This article investigates the evolution of social distancing terms in Chinese and English in two geographically close yet culturally distinct metropolitan cities: Hong Kong and Guangzhou. This study of bilingual public health campaign posters during the COVID-19 pandemic focuses on how the evolution of neologisms and linguistic strategies in public health campaigns adapts to different societal contexts. A baseline meaning of the re-purposed linguistic expressions was established according to the BNC corpus for English and the Chinese Gigaword Corpus for Chinese. To establish the link between linguistic expressions and public health events, we converted them to eventive structures using the Module-Attribute Representation of Verbs and added interpersonal meaning interpretations based on Systemic Functional Linguistics. The two cities are found to have taken divergent approaches. Guangzhou prefers “contact prevention” with behavior-inhibiting imperatives and high value modality. Conversely, the original use of “contact prevention” in Hong Kong was gradually replaced by the neologism social distancing in English, triggering competing loan translations in Chinese. In Hong Kong, behavior-encouraging expressions are predominantly used with positive polarity and varying modality and mood devices, which fluctuate to track the epidemic curve of COVID-19. We conclude that lexical evolution interacts with social realities. Different speech acts, prohibition in Guangzhou but advice and warning in Hong Kong, are constructed with a careful bilingual reconfiguration of eventive information, mood, modality, and polarity to tactfully address the social dynamics in the two cities.