Hate is still a public health emergency — and the epidemic we keep ignoring

I wrote in 2016 in The Advocate in response to the Pulse Nightclub shooting that hate behaves like an infectious agent — that violence is the epidemic, and hate is the pathogen driving it. Eight years later, I wish I could say that the outbreak has slowed. Instead, the data tells a different story. Hate has not only persisted; it has evolved. It has found new vectors, new reservoirs, and new opportunities to replicate. The recent Berlin Pride attack and the CDC shooting in Atlanta about a year ago that shattered a window in my office make one thing painfully clear: we, as a country, are still refusing to treat hate with the urgency of a public health emergency.As a public health official and infectious disease doctor, I’ve spent my career tracking pathogens. I know how they spread. I know how they mutate. I know how they exploit weak systems. Hate follows the same rules. It spreads through rhetoric, mutates through ideology, and thrives in environments where stigma is policy and discrimination is normalized. When we fail to intervene, hate does what every unchecked pathogen does: it causes preventable illness, trauma, and death.Related: Anti-transgender hate crimes spike, leading to calls for a public health emergencyWhen I first described hate as an infectious agent like a virus, bacterium, or parasite, some people thought it was metaphorical. It wasn’t. Hate has vectors — politicians, influencers, extremist networks. It has reservoirs — discriminatory laws, social stigma, misinformation ecosystems. And it has symptoms: shootings, assaults, harassment, chronic stress, and the erosion of community resilience.The Berlin Pride attack is a textbook example of an acute outbreak. Pride is supposed to be a celebration of joy, resistance, and community immunity, a place where LGBTQ+ people gather to counteract the chronic exposures of stigma and discrimination. When violence erupts in that space, it is not just an attack on individuals; it is an attack on a publi