Historically, epidemics have negatively affected marginalized populations by spurring prejudice. During the 1900 bubonic plague outbreak in San Francisco, the discovery of one infected Chinese resident led to an entire community being quarantined. Blockading the city’s Chinatown did not halt the spread of the disease.
Similarly, the case of Mary Mallon (“Typhoid Mary”) in the early twentieth century highlighted how individuals from specific populations, in her case Irish immigrants and working class single women, received more punishing sanctions than others who carried the disease.
This virus is not particular to any race, class, or nationality. Stigmatizing any one group impairs our ability to successfully combat this disease for all.
Mallon, traced to forty-seven cases of typhoid fever in New York City, was subjected to a years-long quarantine during a period when the city was reporting more than 3,500 cases per year. The discrimination Mallon faced is clear in the widely quoted language used by one official to describe her, that “she walked more like a man than a woman.”
These words were irrelevant to Mallon’s carrier status and served to further stigmatize her and others like her. Mallon’s quarantine did not slow the spread of the disease. Instead, the gender and ethnic stigma led to a lack of trust in experts and, ultimately, noncompliance.
During the HIV/AIDS epidemic in the 1980s, gay men and Haitians were wrongly labeled as pariahs for bearing the brunt of the disease. The branding of HIV/AIDs as a disease of the marginalized resulted in the government delaying its response, limiting the necessary cooperation and control that could have saved countless lives.
The history of epidemics and pandemics over the years has demonstrated how racism, sexism, and xenophobia have detracted from efforts to control disease. The World Health Organization carefully avoided national and ethnic identifiers in naming COVID-19.
Others have taken a different approach, one that smacks of tribalism and nationalism.
President Trump has referred to COVID-19 as the “Chinese virus” and “foreign virus” — exactly the sort of accusatory labeling we need to avoid. There have been incidents in the United States of Asian people getting attacked for being seen as disease spreaders.
We are all potential victims, as well as potential spreaders of COVID-19. All of us. We are like the mosquitoes in the spread of malaria or dengue. This virus is not particular to any race, class, or nationality. Stigmatizing any one group impairs our ability to successfully combat this disease for all.
Soon hospitals in the United States will be inundated with sick people suffering from COVID-19. As scientists work to create and test a vaccine, a process that will likely take at least a year, we all need to plan how to utilize our current resources to achieve the best result.
Today, we still lack the testing ability to identify all those who carry the virus. When we do, will the ability to get tested vary by race or ethnic status? What about age, class, and gender?
We have ample evidence of racial and gender differences in quality of medical care under usual circumstances. We must be especially ready to address it in times of stress and crisis.