease outbreaks and sanitation failures in the United States and around the world to particularly alarming effect.

In late-19th and early-20th-century California, for example, political cartoons depicting Chinese Americans eating rats and bunking in crowded, unsanitary lodgings graced countless newspaper covers during the Third Plague Pandemic that crested worldwide between 1894 and 1911. China and its people, these publications alleged, were the “breeding place of King Plague,” and the Chinese had brought their unhygienic lifestyles with them when they crossed the Pacific, threatening innocent white Americans. “Among the population where personal cleanliness is held next to godliness,” the Los Angeles Herald reported, few cases of disease occur, but “anyone is exposed to the bite of an infected flea while passing near some Chinaman or Filipino who permits himself to carry about these tiny pests.” The Chinese, this trope alleged, endangered the health of even the most prudent Anglo Americans through their willful ignorance of sanitary norms.

These narratives were not merely distasteful: They had major consequences. The same plague epidemic that hit California in the 1890s led Honolulu’s Board of Health to target that city’s Chinatown in its efforts to contain the disease’s spread. After quarantining the population, the Board of Health began incinerating garbage, sparking a fire that burned 38 acres of Chinese homes in the city. The idea Chinese Americans were a threat to public health also motivated San Francisco’s authorities to quarantine Chinatown and carry out unconstitutional searches and evictions during an outbreak of plague in 1900.

These dramatic campaigns tread on the civil rights of Chinese Americans while failing to address the real structural causes of health disparities: the poverty and housing inequality that indeed led to greater concentrations of diseases like plague and tuberculosis in Chinese American neighborhoods.

Further, the image of the diseased Chinese became a significant part of an ultimately successful campaign for Chinese exclusion, which banned the immigration of most Chinese people into the United States from 1882 until 1943. Pro-exclusion community members and politicians used infectious disease outbreaks as evidence that Chinese American people were unassimilable because they lived in communal housing, maintained traditional foodways and resisted public health interventions. One publication, for example, reported that doctors used force to “compel the ignorant Chinese and Filipinos to submit” to receiving antitoxin. These narratives bolstered the exclusionist argument that Chinese people were too physically and economically dangerous to accept as legal immigrants.

By animating fear about infectious disease, the United States and other nations around the world constructed exclusionary migration regimes that embedded xenophobia in their exercises of power. These processes produced structures that have far outlasted Chinese exclusion. The HIV/AIDS crisis is the most prominent example: The disease halted the growing momentum of gay liberation as the public came to associate LGBTQ people with unhygienic, sordid sexual and social practices. Moreover, the growing association of Haitian people with the virus led to the unethical detention of HIV-positive Haitian refugees fleeing political violence at Guantánamo Bay in 1991. Since then, epidemics have often motivated racist and xenophobic rhetoric that threatens human rights around the world.

Although most historians would argue the world has long been closely interconnected, our perception that we are intimately connected with people around the globe due to today’s streamlined international travel and Internet communication makes infectious diseases particularly terrifying. They show us our sense of technological control over nature is an illusion and may even be a threat. But given the tools American and international public health bureaucracies have at their disposal, our greatest fear during this outbreak of coronavirus shouldn’t be about its spread. It should be focused on the much more likely danger that fear and xenophobia will lead to restrictions on the human rights of Chinese and Chinese American people.