An incommunicable disease: the difficulties in naming the latest viral outbreak

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TORONTO — The “Chinese Flu.” The “Wuhan virus.” The “Wuhan coronavirus.”

These are some of the names major media outlets have applied to a new illness originating in Wuhan, China whose official name doesn’t exactly roll off the tongue — “2019-nCoV.”

Mainstream media more often refer to it as a “novel coronavirus” or “new coronavirus,” while tweeters and bloggers have been more willing to posit their own colourful — and often culturally inappropriate — labels.

The World Health Organization says it “temporarily” dubbed this new virus “2019-nCoV” (pronounced “20-19 EN-koh-VEE”), a step the WHO employs for very new diseases “so that inappropriate names do not become established.”

Despite those intentions, the absence of a snappy handle is the very reason we’ve seen an array of monikers that are not always politically correct or accurate, say observers.

“The problem is it’s (2019-nCoV) a little clunky to use and people aren’t really going to adopt it. And the longer the WHO wait before they come up with a conventional name that people use, the greater the risk that they’ll lose control over naming it,” says Steven Taylor, a clinical psychologist and author of “The Psychology of Pandemics: Preparing for the next global outbreak of infectious disease.”

Taylor says names in general hold great psychological importance because they operate on several levels: they impart information about the disease, can imply the degree of threat involved, and invite the general public to learn about often complex health issues.

But they can also cause unnecessary cultural, regional or economic offence. Wuhan is already suffering a financial blow from the quarantine and a name like “Wuhan Flu” is unlikely to help.

In the spirit of the Hippocratic Oath “first, do no harm,” experts agree the name of a new disease should not single out ethnic or racial groups, geographic locales, trade and industry groups, or negatively impact animal welfare.

This is the presiding principle of the WHO’s 2015 guidelines on naming infectious diseases, which stress the importance of picking names that don’t offend “while balancing science, communication, and policy.”

That’s a difficult bar to meet, says Nicola Bragazzi, a medical doctor and research chair at York University’s Natural Sciences and Engineering Research Council. Just look at the substantial number of names in wide circulation that are inspired by towns, cities, people, animals, jobs and groups: the Spanish flu, Legionnaires disease, Japanese encephalitis, and bird flu, among them.

Controversies abound, but these names are so well-established in the public consciousness there’s no way to roll them back now, says Bragazzi.

Even inadvertent offence is tough to avoid, he adds, noting that “norovirus” drew ire for unintentionally containing the widespread Japanese family name “Noro.” And this was after the diarrhea-causing flu bug was initially named the “Norwalk Agent,” in reference to the town of Norwalk, Ohio, where an outbreak emerged among schoolchildren in 1968.

In 2011, the flap pushed the International Committee on Taxonomy of Viruses — which oversees the creation and naming of virus species, genus and families — to strongly encourage the media, national health authorities and scientific community to use the name “Norwalk virus” instead.

Naming viruses after the scientists who discovered them would seem to be a safe bet — such as the Epstein-Barr virus, named after Michael Anthony Epstein and Yvonne Barr. But this too, was problematic, because it failed to acknowledge the contributions of a third scientist, Bert Achong, says Bragazzi.

“According to the World Health Organization guidelines, most names of viruses sound inappropriate,” he says, suggesting it may be best to stick to characteristics of the illness rather than where it originated or who it first affected.

This is tough for something as new as 2019-nCoV, whose exceedingly clinical moniker was derived from the few irrefutable facts at hand: It emerged in 2019, it is “novel” or new, and it is part of a family of coronaviruses that can cause a variety of conditions.

Of course the problem with calling something “novel” is that it becomes obsolete as soon as another new pathogen of that type appears, says Taylor.

Allison McGeer, director of the Infectious Diseases Epidemiology Research Unit at Mount Sinai Hospital and a professor at the University of Toronto’s Dalla Lana School of Public Health, says there are bigger issues to contend with than a virus’ name.

“The truth of matter is that we call bacteria by very complex and difficult names and we live with that all the time,” says McGeer, who contracted SARS when she was on the front lines of the Toronto outbreak in 2003.

“I understand the desire for acronyms that roll off your tongue, but it’s not necessarily what we should be doing.”

McGeer says there is an international coronovirus group that has named new illnesses — including SARS, or Severe Acute Respiratory Syndrome — but there is no formal body that is responsible for new human viruses and it’s not clear when, or if, a new name for 2019-nCoV is coming.

The WHO says final names for diseases are set by the International Classification of Diseases.

Most agree that if you want a new disease to resonate with the general public its name should be memorable, short and easy to pronounce, such as “rabies” or “polio.”

“It all gets down to what you want your name to do, or what impact you want it to have on people. If you give it a technical name, it’s only going to have meaning to the people who are involved in the study and treatment of the disease,” says Taylor, also a professor in the University of British Columbia’s psychiatry department.

“If we want people to stop eating wild animals, which are a reservoir of viruses, (then) you can call it something like ‘Wild Meat Coronavirus.'”

There’s little chance that would fly, Taylor quickly adds, noting that name could lead some fearful citizens to start culling wild animals to avoid the virus’s spread.

Naming a new virus in this day and age is no easy task, he agrees.

“There are all kinds of complexities that need consideration.”

 

Cassandra Szklarski, The Canadian Press