Francisca Bartilotti Matos discusses the metaphors we use to describe COVID-19 and the effect these metaphors have
I remember leaving the house on the first day of lockdown. The streets were silent. I could feel the suspicious looks cast down by people still inside their homes, while those on the street tried, indirectly, to prove to everyone else that they alone were meant to be out. As a doctor on an infectious diseases ward, I had watched with anticipation as the virus tracked across the earth, moving from a distant threat to a reality. Initially, our hospital struggled to align itself with the seriousness of the threat, and we went from wearing sophisticated personal protection equipment to examine people who ultimately suffered merely from jetlag, to having only one surgical mask to wear as the wards filled with COVID-positive patients. On phone consultations, I heard the fear in people’s voices, from those concerned about the Chinese food they had eaten, to those frightened that a package mailed from China could carry disease. This turned to widespread panic, keeping people too afraid to come to the hospital. Watching the containment measures come and go, and come again, was a lesson in how people’s responses can adapt, how we can all become acclimatized to threats. I remember, too, the weekly applause for the National Health Service, how it made me feel proud and patriotic, how emotional it was to hear our work recognized. Concurrently, I turned to Susan Sontag, and her essays Illness as Metaphor and AIDS and its Metaphors. Concerning the ‘epidemics’ of their age, decades later they still resonate with oracular clarity on social theory. The framework of thinking they suggest can be applied to most new diseases which present to the world. This year, it was COVID-19.
Despite being updated with each progressive generation, the metaphors we employ to describe diseases of our body are remarkably stationary. Illness as war, illness as profanity, illness as punishment, illness as something foreign: all these perceptual tactics have been used in the past. Unsurprisingly, they have also been used to great effect regarding COVID-19, as a means of constructing narratives and trying to find meaning for both the pandemic, and the disease itself.
Sontag not only describes the way we think of illness but demonstrates the dangers of seeing diseases for more than what they are. Illness as Metaphor was written in 1978, after a breast cancer diagnosis. AIDS and its Metaphors came in 1989, after her experience as a patient. Both were borne from her discomfort with the metaphorical dialogue she experienced first-hand. Metaphors were harmful, she thought, as the way they talk about disease defines how the disease is experienced.
While metaphors themselves aren’t necessarily harmful when talking about disease and can be means for one to come to terms with their ailments, we should critically look to the ones that permeate our lives without us noticing it. It is metaphoric literacy and not anti-metaphoric thinking that we should aspire to (Holmes 2011).
Consider illness as a war metaphor. The war metaphor empowers us. It gives us pride in the fight. Fighting for one’s health becomes akin to fighting for one’s flag. Portraying the fight against illness as a war or battle allows governments an easy transition into the mindset of emergency and the employment of emergency measures. We are fighting coronavirus; we protect ourselves from coronavirus; shield ourselves from it. Healthcare workers are heroes, new treatments are weapons. These are loaded words. Primed language designed to excite and incite. As Sontag reminds us, we must beware of the war metaphor. “The military metaphor […] not only provides a persuasive justification for authoritarian rule but implicitly suggests the necessity of state-sponsored repression and violence.” (Sontag 2002, 94) By treating the pandemic as a war, organs of power are tempted to justify their abuses of power. During the first lockdown, multiple stories of abuses by the police arose in England, where people complained of being followed by police drones. A report by the European Network Against Racism revealed how police enforcement powers targeted disproportionately ethnic minorities in countries like France. In Manchester, prison-like fencing was erected around the university campuses. In the United States, during a White House press briefing in November, Dr. Anthony Fauci (top Infectious Diseases expert in the United States) stated: ‘If you’re fighting a battle and the cavalry’s on the way, you don’t stop shooting.’
Now, consider illness as a foreign entity. Epidemics are often described as arising in a foreign place. Syphilis, for example, was originally “the ‘French pox’ to the English, morbus Germanicus to the Parisians, the Naples sickness to the Florentines, the Chinese disease to the Japanese.” (Sontag 2002, 133-134) AIDS, in turn, began as ‘the African virus’.
Sontag shows us the thin line between ‘imagining disease’ and ‘imagining foreignness’. The foreigner as the other is comparable to pollution. COVID-19 was described as the ‘Chinese virus’ long after it had become established as a worldwide pandemic. As such, it was used as a vindication for racist attitudes and remarks against people of Asian heritage.
