The Indian government’s objection to the use of the term ‘Indian variant’ for the B.1.617 variant of coronavirus, and the World Health Organisation (WHO) backing it up a few days back, has once again brought to the fore the issues surrounding the naming of diseases, viruses and their variants after geographical locations, and the potential for stigmatisation they may carry.
Before the usage of the term ‘Indian variant’, we’ve had the ‘South African variant’ (B.1.351) or the ‘UK variant (B.1.1.7) or the ‘Brazil variant’ (P.1). Prior to that, there have been references to the coronavirus as the ‘Chinese virus’ or ‘Wuhan virus’. Looking back at history would provide us with countless examples of countries/regions/communities being associated with diseases and viruses – from the Spanish Flu to the Middle-East Respiratory Syndrome to Ebola.
That associating a disease, virus or its variant with a country, geographical region or a community leads to stigmatisation and carries a risk of discrimination and hate crimes cannot be stressed enough. So what is the right way to go about referring to them? What systems have organisations like the WHO put in place? For virus variants – which have been receiving a great amount of attention lately – is there a way to shun the use of geographical names, and still not have complicated scientific names as the only alternative?
Association by Geography – A Long List
“We know that for long, these diseases and viruses have been named after the city or places where they (are said to have) originated from. Ebola fever is from Ebola river from Congo. The same is with Zika… But one of the major watershed (moments) came in 2009 when Swine Flu – H1N1 – was initially being reported in the US, Canada and some other parts. So if the same convention would have been followed, then it should have been called 'American Flu'. But as you know, people are really smart, so they quickly moved to call it Swine Flu… So it’s very convenient – one who wields the power determines the naming of the diseases and viruses,” Dr Chandrakant Lahariya, a public policy and health systems expert, told The Quint, while explaining the past discriminatory practices when naming diseases or viruses.
In the context of the current pandemic, while we have got scientific and non-area specific names in the form of SARS-CoV-2 and COVID-19, the practice of geographical tagging has continued with the variants – whether it is the ‘South African’, ‘Indian’, ‘Brazilian’ or the ‘UK’ variants.
Besides the obvious potential for stigmatisation that these labels for variants carry, it’s also wrong to refer to them as such from a scientific standpoint.
“One saying it’s the ‘Indian strain’, ‘Brazilian strain’ or ‘UK strain’ does not serve much of a purpose. Reason being, what we say as the Indian strain now, once it is reported from, say, multiple countries, it does not make a difference where it originated… Knowing from which country it is widely circulating or where it originally started is (initially) helpful, but it does not serve any purpose beyond a certain point of time,” Dr Lahariya points out.
Moreover, one may not even know for sure whether the variant being associated with a particular country actually originated there in the first place. It might have been first detected there, but that does not automatically imply that it also originated there.
The Problem With Purely Scientific Names
For naming of human infectious diseases, the WHO had issued best practices in 2015 to follow “to minimise unnecessary negative effects on nations, economies and people”.
“Terms that should be avoided in disease names include geographic locations (eg Middle East Respiratory Syndrome, Spanish Flu, Rift Valley fever), people’s names (eg Creutzfeldt-Jakob disease, Chagas disease), species of animal or food (eg swine flu, bird flu, monkey pox), cultural, population, industry or occupational references (eg legionnaires), and terms that incite undue fear (eg unknown, fatal, epidemic),” the UN agency had said back then.
Significant to note here is that while the naming of diseases is managed by the WHO, the viruses are named by the International Committee on Taxonomy of Viruses (ICTV).
For naming variants, the process is said to be more informal among the scientific community, and whichever name gets the most currency is the one to be adopted.
“As far as naming of the strains is concerned, there are some laid-down processes where each of the matter reflects different aspects and are linked to the lineage.”Dr Chandrakant Lahariya to The Quint
But what we’ve ended up with as the names of variants – in the context of coronavirus – are complicated combinations of words, letters and symbols. From B.1.351 and B.1.617 to 20H/501Y.V2, these names are extremely useful for scientists to dissect and analyse, but equally not useful for general population to understand and remember.
So What’s the Alternative?
At a time when virus variants are being discussed by all, and not just the scientific community, what’s the alternative? What is it that the common people can use – something which is neither the jumbled scientific jargon nor is associated with any geographical location or community?
Turns out, the WHO is working on a naming system for virus variants. “This new system will assign variants of concern a name that is easy to pronounce and recall and will also minimise unnecessary negative effects on nations, economies and people,” the agency had stated.
Recently, WHO Chief Scientist Soumya Swaminathan told The Hindu that the new naming system will have “names like hurricanes” and will be unveiled soon. “This is so as not to stigmatise and deincentivise countries from making their sequencing results public. It will also be easier for the lay public to remember rather than these complicated lineage numbers,” she was quoted as saying.
(Side note: Let's hope the hurricane names themselves are not laced with prejudices. They often used to be named after women in the past, perpetuating gender stereotypes.)
So till the time a new system is in place, what can be the effective way to refer to variants? The preferable way would be to continue with the scientific names, and if need be, mention the names of the countries as those where these variants were first detected or first found widely circulating.
But certainly not call them names like the 'Indian' or the 'South African' variant!