As cases of the coronavirus have mounted over the last month, the term “patient zero” has begun popping up with astounding regularity. Sources from CNN to the BBC, The Washington Post to People, the New York Post to New York Governor Andrew Cuomo, have reported on supposed “patient zeros,” nearly all of the stories identifying these supposed first patients by name. This pattern has also spread beyond traditional sources of media. One fake news website ran an article titled, “COVID-19: Chinese Health Authorities Confirm Patient Zero ‘Had Sex With Bats,’” which was promptly shared on social media some 30,000 times. The Daily Show called Donald Trump the “patient zero” of a looming “pandumbic.” Such rhetoric can be dangerous: What might happen if a reader or a listener decided to enact some form of revenge on one of these “patient zeros,” helpfully identified by name? Reporting from Kenya has shown that the woman labeled that country’s “patient zero” has been subjected to relentless online bullying.
The immediate and widespread use of this phrase has prompted some criticism, on social media and in the broader media sphere. Andrew Lipman, an environmental historian, tweeted at Michael Barbaro, “You know that ‘patient zero’ is a myth, right? Journalists really need to avoid that phrase.” Helen Jenkins, an infectious disease epidemiologist, told Journalist’s Resource that the phrase “is highly stigmatizing and often wrong anyway.” And a historian of medicine named Richard A. McKay wrote an essay for The Conversation arguing that “patient zero” stories often give “expression to communal fears about dangerously reckless behaviour. On the surface, these stories seem motivated by science. Scratch a little deeper, though, and you will often uncover a desire to assign blame.”
McKay should know—he literally wrote the book on the history of the term and idea of “patient zero.” Likely in response to this pushback, The Daily changed the title of the “patient zero” episode on its website. But it is not so easy to undo the harm that comes with the label “patient zero.” Understanding the history of this phrase and the context in which it arose shows how much damage it has done, the lives it has affected, and the complicity of so many in positions of power who unthinkingly perpetuated it.
McKay’s book, Patient Zero and the Making of the AIDS Epidemic, appeared in 2017, 30 years after the notion of “patient zero” exploded into the world’s consciousness. Back in 1987, with countless people worldwide succumbing to a terrifying illness and no cure in sight, the American journalist Randy Shilts published And the Band Played On: Politics, People, and the AIDS Epidemic, an immense nonfiction book chronicling the early history of HIV/AIDS. A bestseller and an instant classic, And the Band Played On introduced the world to Gaétan Dugas, a French-Canadian flight attendant whom Shilts called the “Patient Zero” of AIDS.
According to Shilts, Dugas had single-handedly spread HIV to hundreds of other gay men as he jetted across the country; the journalist wrote that the flight attendant was the person responsible for introducing AIDS into North America, and that, to a large extent, he’d done so deliberately. Shilts’s portrayal was captivating—Dugas was a beautiful, blond sociopath who continued having unprotected sex long after receiving his diagnosis. “He would have sex with you, turn up the lights in the cubicle, and point out his Kaposi’s sarcoma lesions,” Shilts wrote. “‘I’ve got gay cancer,’ he’d say. ‘I’m going to die and so are you.’”