Pandemic and its metaphors: Sontag revisited in the COVID-19 era

On 24 May 2020, The New York Times (2020) published a list of 1000 names of 100,000 US victims of COVID-19, taking up the entirety of its front page. The list included brief descriptions that reflected upon the victims’ individual characters, with phrases like ‘was never afraid to sing and dance’ and ‘emergency room doctor who died in his husband’s arms’. The cover of the paper resembled a black and white photo of a mass grave site taken from the vantage point of a drone, delivering as much semiotic and visual symbolism as it did affective insight into the lives of victims who, as the pandemic rages, may never receive a proper burial. The list was subtitled ‘They were not simply names on a list. They were us’.

In total, 30 years prior, The New York Times (1991) ran a similar story about ‘AIDS costing 100,000 U.S. lives’. Here, the word ‘costing’ signifies epidemic mortality as a line item on a business ledger. By the time of this story in 1991, a decade had passed since the onset of the disease – this illuminates the stark differences between the current airborne pandemic and the blood and body fluid borne one, with regard to their scale, speed, and means of infection. But it is also the form and placement of the story that further contrasts media discourses of both epidemics: the acquired immune deficiency syndrome (AIDS) story ran deep within the paper on page 18 as an Associated Press article, without a byline and without victims’ names.

Throughout the first decade of the AIDS crisis, The New York Times had a terrible record of covering the epidemic. As Rosenzweig (2018) described, the coverage was ‘sparse and far from dependable . . . as much a testament to the pervasive cultural prejudices of the time as they are study in bias-borne editorial neglect’. For years, the paper rarely acknowledged AIDS as a cause of death, even in the obituaries where grieving gay partners were referred to euphemistically as ‘longtime companions’. As Gross (2001) accounted in Up from Invisibility, ‘not only is the stigma removed from the cause of death, but so is the stigma of a gay identity’ (p. 111).

The semiotics, meanings and metaphors about AIDS are thrown into stark relief when juxtaposed with the rhetoric surrounding COVID-19. Whereas coronavirus is figured as a global blight afflicting all of humanity, the media discourses at the peak of the AIDS crisis signified the opposite. ‘They’ were not commemorated as names on a list, and ‘they’ definitely were not ‘us’.

In the early decades of the pandemic, AIDS was mostly invisible, a disease to be discursively stigmatized, shunned and shamed, as critical theorist Susan Sontag (1989) brilliantly argued. In her pre-AIDS polemic Illness as Metaphor (1978), written after surviving cancer, and then in AIDS and its Metaphors (1989), Sontag described how metaphoric language about different illnesses and the political and medical response to them are inextricably entwined. As Halliwell and Aristotle (1998) defined in Poetics, metaphors refer simply to ‘a name that belongs to something else’. For Sontag, in the context of AIDS, the use of the ‘plague’ and ‘pollutant’ metaphors signified the political weaponization of disease and the diseased, and particularly those afflicted by an illness of unknown origin that was infecting segments of society already deemed pariahs. Sontag detailed how metaphors for illness both shame and blame, cursing the afflicted who, in turn, avoid treatment – or more often, have treatment withheld. The stigmatizing power of metaphor has fatal consequences; per Sontag, ‘metaphors and myths, I was convinced, kill’ (Sontag, 1989, p. 14).

In her treatise, Sontag described how military metaphors are abundant in discourses of plagues, including AIDS. So too now with COVID-19. Donald Trump, America’s ‘wartime President’ delivers his briefings, surrounded by a ‘task force’ that includes his impotent ‘Surgeon General’, while he engages in a war of words with journalists. The Pentagon flies synchronized fighter jets, absurdly named Blue Angels and Thunderbirds, to offer tribute to a nation still at war with both viruses and words.

