What’s in a name? It’s a question international health officials and scientists around the world are asking themselves as a coronavirus spills out of China and across borders.
For now, the new strain has been dubbed 2019-nCoV — an oddly clinical title for a virus that’s so far sickened thousands and killed nearly 150.
That’s a problem, according to Trevor Hoppe, a sociology professor at the University of North Carolina and author of Punishing Disease.
“There’s no way that term is going to be used in everyday language,” he said. “So what are people going to do? They’re going to talk about it in ways that are potentially inaccurate or sensational or stigmatizing.”
The naming of diseases involves three United Nations agencies — the World Health Organization (WHO), the Food and Agriculture Organization and the World Organization for Animal Health. The organizations, which don’t abide by borders, must meet to assign a name for the long term.
While a WHO spokesperson tells Global News the “process of convening a meeting” is underway, they were unable to give a definitive timeline.
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Meanwhile, it’s been nearly six weeks since the virus first emerged from a wet market in the central Chinese city of Wuhan. With no formal name, media and the public have labelled it “the coronavirus,” which isn’t entirely accurate. Coronavirus actually refers to a large family of viruses that includes everything from the common cold to more serious infections like SARS. Online, popular searches for the outbreak typically include “China” in the name — “China virus,” “virus in China” and “China coronavirus.”
Naming a disease is no easy task, said Hoppe. The WHO and other agencies have to strike the right balance by following guidelines laid out in 2015.
It’s the delay in decision-making that leaves the risk of the outbreak taking on a name of its own, which could ultimately mislead the public and inadvertently stigmatize a group of people or a place, he said.
“You have to get it out fast and quick because the public wants to talk about this and is talking about it, and they want to talk about it in a way that is easy and understandable,” Hoppe explained.
“Without one, it’s the perfect stew of stigma, fear and panic and an ineffective health communication that will ultimately harm the way we respond to the epidemic.”
Under the WHO’s guidelines, disease names cannot include specific locations, the names of animals or humans, or make reference to sexual or cultural identities. Terms that “incite undue fear,” like fatal or epidemic, cannot be used. It means diseases like Lyme disease — named after a town in Connecticut where it was first identified — and Middle East Respiratory Syndrome (MERS) would not get the green light these days.
Instead, disease names should try to be generic, according to the WHO. The names can use symptoms like “respiratory” or references to the body like “gastrointestinal.” The name can identify the severity, the season the disease first emerged in and the age demographic it’s impacting.
“The aim of the guidelines is to minimize the unnecessary negative impact of disease names on trade, travel, tourism or animal welfare, and to be sensitive to cultures,” a WHO spokesperson wrote in an email to Global News. “This is why the new coronavirus’ (current) name does not mention a specific location or animal associated with the virus.”
The 2015 guidelines were seen as an important step in public health but followed a long and ugly history of disease naming.
One of the pillars in that history is the Spanish flu of 1918, which infected an estimated 500 million people worldwide and claimed between 20 million and 50 million lives. The world was at war at the time, so while the countries involved censored and suppressed their media, effectively stifling news of the flu, Spain, which was neutral in that war, reported it widely. It was misinterpreted that Spain was where the disease originated when, in fact, the flu had been proliferating in France and the United States for several weeks longer. The finger was ultimately pointed at Spain.
“It was the attitude of ‘it’s their fault. They did it. It’s something about their lifestyles or behaviours. It’s attributable to them,'” Hoppe said.
“But of course, diseases don’t discriminate. They’re not biased individuals. It doesn’t help us understand why diseases move; it’s a way for us to add a sociological framework. It is blame. And blame is not a productive impulse when it comes to creating a rational public health response to disease.”
When the human immunodeficiency virus, or HIV, was discovered in the 1980s, it was given the name GRID, which meant “gay-related immune deficiency.” It ultimately fuelled the spread of the slur “the gay plague” and fostered a complacency that led to weak funding for data collection before GRID was replaced with the more accurate HIV.
“That was a gross misstep by the scientific community,” Hoppe said.
“The impulse is to try and communicate something about the disease. In that case, it was the fact that first people diagnosed were homosexual men in New York City, in Los Angeles. But you have to think: what is this going to communicate to the broader public? While it does communicate something, it, perhaps unintentionally, foments discrimination and bias.”
To avoid that bias, those closest to the situation should have some say in the naming, says Dr. Isaac Bogoch, an infectious disease specialist based out of Toronto General Hospital and the University of Toronto.
“I feel that the Chinese scientists who discovered it should have a strong say,” he told Global News.
Bogoch nodded to the Ebola virus. While it is named after a relatively specific location, it’s still “a beautiful river in the Democratic Republic of Congo… forever associated with a deadly disease.”
“There is a virus named Sin Nombre (meaning without a name) for this very reason,” he said.
The formal designation of this new strain of coronavirus is still a waiting game.
As more time passes, Hoppe fears there’s more of a chance that history could repeat itself.
Until it’s settled, people will find another way to talk about it, he said.
“There might be multiple kinds of discourses out there, and maybe it’ll be fraught along identity lines or geographic lines,” he said.
“And that’s the danger. If it’s killing people and seen as a threat, people are going to fill that vacuum with the stuff WHO is trying to avoid.”
— With files from Reuters