The SARS-CoV-2 Name Game (Long Read)
Politicized disputes over what to name 2019-nCoV raise critical questions about what and how novel the virus really was - and whether something was suddenly spreading at all
More than four years after reports about a cluster of atypical pneumonia cases in Wuhan, China, the origin of “the virus” alleged to be the culprit remains debated and unresolved.
Less mysterious and easier to chronicle is the origin of the virus’s official name: severe acute respiratory syndrome coronavirus 2, a.k.a., SARS-CoV-2. Nothing about the name was accidental. The controversies involved in the naming process have been largely forgotten, overlooked, or dismissed as unimportant or trivial in the grander scheme.1
A closer, retrospective examination of records from early 2020 suggests there were significant politicized disputes between groups of scientists and WHO officials over what to call 2019-nCoV. On the surface, these conflicts were differences of scientific opinion about how new and unique the virus really was, and the “fit” between the virus name and disease name.
Engler and Neil & Engler observed significant differences between iterations of the paper produced by the international group of coronavirus experts that classified and named SARS-CoV-2. The events & analysis I present in this article validates their suspicion that the WHO exerted significant pressure around characterizing the virus as novel and causative of a unique disease.
What under normal circumstances would have been an academic exercise primarily of interest only to researchers turned into a “name game” involving the WHO and virologists from western Europe, the United States, and China, under the auspices of an disease outbreak emergency. Beneath the surface, a disease divorced from an explicit virus name may have been the goal.
[Related timeline.]
Wanted: Name for a ‘Novel’ Virus
In an article for the International Science Council, virologists Stuart Siddell & Andrew Davison describe how viruses are typically named as a somewhat haphazard process, ungoverned by formal rules and “successful” only insofar as the name is accepted, used, scientifically accurate, & stands the test of time.
“…virus names are chosen by the experts who discover and research viruses. They are valid only in so far as they are accepted and used by the relevant community. There are no rules to govern this, but generally, viruses get their names from their hosts, the location in which they were first isolated, the manifestations of the diseases they cause, their phenotypic characters, or combinations of these things.
It is surprising that despite the lack of regulation, virologists seem to work intuitively within an unwritten set of rules, using a limited number of naming patterns that enable the virus, the virus species and the disease to be distinguished from each other. Sometimes it works well – varicella-zoster virus belongs to the species Human alphaherpesvirus 3 and causes chickenpox (although it is not a “pox” virus). On occasion, the system is less successful – Japanese encephalitis virus belongs to the species Japanese encephalitis virus and causes Japanese encephalitis.”
When a virus has a name, it can be more readily studied & discussed. The name validates its identity, status, and existence. If the virus is newly-found and thought to be spreading from person-to-person, creating death or adding risk of death, then giving it an acceptable and accurate name becomes a matter of urgency — especially if the public is supposed to believe the virus presents a serious threat to their own health or life.
Despite being the place an outbreak of a novel pathogen was first reported in December 2019, any formal name for “the” coronavirus with Wuhan or China in it was destined to be short-lived.
Catchy terms like “Wu Flu” and “China Virus” were popular with the public and politicians alike, but were quickly branded as xenophobic, racist, or stigmatizing - especially against an ideological opponent.2 This was somewhat ironic because it was Chinese scientists who initially used “Wuhan seafood market pneumonia virus” and WH-Human-1 coronavirus.3
Best practices in disease-naming published in 2015 by the World Health Organization (WHO) discourage using geographic locations for cultural sensitivity reasons. A WHO Stigma Guide published in February 2020 extended the rationale to terms considered inappropriate for the “new coronavirus disease”.
Before then, around January 10, 2020, the WHO started to use 2019 novel coronavirus (2019 nCoV) as a placeholder. Science journalist Helen Branswell wryly observed the name was “a bit like calling a daughter ‘the girl born in 2019.’” It expressed a year of “birth” or discovery, level of familiarity (novel), and a genus (coronavirus), but little else in the way of unique identifiers or meaningful descriptors.
After the first positive test for 2019-nCoV in the U.S. was announced on January 21, Dutch virologist & gain-of-function fan Ron Fouchier urged coronavirus researcher Ralph Baric to come up with a better, more workable name for the virus.4
Baric was a member and former chair of the International Committee on Viral Taxonomy (ICTV) Coronaviridae Study Group (CSG). He and his lab team at University of North Carolina had brainstormed names like South East Asia Respiratory Syndrome (SEARS) and Chinese Acute Respiratory Syndrome (CARS) — all easy to remember but silly acronyms, besides being outside of WHO parameters.
