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“Patient zero” and “Contact tracing”

Posted on April 20, 2020January 21, 2025 by Robert Parks
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According to Helen Jenkens, an infectious disease epidemiologist at the Boston University School of Public Health,  “The concept of ‘patient zero’ is highly stigmatizing and often wrong anyway. No single person should be ‘blamed’ for starting an outbreak.”  She continues:

Outbreaks occur for a number of reasons and there is never any practical use in the media to attributing the beginning of an outbreak to one person. In addition, this is often incorrect as there can be multiple introductions to a place (as there undoubtedly have been in the U.S.) and attributing hundreds of thousands (as we now have) of cases to one initial one is just wrong.
(https://journalistsresource.org/tip-sheets/reporting/patient-zero-party-coronavirus/)
(Retrieved April 16, 2020)

The same can be said for the expression “party zero”, used by the New York Times in referring to a party in suburban Connecticut, many of whose attendees later tested positive for Covid-19. (https://www.nytimes.com/2020/03/23/us/coronavirus-westport-connecticut-party-zero.html) 

For alternatives, a well researched piece by Richard McKay, a research specialist in the history and philosophy of science, provides a well developed argument for dropping the term “patient zero”, and using the term “contact tracing” to cover similar – but not identical – ground. “Patient zero”, he argues, orients our thinking toward a source or cause of the problem – which is virtually never possible to ascertain in a scientifically supported manner.  This focus also feeds an unhelpful urge to assign blame, or at least some sort of responsibility.  “Contact tracing” on the other hand, assumes the virus is with us, around us, and the problem is not to find a cause, but to stop its spread.  https://theconversation.com/patient-zero-why-its-such-a-toxic-term-134721
[Richard McKay is author of “Patient Zero and the Making of the AIDS Epidemic” (University of Chicago Press, 2017). Retrieved April 16, 2020)]

In the fabric of transmission, there is no accurate way of identifying one person or one gathering as a starting point. But we can close off paths of transmission by tracing the paths of exposure – and trying to stop further spread. Understanding the concepts involved helps to clarify why “contract tracing” rather than “patient zero” is what we should be paying attention to.

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