YELLOW SCARERS:

As the science journalist Laura Spinney details in her 2017 book, Pale Rider: The Spanish Flu of 1918 and How It Changed the World, Spain ended up taking the blame not because the pandemic actually originated there, nor because its outbreak was any more severe. Rather, it happened because while Europe was at war, Spain remained neutral and did not censor its press. Spinney explains that the major combatants in World War I kept their outbreaks under wraps to avoid damaging morale, with French military doctors cryptically referring to maladie onze, or "disease eleven." When influenza hit Spain hard in May 1918, it lit up the international news, and the French, British, and Americans began calling it "Spanish influenza."

With Spain serving as a convenient scapegoat, reports of the disease's spread followed the old xenophobic tropes. For instance, in July 1918, the Fort Worth Record picked up a wire report about a Spanish passenger liner arriving at an unnamed Atlantic port and being "thoroughly fumigated and those on board thoroughly examined by federal and state health officers." The article carried the headline "Spanish Influenza Is an Undesirable," conflating the disease with the foreign "undesirables" blamed for spreading it. The irony, in retrospect, is that the leading theory for the origin of the so-called Spanish flu places it right here in the United States. In early 1918, the first wave of the pandemic started at Camp Funston, an Army training camp in Fort Riley, Kansas, before it spread to other military camps and traveled overseas.

Even when a geographic label for a disease is more accurate in pinpointing its origin, such names can be quickly outgrown. The Ebola virus was named for the Ebola River in the Democratic Republic of Congo in central Africa, where it was first identified, but the 2014 epidemic took place far away in western Africa. Similarly, the Zika virus was named for a forest in Uganda where it was first isolated in 1947, but the outbreak that began in 2015 started in Brazil and spread throughout the Americas.

More recently, world health officials have tried to be more sensitive in naming diseases by avoiding geographic references that may seem to assign blame to a particular region. Sometimes names can have unexpected connotations, however. As Spinney notes in her book, the acronym for "severe acute respiratory syndrome," SARS, seems innocuous enough, but it created problems in Hong Kong when the disease reached epidemic levels in East Asia in 2003. Some in Hong Kong found the designation offensive because the official name of the country in English includes the phrase "special administrative region," which is abbreviated as "SAR."

Cognizant of how geographic labels have been unfairly used in the past, the WHO introduced a new set of best practices for naming infectious diseases, in 2015. Geographic names are to be avoided in order to "avoid causing offense," though the WHO did not insist that already established names like Middle East Respiratory Syndrome, or MERS, should be retroactively changed.

When the WHO director-general, Tedros Adhanom Ghebreyesus, announced last month that the new coronavirus disease would be called COVID-19, he referred to the 2015 guidelines to explain why the name did not refer to Wuhan, the city in central China where the virus is thought to have originated. "Having a name matters to prevent the use of other names that can be inaccurate or stigmatizing," he said, adding, "It also gives us a standard format to use for any future coronavirus outbreaks."

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