Movies have tried to teach us how to behave in disease outbreaks for at least 100 years, and they contain instructive lessons for the coronavirus pandemic. Many public health films mixed fictional narratives of diseased individuals with animated sequences dramatizing the spread of contagion on a global scale too extensive for human eyes to see without the assistance of cinematic imagery. Elaborate musical scores and expert editing further transformed public health messages into emotional exhortations. Through these subtle rhetorical techniques, these films worked to instill implicit beliefs about contagion: that disease comes from nonwhite people, but also that modern technologies, guided by nationalistic ideologies, can stop its spread. By fostering these harmful beliefs, health films encouraged viewers to seek false security in racist ideas. Health officials should look back at these films to learn to identify — and avoid — racist messages, while also learning how cinematic art can amplify the impact of real information in a health emergency.

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In the 1920s, a silent film called “How Disease Is Spread” stuck small black stars on actors’ fingers and lips to show the transmission of germs from the rim of a shared drinking glass, a dollar bill and a magazine, eventually landing on a little girl’s cheek as she boarded a train, further spreading the contagion to sites unknown. As part of a series called “The Science of Life” that was co-produced by the U.S. Public Health Service, “How Disease Is Spread” represents the prevention of contagion as a responsibility of the individual, not the community or the government. Films like this one showed viewers that we cannot see the spread of invisible pathogens with our naked eyes, but we can learn to see them with our mind’s eye. By highlighting the behavior of infectious individuals, these films taught us how to see social situations as threatening to our health by depicting contaminated people and places to be avoided. The problem was that these films often intermingled moralistic or ideological judgments with scientifically valid instructions, treating both as though they were factually correct.

Who and where were the sites of contagion in these films? As in “The Eternal Fight,” they were often people from countries outside of the United States, who were depicted through racist and xenophobic imagery. A film from the 1930s called “The Work of the Public Health Service” was rereleased in the 1940s with the self-explanatory title, “Prevention of the Introduction of Diseases From Abroad.” The film captures a sentiment that is all too familiar from the current pandemic. Featuring documentary footage of immigrants disembarking on Ellis Island, intercut with scenes of large trading vessels quarantined at sea, with rats scurrying up and down the mooring lines, a booming voice-over narrates the transmission of bubonic plague, declaring, “This disease is constantly present in the Orient, and this fact makes it an ever-present threat to the United States and its possessions.”

The idea of “foreign” disease that contaminates an otherwise pure United States has been with us for a long time. When “The Eternal Fight” used animated maps to show the spread of infections from Africa and Asia to Europe and the United States, it did so by picturing inhabitants of those countries in traditional attire, in settings meant to frame them as exotic in their foreignness, especially as contrasted with the efficient bureaucrats in stern suits at WHO headquarters. Despite growing awareness of globalization in this era, the idea persisted that certain places and people were diseased, and others were under threat from those “endemic” sites of contagion. The threatening people and places were always brown and black; the vulnerable populations were white. Human and natural resource exploitation under colonialism was never acknowledged as playing any role in the emergence of these global pandemics.

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In the 1950s, “The Silent Invader” once again reinforced this imagery in a health film meant to prepare the American public for the threat of “Asian influenza.” This story goes on and on, in health films from the AIDS era and in Hollywood movies from “The Andromeda Strain” (1971) to “Outbreak” (1994) to “Contagion” (2011). At present, “Contagion” is climbing the charts on iTunes, and New York Times film critic Wesley Morris argues the film’s appeal is that it offers a “plausible speculation of life during a global outbreak.” It certainly gives us a familiar narrative for how to explain the spread of contagion, from a wet market in Asia to the global business executive who brings the contamination home to the United States.

What can we learn from the long history of influential racist and xenophobic imagery that might help us in the current outbreak? For one, we can see that the desire to visualize the invisible during times of contagion is powerful and enduring. These films tell us that if we could only see the virus, we could avoid it and the disease it causes. But the films present this logic through a racialized contagion narrative that causes a lot more harm than good. One hundred years of filmmaking shows us that this impulse will not go away, so we need instead to find new ways of visualizing contagion. In particular, we need to look at the images in media coverage of outbreaks, which often seem to draw from familiar iconography and narratives, perhaps unintentionally reinforcing ideas about the association of disease with a vaguely defined “Asia.” When elected officials call coronavirus a “foreign disease,” “China virus” or “Wuhan virus,” they perpetuate these stereotypes, fueling racism and directing xenophobic fears toward vulnerable people. Asian and Asian American people in the United States and around the world have suffered racist attacks that are clearly entangled with this kind of stigmatization. Scapegoating puts everyone at risk by misdirecting our attention toward false ideas about where the real risks lie.

Second, we need to recognize that — for better and worse — visual narratives (including movies, television and Internet memes) play a major role in shaping and perpetuating cultural narratives about why outbreaks happen and how to stop them. Organizations such as the U.S. Public Health Service and the WHO used to make narrative films that explained the spread of disease to help viewers learn the emerging science of germ theory and modern approaches to hygiene. We can see how effective these films were by how long their iconography and narratives have endured. We don’t need any more racist contagion narratives. But we do need compelling narratives that help us envision a way forward, not just for this pandemic, but beyond. Public health resources should be expanded around the world, and agencies should be equipped with experts in the art and science of communication. The WHO needs filmmakers and storytellers who can help us all understand how to behave in a world where the unfolding climate crisis will only make pandemics and natural disasters more frequent features of our daily lives.