Leaders around the world have marched in symbolic step, into the discursive breach of yet another global pandemic. France’s Macron declares we are ‘at war’ (Erlanger, 2020). Yet, the battle cry is less ‘charge’ than ‘retreat’ inside one’s home. These military commands proliferate with phrases like ‘stay at home’, ‘shelter in place’, and with mandates for ‘self-isolation’. These are policy metaphors strategically designed to valorize self-reliance and the integrity of the private home, instead of the more suspect ‘quarantine’, a term that conjures up imprisonment for Americans who suffer from idealized conceptions of freedom.

‘Covid-ian’ military metaphors marshal us to valorize ‘front-line workers’ – those deemed ‘essential’ to the medical, economic, social, and of course, political establishment. These laborers vary from sanitation and restaurant workers to the gig employees delivering food, risking their lives for tips, to the medical workers. The latter receive nightly tributes of applause delivered from anonymous citizens across urban balconies, spread and shared across broadcast and social media. These celebrations appear less like victory parades than outtakes from The Hunger Games – thundering huzzahs that claim to value workers even as bureaucracies strip medical laborers of vital battle gear (see Wood and Skeggs, 2020 for a discussion of the similar ‘clap for carers’ phenomenon in the UK context). The term is personal protective equipment, or PPE, which is an acronym that operates like a metaphor - only, in this instance, it can save lives.

As the battle has emerged between the right to life and the right to work, President Trump described as ‘warriors’ those willing to risk their lives in the name of late capitalism (Megerian, 2020). This harkens back to Dickens’ (1913 [1864–1865]) Our Mutual Friend, perhaps his darkest satire, written around the time of the cholera outbreak in London. A sewer scavenger, or ‘tosher’, is chided for fishing for coins from the pockets of corpses in the Thames. He turns to his accuser and rhetorically asks,

Has a dead man any use for money? Is it possible for a dead man to have money? What world does a dead man belong to? Tother [the other] world. What world does money belong to? This world.

In the lethal sewage that mixes late capitalism with American democracy, where freedom is a gun and a mask a prison, political discourses about COVID-19 transform toshers into heroes.

In the Coronavirus War, as the top infectious disease expert in the United States, Anthony Fauci has emerged as much media metaphor as medical expert. His exasperated smirk at the President’s press conference ranting – the face palm seen around the world – set off an AK 47’s worth of memes across the Internet. ¹ But Fauci is no stranger to the stage of pandemic media. Thirty years ago, as the Director of the National Institute of Allergy and Infectious Disease, he played the villain in the bloodsport of AIDS-baiting led by the HIV Avengers, ACT UP (the AIDS Coalition to Unleash Power) (Bernard, 2020). Fauci symbolized a health establishment clinging to lethal, outdated treatment protocols and embodied the homicidal neglect by the Reagan Administration. In time, Fauci the Hero was revealed, changing how drug trials worked and how the medical establishment might collaborate with activists, rather than ignore, condemn and arrest them. Now, in this latest crisis, Fauci has became ‘America’s doctor’ (Spector, 2020) or perhaps more accurately, a spectacularised Marvel superhero – The CoVinger.

Alongside the military metaphors, the discourses around plagues have nurtured Western-centric racist xenophobia. As Sontag notes, ‘one feature of the usual script for plague . . . [is] the need to make a dreaded disease foreign’ (p. 47). Western AIDS discourses described how the disease traveled from the ‘darkest continent’ to the Western world, spread by Haitians and queers. But these accounts rarely acknowledged or expressed compassion for how AIDS decimated the African continent and, notably, the majority straight population there. In the West, these discourses engendered little heart toward those dying in the ‘heart of darkness’.

The 1918 ‘Spanish flu’ remains most analogous to COVID in virality, as well as the roundelay of nationalistic name-blaming. The Spanish referred to this flu as ‘The Soldier of Naples’ and the ‘French flu’. The Germans called it the ‘Russian flu’ and the Russians called it the ‘Chinese flu’ (Shafer, 2020). The latter reference points to how Asia has for centuries been identified and vilified as the source of global pandemics – and the blaming labels assigned to them accordingly. In The New York Times (1968), the headline read ‘Hong Kong flu now U.S. epidemic’, as if viruses carried passports.

