President Trump has doubled down on calling covid-19 the “Chinese virus,” after earlier calling it a “foreign virus.” These terms may help him increase political support for closing U.S. borders, but they also reflect a much longer history of racist and xenophobic responses to infectious epidemics. Here’s what you need to know.

Names matter

In 2015, the World Health Organization put regulations in place for naming a novel disease. One regulation attempts to correct previous patterns of using geographic descriptions for disease. The 1918 H1N1 influenza, for example, was generally called the Spanish flu. More recently discovered diseases have also been named for the places they were first discovered, in ways that the WHO now prohibits, including Middle East Respiratory Syndrome (MERS-CoV) and West Nile virus, in large part because such names stigmatize groups of people.

When diseases named by the scientific community come to be understood and disseminated in public, descriptors that link to a place, types of professions (remember legionnaires’ disease?) or contain cultural references can take on novel and stigmatizing meanings that can cause severe harm.

Naming diseases is controversial and delicate. Assumptions about a disease’s origins or about the people associated with it can lead to stereotyping, stigma, and mistreatment, and can hamper public health efforts.

In 1982, as what we now call the HIV/AIDS pandemic was just beginning, a New York Times article described the condition as G.R.I.D. or Gay-Related Immune Deficiency. This name associated the disease exclusively with “homosexuals,” the term the New York Times still used at the time. This had two effects. It treated gay men as responsible for the disease — and suggested the disease itself was only a problem for gay men. This had devastating effects on health responses and harmed health interventions for years. That same year President Reagan’s press secretary referred to the disease — which had by then been named A.I.D.S — as “the gay plague.” Homophobia slowed U.S. responses to the epidemic, and increased open discrimination against gay men in policing, housing, jobs and street violence. At the same time, that stigma slowed public health responses to the disease both within the gay community and outside it — leading the epidemic to spread further.

The U.S. has long blamed disease on people of Asian descent

The United States has a history of assigning blame for disease spread to unwanted immigrant populations, often as justifications for anti-immigration policies — in particular, targeting people of Chinese and East Asian ancestry. The United States relied on Chinese labor as it expanded the continental empire westward and laid claim to the Hawaiian Kingdom. But most people in the United States did not want Chinese people to settle here permanently. In the late 1800s, as concerns about Chinese migration and labor competition rose, public health officials and politicians associated Chinese laborers and migrants with sickness, depravity and filth.

These officials blamed Chinese people for bringing smallpox, syphilis, trachoma and the bubonic plague. Racialized ideas about disease were part of the reasoning used to pass the Chinese Exclusion Act of 1882. Congressional and public support for Chinese exclusion hinged on the notion that Chinese migrants could not adapt to civilized, respectable Western lifestyles and therefore were not worthy of inclusion in the U.S. nation or civil society. Their imagined diseases were seen as a result of their uncivilized habits.

What’s more, the association between disease and people of East Asian descent was used to justify quarantining and burning Chinatowns in San Francisco and Honolulu. As officials in San Francisco and Honolulu set up bubonic plague quarantines and other forms of control beginning in 1898 and through 1904, they blamed Chinese people for the unhygienic conditions.

At the same time, this common-sense association gave officials justification for limiting the legal and political rights of Chinese and other East Asian people. Rather than blame U.S. policies like segregation, poor tenement housing conditions, and overseas labor recruitment, U.S. officials instead assigned blame for the spread of disease to unwanted immigrant populations.

Calling it a ‘Chinese virus’ threatens both individuals of Asian descent and general public health efforts

Today, by referring to covid-19 as a “Chinese” disease, Trump appears to be blaming the disease and its transmission on people with Chinese and East Asian ancestry. When that attitude comes from the presidential bully pulpit, it easily spreads. For instance, a Kansas county commissioner claimed his county didn’t need stringent public health measures because it had so few Chinese people, making it safe. Such rhetoric mistakenly suggests China and Chinese people are medically or pathologically diseased.

Referring to the virus as “Chinese” also encourages people to assume perceived race or cultural practices are health risks. The Internet is overflowing with mocking memes blaming the virus on Asians’ personal habits like not wearing masks, wearing masks, shopping at particular markets, or eating certain kinds of meats. Asians and Asian Americans are reporting an increase in racially motivated verbal and physical abuse, both in the United States and the United Kingdom.

Calling covid-19 the “Chinese virus” not only scapegoats Asians and Asian Americans for the unfolding pandemic, but also waters down the message that everyone’s daily decisions — from social distancing to voting — will shape how quickly the disease spreads.

Alexandre I.R. White is assistant professor of sociology and the history of medicine at Johns Hopkins University and Johns Hopkins University School of Medicine.

Katrina Quisumbing King is a Provost’s Postdoctoral Scholar in the department of sociology at the University of Southern California.