• by Beatriz Mallory , Columnist, November 2, 2016

Last week, an object lesson in health care marketing and branding nearly escaped notice outside of HIV/AIDS circles.  

Those of us building brands in this therapeutic area now know that the so-called “Patient Zero” was not the source of the AIDS epidemic that has so far killed 500,000 people in the United States. Nor was he supposed to be labeled “zero.” A circular symbol on an epidemiology chart — an “O” for “outside of California” misread as a “zero” — gave us a human villain with a media-ready moniker.  

In the panic of the early days of the epidemic and the scramble to decipher its origins, it was somehow comforting to shift the blame for the carnage from the arcane-sounding “acquired immune deficiency syndrome” to a malevolent, promiscuous “Patient Zero.” The reality is that the virus was infecting men in New York in 1971, three years before Patient Zero arrived in the city and began frequenting its then- carefree nightlife.

The former Air Canada flight attendant had a name, Gaëtan Dugas. And like all purported villains, there was more to his story. But he died in 1984, and any nuance went with him. What remain are a sordid tale and a powerful brand to envelop it. 

Hearing of the posthumous recognition that Dugas was not the source of the river of horror that engulfed New York, San Francisco — and eventually the nation — surely shakes up many like me. I arrived in New York in the early ’80s, finding myself dancing with friends one week and burying them scant months later. My list of the lost is too painful to revisit, but time and objectivity keep sentiment at bay.  

Yet last week’s news brought to my marketer’s mind the searing power the Patient Zero brand had on grief-stricken communities after reading Randy Shilts’s seminal book And The Band Played On.” The disease now had a face beyond that of their gaunt brother, sister, or lover. And the Patient Zero brand itself has grown to represent the fount of calamity for other epidemics.  

In 2009, the term was used to describe 5-year-old Édgar Hernández in Mexico, the likely first case of swine flu.  According to an account at the time, his mother María del Carmen Hernández lamented, “I feel terrible about all of this, because the people are thinking that this was all my son's fault. I don't think this is anyone's fault.” But the smiling countenance of a recovering child didn’t match the brand image of a Patient Zero, as did the tragic figure of Gaëtan Dugas.

The hope of AIDS researchers like Dr. Robert M. Grant from the University of California, San Francisco, is that this news will help “humanize” Dugas, and thus help in the continuing fight against the disease. “No one wants to be the Patient Zero of their village,” he said in the New York Times article. “But this may be helpful because it says, ‘Just because you are the first to be diagnosed doesn’t mean you started the epidemic.’”

As health care marketers, we work hard to build powerful brands that evoke positive emotions like confidence, sophistication, social justice and playfulness. They take us to earlier, happier times or project a brilliant future. It is too late for the exculpation of Mr. Dugas. But the brand he unwittingly inspired, Patient Zero, has only grown, and whenever used, will continue to stoke the darkest fears of a traumatized public.  

In the narrow purview of epidemiologists, it’s argued that naming a living Patient Zero can protect public health. But marketers have a different responsibility — it is incumbent upon us as communicators to tread carefully in using this brand, and similar language the inevitable next time a new disease enters our consciousness. If we are truly committed to the health of our villages, we should refrain from dehumanizing any member with an unfortunate brand they may not outlive.