Until recently, these discourses were shared not only by the media, but international health organizations. As recently as the mid 1990s, the World Health Organization referred to outbreaks of the ‘Beijing flu’, before a shift to a more enlightened, politically correct discursivity that differentiates viruses by year of outbreak. The 19 in COVID-19 means 2019. But in the partisan politicization in the United States, the President and his spokespeople have circled back to these racialized terms to signify the other, referring to the ‘China flu’ and the ‘Wuhan virus’.

Metaphors not only kill. They survive. What once was referred to as ‘gay cancer’, a term used to not only describe but stigmatize, persisted in press and political discourses even after the epidemiologists renamed it ‘Acquired Immune Deficiency Syndrome’. Although Reagan went years without uttering the word ‘AIDS’, his press secretary would joke about the ‘gay plague’ with journalists in the same room where Trump now conducts his daily COVID briefings (see Lopez, 2016).

Journalists and scientists wasted time and resources pursuing AIDS co-factors in gay sex practices, long after the disease was also found in additional populations. In 1986, the Los Angeles Times declared that ‘new AIDS research stirs concerns over “poppers”’ (McGraw, 1986), the terms for odorants often used by gay men as aphrodisiacs. After 15 years, despite the discovery of the retrovirus causing the disease, scientists were still investigating the ‘poppers-HIV connection’ (Wilson, 1999).

In the AIDS age, Foucaultian biopower worked its magic to demonize a minority, although pandemics, metaphors, media and puritanism were bedfellows long before the stigmatization of fellows who share beds. In the wake of cholera outbreaks in New York City in 1866, The New York Times described the disease as ‘the curse of the dirty, the intemperate, and the degraded’ (cited in Rosenberg, 1962). But the scourge of AIDS discourses were, like religious stigmata, symbolically transmuted into the lesions of Karposi’s Sarcoma on the flesh of AIDS victims. No such embodiment of disease has been made visible in the media spectacles of the coronavirus, with the exception of neon-colored body bags: these incongruous and anonymizing images render victims less like plague sufferers piled into mass graves, and more like a fashion line launched by disco or fitness couturiers.

While the malignant discourses about AIDS were just the latest in a long line of moral panics masked as epidemiology, in COVID-19 we depart from Sontag’s script. The coronavirus victims are less often shamed for their sexual practices or their deficient hygiene, with the notable exception of how Wuhan wet markets were described as coronavirus incubators. After all, in the earlier stages of the disease, it was the elite and cosmopolitan set in our deeply globalized world who were most visibly afflicted. Rather, as symbolized by The New York Times, the dead are not just names, but ‘us’.

The valorization of victims on the front page belies the demographic analysis within, which details how victims of the disease are patently not equal. Rather, much like AIDS, the virus takes a greater toll on the weak, the old and the already-marginalized. There is a familiar trajectory with the victims of both diseases. Much as AIDS once struck urban White middle-class gay men, today it more readily affects people of color. COVID-19 has progressed accordingly, if more rapidly due to its virality, to affect those least likely to afford to quarantine, much less to fly or cruise. These victims overpopulate the sanitation crews and housekeeping, public transportation, trucking, warehouse and childcare services deemed essential, if also and tragically expendable. As expressed in this lengthy Los Angeles Times headline, ‘Institutional racism, inequity fuel high minority death toll from coronavirus, L.A. officials say’. With COVID-19, race, place and class are cause factors that have exposed the structural inequality and fault lines in a society driven by late and global capitalism, which is overwhelming for language and even metaphor to describe. Perhaps the most apt metaphor might be the ‘Social Mirror Flu’?