Fouchier said he told Baric:
“If nobody steps in quick, then I think that the name the lay press is going to give it is probably what’s going to fly…nCoV is not going to fly for long…And if they don’t do it in an authoritative way, then other people will come up with a name.”
The sense of urgency was tied to the idea that a deadly virus was spreading.
Enter the Coronavirus Study Group (CSG): January 23-24, 2020 Email Discussion
The CSG did step in quickly.
Records obtained from the University of North Carolina via freedom of information request5 show a two-day conversation in which most CSG members participated.
List taken from the CSG’s March 2, 2020 paper on the classification & naming of SARS-CoV-2. Asterisks show which members appear in the email conversation records obtained from University of North Carolina.
Chair John Ziebuhr emailed committee members on January 23, 2020, with an invitation to discuss and decide the phylogenetic position, species, and name of the 2019-nCoV virus “as soon possible”. The WHO would be involved after CSG reached agreement, Ziebuhr said, and Alexander (Sasha) Gorbalenya already had a paper in the works.
Ziebuhr was confident the virus was from an existing species, severe acute respiratory syndrome related coronavirus (SARSr-CoV). Though one of his own name suggestions included SARS, he was well aware of the challenges inherent to using the acronym in the virus name. He offered RS-CoV 2019 as an alternative that might help distinguish 2019-nCoV from SARS-CoV.
In larger font, Ziebuhr typed, “The disease caused by the ‘new’ virus may be very different from that caused by SARS-CoV-2.” The size difference may have been a mistake or a consequence of copy/paste, but the quotes around “new” were intentional (and used twice), showing that Ziebuhr, if not all CSG members, understood the virus wasn’t new.
In emails spanning 36 hours across multiple time zones, the participants chiefly talked about nomenclature. There was no disagreement over the virus species: severe acute respiratory syndrome-related coronavirus.6 Many of the scientists acknowledged the potential problems with using SARS, such as inducing fear, creating confusion with SARS-1, irritating China, and getting pushback from pathologists over the receptor difference.
Leo Poon, the only CSG member from east Asia, was sensitive to the public health message “SARS” might send:
“I agree this virus is technically a SL-CoV. But I am for the 2nd option, purely from the public health point of view. We don't want the public have any confusion between SARS and this new respiratory disease. This might create some misunderstands and miscommunications, which might end up with a even greater problem.”
Christian Drosten, an architect of the workflow for an early real-time PCR test (aka, the Corman-Drosten protocol), favored SARS-CoV in the name and was quick to point out that anytime a SARS-CoV emerged, an “emergency” existed.
Dear All,
I favor some name that includes SARS-CoV. Everything else is not purely systematically motivated (note that any emergence of SARS-CoV is a PHEIC by definition and does not need specific decision by the emergency
committee:https://en.wikipedia.org/wiki/Public_health_emergency_of_international_concern. I guess that's why "SARS-CoV" per se is not popular these days. We don't have to call it "SARS- CoV" but I firmly believe we should point at the fact that it is a species member.The species is Severe acute respiratory syndrome-related coronavirus
To the species belongs the SARS-CoV (a strain) as well as several bat-associated viruses usually abbreviated SARSr-CoV followed by some specific designation. A name such as "Human SARSr-CoV 2019" (the "r" borrowed from "related" as in the taxonomic species designation) is honest and at the same time discriminative enough. For my taste John's suggestion of Human SARS-CoV 2019 is even better because it is simple less subject to debate (I can already imagine the gossiping about the "r"). In any case my suggestion is to not drop the "SARS" engram from the strain designation. My concept as a more clinically-rooted virologist is that of a new serotype of SARS-CoV. This idea becomes even more real when considering the likely use of ACE2, suggesting technical serotype discrimination via antibodies interfering with receptor binding. Just like in enteroviruses, influenza, etc.
Christian
Drosten’s stance was consistent with his preparation for and predictions about outbreaks involving MERS and SARS viruses (illustrated well in this 2017 article).7
He wasn’t the only one thinking about potential debates. The whole group was aware of the perils of “name-checking Wuhan,” as Ben Neuman put it. Several members liked WURS (Wuhan Respiratory Syndrome) - the name Stanley Perlman said his children had given “the disease” - because it was distinct from SARS and easy to say. Yet all were able to concede the WHO’s rules…ruled and would preclude Wuhan being a part of the name.
