During his campaign rallies and back when he still had access to Twitter, then-President Donald Trump often referred to the coronavirus as the “Chinese virus” or “China virus” — reports have even linked his October COVID-19 diagnosis to an uptick in anti-Asian racism on Twitter.

But Trump’s attempt to blame China for the spread of the coronavirus isn’t new. Several historians and psychologists I talked to said that when diseases like COVID-19 become associated with a specific country or group of people, a scapegoat often emerges. That’s especially true if those in power find they can target a marginalized group in a way that reaffirms beliefs already held about these communities. 

The wave of racism, harassment and violence against Asian Americans during the COVID-19 pandemic is just the latest example. There were 122 incidents of anti-Asian hate crimes in 16 of the country’s most populous cities in 2020, an increase of almost 150 percent over the previous year, according to data compiled by California State University’s Center for the Study of Hate and Extremism that was shared with Voice of America. Restaurateurs in some of New York City’s predominantly Asian American neighborhoods also said their businesses had taken a nosedive: According to Yelp data provided to Today in March 2020, half of the worst days for Chinese restaurant searches in the U.S. over the past year had occurred that February.

The instinct to vilify minority groups, especially during times of crisis, has a long-standing history in the U.S., rooted in the country’s relationship to white supremacy or fear that white people might become less powerful, said Sherry Wang, a professor of counseling psychology at Santa Clara University. Wang explained that the U.S. has often promoted racist myths to portray different groups of people as either inferior, dirty or dangerous to white people. For Asian Americans in particular, she said, there’s the “Yellow Peril” stereotype, a fear that emerged in the late-19th century, after an increase in immigration to the U.S. from China — and after the West realized that Asians were strong enough as a political, economic and military threat to surpass the U.S. “When the West realized Asia was very big and could take over, they wanted to paint Asians, especially East Asians, as dangerous outsiders but not so threatening that they were superior,” she said. “They were seen as threatening to the white, Western way of life.”

That’s one reason why we’re seeing discrimination and other racist acts against Asians: America once again fears China’s dominance. Ultimately, blaming China for the pandemic didn’t help Trump win reelection in 2020, but unfavorable views of China are at a record high among Americans. And there are signs that Americans, especially Republicans, blame China for the spread of the coronavirus. A November Economist/YouGov poll found, for instance, that 64 percent of all registered voters and 86 percent of Republicans said it was definitely or probably true that China was responsible for the pandemic.

Some of the most overt aspects of anti-Asian racism in the U.S. have been tied to diseases, too. Take the bubonic plague outbreak in Hawaii in 1899-1900. After several people of Asian ancestry died of the disease in Honolulu, authorities locked down a predominantly Asian neighborhood housing several thousand people and tried to “sanitize” the area by permitting controlled fires. But the wind picked up, setting all of Honolulu’s Chinatown ablaze, leaving thousands of people displaced and dozens of acres of land scorched. And it didn’t stop the virus from spreading: A U.S. Public Health Service official later concluded that the disease was spread by rats and other vermin.

There’s also the 2003 global outbreak of SARS, first identified in China in 2002. In North America the respiratory disease was mainly confined to Canada, but even still, there were reports of rampant harassment toward people of Asian descent in both countries, similar to what we’re seeing today. “A lot of people avoided Chinese people,” said an interviewee in a 2004 report illustrating the impact of SARS on Asian communities in Canada. “I know there were a lot of experiences regarding the subway. If you sneeze or cough, you could empty the train!” Other reports at the time said that fear was spreading faster than the virus, which led Chinatowns in some large U.S. metropolitan areas to report a 90 percent drop in revenue from the previous year. These fears, however, came even though there were no SARS-related deaths in the U.S., according to the Centers for Disease Control and Prevention.

Of course, Asian Americans aren’t the only group to be marginalized for the spread of a disease in the U.S. In 1982, the deputy press secretary for then-President Ronald Reagan laughed when asked at a White House press briefing whether the president was tracking the spread of HIV/AIDS, which the journalist referred to as “the gay plague.” Reagan himself was largely silent on the issue, taking more than four years after the AIDS crisis began to mention it publicly. This stigmatization came with real consequences. In 1986, according to a Gallup poll, 44 percent of Americans said they or someone they know avoided places where they thought gay people might be in order to avoid getting HIV/AIDS, even though we know that is not how it is contracted. And even as late as 2006, 43 percent of Americans said in a Kaiser Family Foundation survey that they thought “gay men/homosexuals/bisexuals” were the most likely to get HIV/AIDS, even though we know HIV/AIDS can affect anyone regardless of race, gender or ethnicity. (Respondents also said they believed Black people and other minority groups were more likely to be infected than white people.)

Black Americans have also been stigmatized, particularly during the 2014-16 Ebola epidemic in West Africa. Navarro College, near Dallas, denied admission to two Nigerian students, not because they were diagnosed with Ebola but simply because they were from a country where cases of the disease had been identified. Prior to that, in Pennsylvania, a Guinean high school student and soccer player was subjected to chants of “Ebola” from an opposing team. The incident left the student in tears. A Pew survey around the time of the spread suggested that Americans were becoming increasingly alarmed about Ebola. The poll found that 41 percent of Americans were worried that they or a family member would be exposed to the virus (up from 32 percent just two weeks prior). “If you don’t know about a place, group of people or have a stereotypical working knowledge of them, you see the stigma play out,” Rana Hogarth, a professor of history at the University of Illinois at Urbana-Champaign told me. But the stigmatization and accompanying fears proved to be mainly unfounded: According to the CDC, only four patients in the U.S. were diagnosed with Ebola.

Naming pathogens by their geographic origin — for example, the Zika virus was first identified in the Zika forest in Uganda, and Ebola was named after a river in the Democratic Republic of Congo, near where the virus was first identified — can also help create a scapegoat for a disease. It’s one reason why the World Health Organization said infectious diseases should not be named after the places where they originated. “[S]tigma, to be honest, is more dangerous than the virus itself,” said Tedros Adhanom Ghebreyesus, the WHO’s director-general, when talking about the coronavirus in March 2020. But that didn’t stop Trump and others from referring to COVID-19 as the “Wuhan virus,” after the city in China where it was first identified. Tying diseases to where they originate in addition to racializing a disease can also create a false sense of security that a disease can be contained. As Wang told me, many leaders thought the coronavirus could be stopped by simply cutting off travel to the country in question, as Trump did early in the pandemic when he restricted travel to some of the countries reporting large outbreaks, but that just wasn’t possible.

While the instances above are extreme and alarming, the experts I’ve talked to think that if people uphold a specific worldview by delegitimizing another group, the framing of diseases will always be political — no matter how apolitical we think diseases are. That’s because racism itself is a disease, and as Roger Keil, a political scientist at York University, told me, “[I]t seems to spread sometimes like a virus.” Keil compared it to watching a video online: “For every video that links the disease to Chinese people, there will be 10 or 1,000 people watching, so it’s normalized,” he said. “It’s terrible, but that’s how racism spreads.”

When asked how we can stop racializing diseases going forward, Hogarth told me it starts with holding those in power accountable: “Simply stating that racially motivated attacks are wrong is a good start!” She said it’s also important for leaders to be honest with the public about what’s known about a virus versus what’s unknown, and to urge people not to speculate and make broad generalizations about groups early in a pandemic. “I think when people have just a little bit of information, not the whole picture,” she said, “it becomes easy to fill in the gaps with claims that may be fueled by ignorance, stereotypes and xenophobia.”