Sontag describes how AIDS discourses refer to the temporal stages of the disease, from HIV to full-blown AIDS. In contrast, the spatial discourses of cancer refer to its ‘spread’ from one organ to another. With COVID-19, we add yet another kind of movement in the form of ‘waves’ of disease. These describe the ebbs and flows in the epidemiological progression of the disease, multi-factored to account for changes in seasons, medical treatments and ineffectual government policy. At the time of writing this article, in the United States, COVID-19 is, at best, mid-first wave, with scientists anticipating the second and the third (Jefferson and Heneghan, 2020). Rather than seek high land, delusional if democratically elected authoritarians like Trump and Bolsonaro are clinging to the shore, expecting the next wave will magically disappear.

Waves as metaphor can also easily refer to the surges of news and fake news witnessed by those ‘surfing’ the Internet and cresting across platforms. Sontag (1989) presciently described how viral metaphors have been extended from AIDS to the rise of computers, with software viruses ‘paralleling the behavior of biological viruses’ (p. 69). Decades later, Paul Ellie (2020) argues in The New Yorker against the potency of virus as metaphor for disease: ‘Rather than applying societal metaphors to illness, we’ve applied illness metaphors to society, stripping them of their malign associations in the process’.

In the age of social media, with content and commentary proliferating across streaming portals and networked platforms, perhaps Sontag may have found relief from the hegemony of political discourse limited to the handful of gatekeeping national media outlets ruling air and print in the 1980s. Alternatively, she may have been as frightened by the scale and spread of disinformation as she was disease and its metaphors. Indeed, this latest pandemic in the age of pan media has solicited fears of pandemonium, if especially among critical cultural scholars, including this author.

In writing both books with ‘evangelical zeal’, Sontag was attempting a cultural intervention – ‘my aim was to alleviate unnecessary suffering’ (p. 13). But Sontag was not alone in turning her pen against poisonous discourse. Around the same time, Tony Kushner (1995) was writing Angels in America, a brilliant attempt in the midst of pandemic to advocate for the progress of humanity. In the final monologue, the central protagonist, Prior Walter, delivers a monologue on the fate of the world after the passing of the AIDS crisis:

This disease will be the end of many of us, but not nearly all, and the dead will be commemorated and will struggle on with the living, and we are not going away. We won’t die secret deaths anymore. The world only spins forward. We will be citizens.

Spun forward now three decades, and the AIDS crisis has not fully passed, although it is now passed over by media attention. Even with all the advances in prevention and treatment, AIDS continues to spread and kill, although annually updated statistics garner scant mention in the press. In 2018, there were 1.7 million new AIDS infections and 770,000 deaths, while more than one-third of those infected cannot access treatment (UN AIDS.org). Even with prevention in the age of PReP, AIDS is spreading. PReP means pre-exposure prophylaxis and describes how AIDS medications can lower the risk of HIV infection. Here, pharmaceutical acronyms operate as metaphors for risk-avoidance behavior that but a few privileged White urban gay men have access to or dare to use (Goldstein, 2019). In queer-positive parlance, PReP is for sissies.

As Camus described in his great plague novel La Peste, ‘But what does it mean, the plague? It’s life, that’s all’ (Camus and Gilbert 1947). For those AIDS-affected populations, whether vilified or rendered invisible through these discourses, their lives seemed to matter little to the rest of the world. There was one notable exception. AIDS activist Larry Kramer turned language, narrative, and media into a weapon. Through his AIDS-themed commentaries, books, and plays, Kramer used metaphor to deliver prophetic, searing indictments of the government, the medical establishment, and his own gay community.

The title of Kramer’s The Normal Heart is derived from the poem, September 1, 1939 by W.H. Auden, in which he entreats us to ‘love one another or die’. Tragically, Kramer died on the day this piece was written (27 May 2020), but only after surviving AIDS for decades. Sontag died in 2004 of leukemia, after having beaten cancer twice. Now, here we are, literally and metaphorically, in the midst of yet another global pandemic. We are in dire need of Sontag’s incisive polemics and Kramer’s angry indictments, if also Kushner’s optimistic rhetoric. Because, even as the world appears to have spun backwards, language has the means to convey hope that it will one day spin forward again.