Ann Mongoven is the associate director of Health Care Ethics at the Markkula Center for Applied Ethics. Views are her own.
Are we facing a novel virus, a global virus, or a foreign Chinese virus? Is COVID-19 a new SARS, or a new seasonal flu? Are we at war, or in a different kind of struggle? How is the threat of COVID-19 like, or unlike, other public threats such as 9/11, or heightened storms in the age of global warming?
Language matters. Analogy matters. Humans are by nature metaphorically-shaped. In a paradoxically deadly combination, COVID-19 has been both over- and under-“othered” in prevalent rhetorical webs. (I here use “other” as itself a metaphor—as a made-up verb for how we locate something in relationship to something else.)
No metaphors have ill-served us as much as those that racialize the virus—the “Chinese” virus or the “Wuhan” virus or the “foreign” virus. While the virus first emerged outside the U.S., this metaphorical family makes no sense in terms of virology. Viruses pay human borders no attention. Of course, metaphors don’t arise in historical vacuums. Descriptors equating the virus to a foreign devil arose in a political context in which U.S. immigration policy and border control are hotly contested. The ethically vicious and scientifically bankrupt racialization of the virus has degenerated to a new even rawer slang: “the Kung-flu.”
The result has been a double-loss: the wrongful stigmatizing of Chinese people and Asian-Americans, and a false sense of security among Americans insulated from international travel or cosmopolitan neighbors. A common misconception remains, that most Americans contracting the virus have identifiable international connections. But that is false. The majority of American cases now arise from community spread.
Europe has become the new “other” as many Americans congratulate the U.S. for not having the case- and death-load of European hotspots. This “othering” is dangerous because all epidemiological evidence suggests that absent radical social distancing, the U.S. will move toward those levels of crisis shortly. The analogy is also falsely reassuring because it’s based on an apples-and-oranges comparison. One reason European case-loads are higher than American is artificial: testing has been more widely implemented in many European countries. As the U.S. belatedly scales up testing, we may find we are Europe. In a tragic chain, we first “othered” the virus as Chinese, then as Italian, then as European, as more and more pods of infection spread in the U.S.
Other ways of speaking deceptively “other” the virus by describing it as a political, not biological, threat. In partisan crossfire, the virus has been described alternatively as either an election-year charade concocted by Democrats, or collateral damage of a Republican president who himself is the core threat. But the COVID-19 virus pays this politicization no more mind than it does borders. The real collateral damage has been public trust in government, when a threat that truly is beyond politics endangers us all.
Yet the coronavirus has also been under-“othered” in some important ways. None has been more detrimental than repeated comparisons of it to the seasonal flu. Many American public health professionals have been guilty of this. By, at first, emphasizing the U.S. had more deaths from seasonal flu than coronavirus (which regrettably will not remain true), and reminding people to get their flu shots, they implied Covid -19 was just like a new seasonal flu. Their intent was good: to use the emergence of a new virus as a chance to highlight that seasonal flu deaths remain an oft-preventable loss. But the result was a disastrous minimization of the real risk of coronavirus—for which there is no vaccine.
COVID-19 truly is “other,” compared to seasonal flu. Because it is the result of a recent animal-to-human jump, there is no established human immune response to it. The virus can stealthily fly under the radar of the human immune system as it entrenches itself in the respiratory tract. While precise statistics are still being gathered, its mortality rate appears to be at least twenty times the seasonal flu.
Although a much better comparison-basis, COVID-19 is also “other” to—and worse than—SARS (the respiratory virus that caused a 2003 global outbreak in East Asia and Canada). SARS, in the same broad viral family, also arose from an animal-to-human jump, and had a higher mortality rate than COVID-19. However, many more have already died from COVID-19. COVID-19 spreads much more easily, because it is contagious before the carrier has any symptoms, and because it can remain viable on metal surfaces and clothing for hours. It will be much more difficult to contain and mitigate than SARS.
Coronavirus also is a real “other” in what kind of resilience is required to meet the threat. Going on with routine life as much as usual, the definition of resilience in so many other kinds of disasters, is the opposite of resilience now.
This may be why some of the usually civic-minded among us can be the hardest to bring on board with current emergency public health measures. Public questioning of who will have the civic fortitude has focused far too narrowly on millennials, and far too quickly assumed selfishness is the reason anyone would fail to comply with social distancing guidelines. For example, now-viral social media memes joke about the generational inversion of trying to keep the old folks from going out and getting into trouble. That generation was shaped by crises from World War II and the post-war years early in their lives, to 9/11 later. They have always helped everyone else to carry on by, well, carrying on. There also may be gender and cultural correlations with who most equates resilience to continuation of normal routines. We must confront the hidden analogies and explain why coronavirus truly is “other.” We must name social distancing as public resilience.
It doesn’t help that “social distancing” itself is a problematic metaphor. As director of the National Institutes of Health, Dr. Francis Collins complains about the term: social distancing is literally the opposite of what we must do. Our challenge is to stay as socially connected as we can, including through innovative use of technology (hooray for virtual children’s reading circles and virtual adult happy hours!), while we physically distance ourselves.
Wartime is the ultimate “other” to normalcy. President Trump has declared himself a wartime president in response to the epidemic. At this historical moment, I like this analogy (as long as we emphasize the inverse form of home-front resilience needed). To defeat wartime enemies, we must engage in massive mobilization of resources and expect sacrifices from all for the common good. Both of those are necessary in our battle with COVID-19.
At the same time, we must be mindful of the ethical limits of the war analogy—especially as wartime exigencies can weaken democratic processes and deflect critique of resource-allocation. The “war on terror” taught us the danger of declaring war on things that can never be eradicated completely. In a best-case scenario, there will be regional flares of coronavirus indefinitely in the future, even after we survive the current mass global crisis. To avoid war without end we must consider what will count as an adequate victory; when and to what degree we can let down our guard.
In short, we must speak very carefully to meet the threat of novel coronavirus. Our rhetoric must discriminate between how it is, and is not, the “other.”