�󷢲�Ʊ

There is an old linguistic theorem suggesting that the language we use reflects the way we understand the world around us. The Sapir-Whorf hypothesis, while fraught with some real problematic assumptions and implications, is useful when we think about why and how the naming of things, like disease, matter.

As students in my global-health-related courses will tell you, I was fascinated and focused on COVID-19 generational terminology — after the Mu variant for example, the World Health Organization (WHO) labeled the next variant strain Omicron, skipping over Nu and Xi. As the epidemiologist Dr. Martin Kulldorff at Harvard in 2021, the concern was raised that Nu would cause confusion with the word “new” and Xi was passed by to avoid unnecessarily stigmatizing the region or leader of China as pandemic politics continued.

Indeed, similar concerns arose when the Centers for Disease Control and Prevention (CDC) and the WHO announced in 2022 that the United States reached a new milestone in the pandemic: We were approaching endemicity, and a level of COVID-19 virus would remain constant in populations across geographic regions but at expected and manageable levels. The fear this time was that using public health parlance “endemicity” would create confusion as reports of far too many individuals across the country interpreted this announcement as the “end” of the coronavirus and abandoned precautions.

So, at the advent of the Mpox outbreak last year, it was not surprising that persistence in calling the virus “monkeypox” had critical implications for public response. Despite the on best practices in naming new human infectious diseases, the use of the name monkeypox stuck (the WHO and CDC did not officially change the name to Mpox until November of 2022) and arguably helped foster misunderstandings, misperceptions, and missed opportunities for better intervention.

Misleading medical misinformation can be dangerous to our health and to our human rights. As science columnist  when cautioning the public against seeing Mpox as simply another STD, “The public language and framing around healthcare needs to be incredibly clear and specific; otherwise, entire communities may end up underestimating or even dismissing their own risk levels … muddled messaging or, worse, language that implies blame can end up emboldening existing stereotypes and biases, exacerbating the discrimination faced by already-marginalized groups.”

Indeed, the WHO best practices told us this, but perhaps we missed it … as , assistant director-general for health security at the WHO, reflects in the 2015 statement, “In recent years, several new human infectious diseases have emerged. The use of names such as swine flu and Middle East Respiratory Syndrome has had unintended negative impacts by stigmatizing certain communities or economic sectors … This may seem like a trivial issue to some, but disease names really do matter to the people who are directly affected. 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.”

What were some of the consequences of the Mpox outbreak in the past year? In November of 2022, �󷢲�Ʊ’s Global Public and Environmental Health Program, with the support of ALST, invited Kenneth Cruz to campus to give an overview of those consequences, missed opportunities, and lessons learned from other virus policies and outcomes in the United States. Cruz is the the Monkeypox Awareness and Prevention Partnership Program data and communications lead for the African Services Committee in New York City. [Despite the official move to Mpox as correct nomenclature, Cruz pointed out that this remained his title and the name of the program at the time.] His talk, “Walk don’t run: How NYC’s failed MPV outbreak response struggled to learn from the HIV and COVID-19 crises” highlighted several crucial aspects of the failed response to the outbreak. Cruz pointed out the implicit biases; the missed opportunities for treatment and for vaccinating a wider portion of at-risk populations; the missed timing in terms of information dissemination — and how we should have more carefully heeded lessons learned from recent HIV/AIDS and COVID-19 epidemics.