Raoul Groot (the first to suggest SARS-CoV-2) conveyed competing views well when he said,
“Better not have Wuhan in the name. Although I do not see any problem with geographic names as they add relevant context on origin and history, and poetry (O'Nyong Nyong, Semliki Forest, West Nile, Ross River...), the WHO would not approve.” 8
Practical considerations were weighed too, like the length of the name, number of syllables, and ease of pronunciation. Neuman’s comments are illustrative:
I think there is a balance to strike here between full information and usability.
My suggestion would be to try to say these names out loud.
Something like hSARS-CoV-2019 has twelve or thirteen syllables minimum, and it doesn't shorten gracefully to anything that would be distinct from SARS 2002.
In other words, you can name your kid Benjamin, but to everybody except his headstone, he is always just going to be Ben.
John Ziebuhr agreed:
If we go for SARS-CoV-2, this is short (4 syllables) and distinctive enough and will probably be used. [Ben] I am very pleased to see your suggestion in the second paragraph (which is essentially what I wanted to say...)
The hesitation toward using “SARS” was ultimately trumped by fidelity to the virus species and relationship between the genomic sequences of 2019-NoV 2019 and SARS-CoV. In one email, Ralph Baric called them “kissing cousins.”9
Early in the discussion, Susan Baker raised the question of how to sensibly distinguish virus isolates, strains, and introductions:
“SARSr-CoV 2019 may be appropriate, with additional details provided in the Genbank listing (location the virus was isolated from, full date of isolation, etc). The detailed extension of the name would be helpful for scientists, but not widely used for communicating with the public.
Whatever we decide to use as a starting point for the virus, we may also want to provide suggestions for the designation of the strains/isolates. How do groups decide on specific names for isolates (ie SARS-CoV-Urbani, SARS- CoV--Tort, etc)?”
Further into the conversation, Isabel Sola weighed what would be best in the long term versus the short term:
“I accept that when naming a virus, the long-term perspective should prevail over the short-term considerations. However, do you think that the number 2 in SARS-CoV-2 might be replaced by a more significant extension? SARS-CoV-WU19 or SARS-CoV-Wuhan?”
Raoul Groot observed that in the long term using 19 as an extension would raise the question what 1-18 might be. “In case of recurring introductions,” he added, “it would be a counting system anyway.”
By the evening of January 24, Ziebuhr announced the group had reached agreement on SARS-CoV-2 and a naming scheme for specific isolates (SARS-CoV 2/Human/2019/Wuhan_XYZ12345). Next, he said, the group would work on the paper Alexander Gorbalenya had started that “firmly establishes the phylogeny of SARS-CoV-2 and puts this virus in context to previously described viruses in that particular species and lineage.”
Reading the CSG’s conversation four years later, it’s striking how unimpressed and unconcerned the group of experts were about the coronavirus they were discussing. Neither “pandemic” nor “pandemic potential” surface in the threads. Clinical manifestations of disease aren’t a focus or concern of many research-driven virologists, and (like everyone else at the time) this assembly of academics wasn’t given a sense of what the disease allegedly caused by 2019-nCoV involved. They simply accepted that a freshly-uploaded coronavirus sequence was causing an outbreak of a new disease and that the disease might be substantially different from that caused by SARS-CoV, or from typical pneumonia.
WHO’s Afraid of SARS-CoVs?
While the CSG wasn’t bracing itself for a deadly pandemic resulting from a viral agent, they did seem concerned about political firestorms their decision could ignite with the WHO.
The question of CSG’s authority in deciding the virus name was raised, with Ralph Baric capturing the sentiments of those who expressed a opinion on the subject
“The CSG should be in charge, in consultation with other bodies, e.g. WHO re: virus-naming.”
John Ziebuhr anticipated the WHO would “not be keen on” a name that used SARS. He reached to his contacts there about the CSG’s decision but didn’t receive a reply, which he attributed to the agency dealing with “the current emergency state in China.”
It wasn’t the first time CSG had reached out to WHO officials. Bart Neuman had contacted Maria Van Kerkhove on January 23 with a status update:
“I talked to Maria van Kerkhove at WHO and she will act as contact person. They are apparently convening a group to work on this. So probably best if John communicates the outcome of our discussion to WHO on behalf of the Coronaviridae Study Group.”
Interestingly, in a January 30 situation report (SitRep), the WHO made a more formal recommendation about the interim names 2019-nCoV acute respiratory disease for “the disease causing the current outbreak” and 2019-nCoV and “the virus”.
