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The coronavirus and the long history of blaming ‘the other’ in public health crises



Outbreaks often have been attributed to marginalized groups in society, or the “other,” experts say. Asian Americans are still seen as “forever foreigners,” no matter the reality of how long they’ve lived in this country. Time and again, they have been blamed for importing diseases.

“I wish I could change my face,” Taiwanese American writer Monica Sun said after seeing violent reactions to Asian Americans on Twitter. “I get into multiple online arguments a day responding to people commenting, ‘Maybe they should stop eating everything,’ ” a reference to coronavirus possibly coming from bats or pangolins at a market in Wuhan, China.

The 35-year-old from Yucca Valley, Calif., said that just last week, her roommate’s mother asked her roommate to avoid Chinese people and Chinese food, not realizing that Sun’s grandparents came from China.

Monica Schoch-Spana, a medical anthropologist at the Johns Hopkins Center for Health Security, says other racial and ethnic groups have faced similar scrutiny and discrimination during public health crises.

“What you have over history and throughout modern-day outbreaks is people fixing blame on a contagious disease on outsiders,” she said, citing past instances. In 2009, H1N1, or swine flu, was associated with Mexican Americans; in 2003, SARS with Chinese Americans; and in the 1980s, HIV with Haitian Americans. That virus was also called the “the 4H disease,” a reference to the “perceived risk factors” of “Haitians, homosexuals, hemophiliacs, and heroin” users.

Schoch-Spana adds that this pattern of association goes back centuries: In the 1300s, people thought the bubonic plague was believed to have come from the Jewish community; in the 1800s, typhoid was thought to be spread by the Irish; and in the 1900s, the influenza pandemic was blamed on Germans.

Asian Americans are frequently associated with public health scares because they are seen as “forever foreigners,” never able to fully blend into America.

Although other groups also are labeled as foreigners, Asian Americans feel the need to constantly prove their American status because of their physical appearance, their language and culture, said John C. Yang, president and executive director of Asian Americans Advancing Justice in Washington. “We need to educate on what is fact and what is myth. Asian Americans are not genetically more likely to carry coronavirus or more susceptible,” he said.

There is also a history of discrimination against Chinese Americans, sometimes written into law, which Doug Chan, the president of the Chinese Historical Society of America, calls “institutional racism.”

Chinese immigration started in the 1850s with the Gold Rush and railroad construction. As the population grew, so did complaints that the Chinese were stealing jobs from white men, and that they were unclean and carried disease.

These racially charged insinuations led to the passage of the Chinese Exclusion Act in 1882. It was the first immigration law that excluded an entire ethnicity, barring Chinese laborers from immigrating to the United States. Then came the Geary Act of 1902, requiring Chinese residents to register and obtain proof of residence or face deportation.

During this period, another wave of the bubonic plague was sweeping China when a Chinese American was found dead, allegedly because of the plague, in San Francisco’s Chinatown, leading to a quarantine of the whole area in 1900.

“It began a long cascading string of events, quarantining Chinatown, and a characterization of a people and community as unclean, filthy and a constant menace to public health,” Chan said.

It was not until 1943 that Congress repealed all exclusion acts. Asian immigration did not really open up again until 1965 with the Immigration and Naturalization Act, designed to reunite families and attract skilled labor.

“A lot of the same things have played out, a conflation of events that occur overseas with the American community. … So Chinatowns around the country are experiencing an economic downturn precisely because of fears that American Chinese restaurants and businesses have something to do with the outbreak in Wuhan,” said Chan, a fourth-generation Chinese American. “We just happen to look like the nation-state that the epidemic is occurring in.”

On top of that, many are unable to distinguish between the different ethnicities of Asian Americans.

When Korean American Sam Lee coughed on the Metro in Washington, other passengers looked alarmed, mouthing, “Coronavirus, Wuhan?”

“That’s absolutely something a lot of Asian Americans deal with,” said Lee, 40, referring to the question of origin. “We can laugh about it internally … like when Asian Americans went to the Oscar cast party and were assumed to be in the cast of ‘Parasite’ and randomly took photos with a bunch of celebrities. … It feels like it shouldn’t be happening in 2020. It’s not as much that education is the answer but exposure and empathy.”

Some Asians bring over the practice of wearing masks to America as a precautionary measure, which draws even more attention to them during a time of heightened public concern about the disease.

When Joanne Leung wore a face mask to the post office in Los Angeles to mail masks to her family in Hong Kong, where supplies are running low, a man started calling out to her, “Hey, corona. Hey, corona.”

“It just made me more aware that I have an Asian face, and I may not be the most welcome in this country right now,” said Leung, a 30-year-old photographer.

All of this stigmatization can affect mental health, too. When news of an unknown virus from China first broke, Meredith Li-Vollmer started bracing for the impact, worrying about what it would mean for the community here in the United States, of all the “kinds of stress and fear that comes out of those situations.”

“We are worried that this adds additional stress of those facing potential discrimination and those experiencing it. That’s a public health concern for us as well,” said Li-Vollmer, a risk communications specialist for Public Health Seattle and King County in Washington state and a fifth-generation Chinese American whose family immigrated during the Gold Rush days.

Not to mention the medical effect on marginalized groups who may not seek out care in fear of being stigmatized, which will “contribute to the larger presence of disease in the community,” said Schoch-Spana from Johns Hopkins.

Some cities are choosing to stand with their Chinese communities in direct opposition to these stereotypes. For example, Li-Vollmer recently helped organize a news conference in which Seattle city officials publicly challenged perceptions and answered questions.

“We’re stronger as a community when we stand together against discrimination and stigma, wherever it appears,” said King County Executive Dow Constantine. “Misinformation about novel coronavirus can create fear and hostility that hurts people and makes it harder to keep everyone healthy.”

In Houston, where there are no cases of coronavirus, online rumors spread about an outbreak in Chinatown, so Rep. Al Green (D-Tex.) held a news conference there, saying that whoever started the rumor was “subject to litigation.” In New York, city officials launched a “Show Some Love to Chinatown” campaign, encouraging people to shop there. And in Philadelphia, Mayor Jim Kenney ate in Chinatown to assuage fears, saying, “Chinatown is safe. The city is safe. America is safe. Everybody should relax.”

There is a long history of connecting a disease to a place, said Fengyong Liu, but many in the public health sector pushed against naming this outbreak the “Wuhan Coronavirus.”

“We really need to unite together, we’re on the same team, we have the same fight,” said Liu, a professor of infectious diseases at the University of California at Berkeley’s School of Public Health. “Openness, transparency and a united attitude is the key because disease can affect everybody.”

Because in the end, Li-Vollmer added, “Viruses don’t discriminate. Neither should we.”

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