On a March morning, an American soldier named Albert Gitchell woke up with a sore throat, fever and headache. Within hours, many of the people on his army base were symptomatic. The year was 1918. By some accounts, Gitchell was the first victim of the Spanish flu, even though he was posted to Fort Riley, Kansas – about 7,400 kilometres from Spain.

What’s in a name? A lot when it comes to diseases.

One hundred and two years after Gitchell fell ill, we find ourselves in the midst of another global pandemic. So consider how the Spanish flu got its name (when it didn’t even originate in Spain). Why COVID-19 is sometimes (intentionally) mislabelled. And what the World Health Organization (WHO) says about disease nomenclature.

The Spanish flu hit during the last year of World War I, which ended in November 1918. Military censors wanted to maintain morale, so reports of cases and deaths weren’t fully reported in the U.S., U.K., France and Germany.

Meanwhile, in neutral Spain, the media were able to report freely on the influenza pandemic. It hit the country hard. Because people around the world associated the outbreak first with Spain, it became commonly known as the Spanish flu.

Most flu strains are a particular threat to people who are older or who have reduced immunity. That’s true with COVID-19, as best we know. Not so with the Spanish flu. Younger and otherwise healthy people died in high numbers too.

Over three waves, between the spring of 1918 and the winter of 1919, the Spanish flu infected some 500 million people. It killed anywhere from 20-50 million (maybe more), including 50,000 Canadians.

There’s a long history of diseases and disorders being named after places, like the Ebola virus, the Zika virus and MERS (Middle Eastern Respiratory Syndrome).

In the past, many diseases have also been named after people, most often the doctor who identified it. Think of Alzheimer’s disease, Parkinson’s disease, Crohn’s disease, Hodgkin’s lymphoma, Tourette syndrome and Asperger’s syndrome.

The International Classification of Diseases, managed by WHO, has the task of assigning the final name of any new human disease. Sometimes, diseases also get a more colloquial nickname.

Four years ago, WHO came out with best practices on naming diseases. They stated that a disease name should be more generic.

That means basing names on things like the symptoms the disease causes and, if possible, a more descriptive term – how the disease manifests, who it affects, its severity or seasonality, and the pathogen that causes it.

In the case of our current outbreak, COVID-19 refers to coronavirus disease and the year, 2019, when it was first identified in Wuhan, China.

WHO wants to avoid names that include any geographic locations, people, industry, occupation, culture or species (e.g. swine flu or bird flu).

Why? Because of possible stigma.

At the time the WHO edict came out, Dr. Keiji Fukuda, Assistant Director-General for Health Security, explained why these best practices make sense.

“This may seem like a trivial issue to some, but disease names matter to the people who are directly affected,” said Dr. Fukuda. “We’ve seen certain disease names provoke a backlash against members of particular religious or ethnic communities, create unjustified barriers to travel, commerce and trade, and trigger needless slaughtering of food animals. This can have serious consequences for peoples’ lives and livelihoods.”

The current occupant of the White House didn’t get the message.

During a recent briefing he gave on COVID-19, he had speaking notes on the lectern. A Washington Post photographer took a shot of them. Someone had crossed out the word “corona” in coronavirus and replaced it with the word “Chinese.” And that’s what came out of Trump’s mouth.

This was after CBS News reporter Weijia Jiang tweeted that “This morning a White House official referred to coronavirus as the ‘Kung-Flu’ to my face. Makes me wonder what they’re calling it behind my back.”

Were these alternative names used to assign responsibility? Stir up animosity?

It wouldn’t be the first time. Back in 1918, Spaniards saw “Spanish flu” as a slur. Kenneth Davis, who wrote a book about the pandemic, notes that Spain gave the outbreak another name: French flu. Meanwhile, Germans called it the Russian pest. And Russians called it the Chinese flu. Round and round went the blame game.

Viruses don’t have addresses. They don’t hold passports. And they don’t know borders.

For anyone who thinks it’s politically correct to give diseases descriptive yet generic names, not really. It’s just medically correct.

Stuart Foxman is a Toronto-based freelance writer, who helps clients’ products, services, ideas and organizations to come alive. Follow me on Twitter @StuartFoxmanconnect with me here on LinkedIn, or check me out at foxmancommunications.com. I would love to hear from you. More articles like this coming, with original posts every week about communications, information, motivation, writing, branding, creativity, media, marketing, persuasion, messages, learning, etc.

March 25, 2020

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