Illness has also been used as a metric of punishment for western society’s flaws. Tuberculosis exemplified the condoned behaviors of the 19th century “homo economicus”, with images of “consumption” and wasting”. In the 20th century, the reasons “abnormal growth” and “repression of energy” (Sontag 2002, 64-65) thought, in the popular imagination, to provoke cancer in the popular imagination were comparable to the problems which arose from capitalism. Now, COVID-19 has been represented as the worst of neoliberalism: spread by indulgent trans-global flights, and the result of environmental destruction, COVID-19 is globalization gone rampant.
Of course, it is natural to try and find societal meaning in the carnage wrecked by deadly diseases and it is undeniable that social inequalities influence how a disease spreads. But the tone and rapidity with which judgments are made is important. Made too quickly, these condemnations are only more likely to be rash and unhelpful. For a patient of COVID-19 or a healthcare worker, it is not soothing to think of their struggle as a punishment for humanity’s ills.
Metaphors of illness tend to separate people from good and bad. Sontag tells us there is a persistence of the belief that illness is a punishment for moral laxity. AIDS portrayed this moralizing aspect of illness by creating a gully between the blameless and the guilty; people who, for instance, acquired the disease through faulty blood transfusions were seen as innocent, opposing those who contracted the illness through more ‘shameful’ means, such as sexual activity and drug abuse. Similarly, metaphors have successfully enabled COVID-19 to divide people beyond what was necessary to slow the spread of transmission. On one side, the metaphor goes, are the ones at risk – those we need to shield, the vulnerable, the elderly, the imunossupressed. On the other side are those too careless or callous, too concerned about their social contact to bother with social distancing. As people were classified as selfish or selfless, good or bad, responsible or irresponsible, society once again found itself divided along a moralistic line, beyond which personal circumstance had melted into the ether of the greater good. Outlying health problems have been put aside for months, including the risks of isolation to mental health. If someone is anxious, lonely, depressed, the burden of blame falls on them and their need to see others. They are not only refusing to fight, but to sacrifice. They are publicly called bad people. There are no caveats, no excuses, no sympathy – stay home, save lives.
There are other divisions, too: young versus old, essential versus non-essential, believers versus non-believers. Neighbors are encouraged to report each other to the authorities; people spy the other from their windows, eyeing to see who breaks the rules. By maximizing individual responsibility, governments are able to downplay the importance of their role. As Sontag states, “the reality of the response (typically) falls short of what seems to be demanded.” (Sontag 2002, 142) Governments have repeatedly failed in their actions to control the pandemic (lack of PPE, poor testing systems, delay in instituting national lockdowns) while constantly putting the onus of the blame on the individual. The burden of duty falls upon each soul individually, as they are tasked with protection of their community even when the evidence behind the role of small gatherings on the spread of the pandemic has been contested. Worryingly, the shaming of individuals for their behavior induces fear of seeking out testing. A positive result becomes dangerous not only for its health implications, but the subsequent ostracizing from loved ones and community. The implication is: you are irresponsible and to blame for your disease and, worse, the disease of the guiltless ones.
As a war, COVID-19 has been total. Portraying the control of the pandemic as a fight legitimizes state-imposed violence and repression and widens the well of minority discrimination. It causes people to see each other as enemies, and themselves as soldiers. Casting it as a foreign event legitimizes racism. Looking for political meaning shifts attention from immediate action against a virus to condescending superiority from those against the system. Establishing a culture of morality around COVID-19 isolates further, risking mental health consequences to those most susceptible and stopping people from accessing the testing necessary to control the pandemic.
We should try to avoid harmful metaphors which seek to gradate our goodness. It is empathy, and not mistrust towards our neighbors, that should be stressed. They will still matter, long after the coronavirus doesn’t.
Francisca Bartilotti Matos was born and raised in Portugal and has been living in Scotland for the past three years. Now in Orkney, she divides her time between the hospital, reading her books, playing the accordion, and swimming in the sea.
Holmes, Martha Stoddard. “After Sontag: Reclaiming Metaphor”. Genre 44, No 3 (Fall 2011). DOI 10.1215/00166928-1407594
Sontag, Susan. 2002. Illness as Metaphor & AIDS and its Metaphors. London: Penguin Classics.