This summer, yet another disease unfamiliar to most people in the United States is being transmitted around the world—as is the impulse to find someone to blame. Many news stories about the current monkeypox outbreak make reference to a “patient zero,” supposedly the one person who brought the virus into a particular state or community. This kind of finger-pointing, which long predates monkeypox, is a deeply flawed framing. Worse yet, stigmatizing individuals who get sick—and portraying the social, interconnected nature of communicable disease as an individual matter—actually impedes efforts to slow the spread of infection.
We’ve been here before. When the term patient zero first began to circulate, during the early days of the AIDS epidemic, in the 1980s, it etymologically invoked ground zero, a term coined near the end of World War II to describe the point closest to a nuclear explosion. In the summer of 1945, this referred to the sandy ground in New Mexico—where the first atomic bomb was tested—and to Japanese soil beneath Hiroshima and Nagasaki, where the United States dropped nuclear bombs that killed about a quarter million people. Decades later, after hijackers flew two 767s into the World Trade Center’s Twin Towers, the heaping pile of burning wreckage left behind was dubbed Ground Zero.
When patient zero was first used in relation to a person living with AIDS, it was as if that person contained the kinetic energy and evil of an atomic weapon. And when it was invoked decades later to describe the first person thought to be living with SARS-CoV-2 in various communities, the term associated any person living with the novel coronavirus with all the malevolent intent of hijackers who had purposefully killed thousands of people. Of course, people living with viruses or bacteria are not bombs or terrorists.
The first popular use of patient zero was largely predicated on a mistake. In the 1987 book And the Band Played On: Politics, People, and the AIDS Epidemic, the journalist Randy Shilts identified and vilified Gaetan Dugas, a French Canadian flight attendant who died of AIDS in Quebec City in 1984, as the “patient zero” who had spread AIDS around North America. But in 2016, a study in the journal Nature yielded evidence that HIV had been circulating in North America since at least 1970.