Whether this was a WHO work group which was “not keen on” SARS-CoV-2 being passive-aggressive with CSG is impossible to say without knowing more about conversations that may have taken place between January 24 -29. Although the Jan 30 SitRep said a final decision on the official name of the virus would be made by ICTV - not the CSG - the WHO was at least acknowledging 2019-nCOV was temporary and an official name was forthcoming.
Any conversation(s) that did take place with WHO didn’t change the CSG’s name choice. On February 5th, lead author Alexander Gorbalenya submitted the group’s manuscript “Severe acute respiratory syndrome-related coronavirus: The species and its viruses – a statement of the Coronavirus Study Group“ to Nature Microbiology and uploaded the pre-print to bioRxiv on February 7th. It used SARS-CoV-2 as the virus name and referred to 2019-nCoV as tentative.
The pre-print wasn’t made public until February 11, the same day the WHO announced COVID-19 (coronavirus disease 2019) as the name of a disease caused by 2019-nCoV.10 During the press conference, WHO officials said coronavirus and corona, but not SARS-CoV-2. When a reporter asked about the virus name, Soumya Swaminathan said “The virus itself is named by the international group of virologists who will look into the taxonomy,” without mentioning ICTV or the CSG.11 For its part, ICTV updated a news page on February 11 or 12 to say that the CSG manuscript was available and had named the virus SARS-CoV-2.
Why the WHO didn’t make public mention of the CSG’s choice of name isn’t clear, but the largest health organization in the world was giving the impression it was “afraid” to use a name with SARS-CoV.
With apologies to Taylor Swift, it seems the WHO was “afraid” of SARS-CoVs - at least in name.
Enter China
Thanks to emails previously released by USRTK, it’s no secret that Shi Zhengli and other Chinese virologists were unhappy with the name SARS-CoV-2 as a replacement for 2019-nCoV.
Zhengli emailed Ralph Baric on February 13, 2020,
“We heard that the 2019-nCoV was renamed as SARS-CoV-2. We had a fierce discussion among Chinese virologists. We have some comments on this name, I'm wondering if the CoV study group would consider a revision. I attached the comments from me and my Chinese colleague.”
The comments - titled “A unique and unified name is needed for the novel coronavirus identified from Wuhan” - are signed by Zhengli, Shibo Jiang, Wenjie Tan, Yuelong Shu, & Deyin Guo.
Zhengli & colleagues affirmed the species classification but argued that “the new virus” needed a “unique and unified name” more specific than those that had been proposed and reflected its still-evolving properties.12 They felt strongly that the name shouldn’t use “Wuhan” or “SARS.” The former so as not to “stigmatize & insult” the people of Wuhan who were “still suffering from the outbreak” and the latter to avoid confusion with SARS and prevent misperceptions about 2019-nCoV having similar lethality and epidemic curve as SARS-1. They said as well that the new virus had a lower case fatality rate than SARS-1 but higher transmissibility and proposed HARS-CoV (Human acute respiratory coronavirus) or TARS-CoV (Transmissible acute respiratory coronavirus) as alternatives to SARS-CoV-2.
John Ziebuhr was hearing from Chinese virologists too.
On the same day Shi Zhengli wrote to Ralph Baric (February 13), Ziebuhr emailed the CSG saying he was “swamped with emails from Chinese colleagues, including many eminent scientists in the field.”
Ziebuhr felt the Chinese and WHO were ignoring the “scientific essence” of the CSG’s paper and that discussions were on the verge of being hijacked by politics. His summary of a meeting with WHO the previous day suggests that, like China, the agency did not want “SARS” in the virus name and was not truly hearing or understanding CSG’s “central point”:
In yesterday's discussions with WHO, CSG members including myself did their best to get across our central point that the name SARS-CoV-2 makes reference to a variety of (not just one) virus(es) isolated mainly from bats which all have been classified as belonging to an established virus species called Severe acute respiratory syndrome-related coronavirus. The virus name that the CSG decided upon makes reference to (the names of) genetically related viruses in that species (which all carry "SARS" in their names) rather than the disease (SARS) that few of these many viruses in that species caused in (some) humans in 2003. All this is laid out very clearly in our paper available at bioRxiv. And there is little to add...
Ziebuhr conceded that primarily using the disease name (COVID-19) would be helpful in communicating with Chinese health authorities.
WHO did not question in any way that ICTV is in charge of classifying and naming viruses including the current one. There was no argument about that! - Possibly, they may resort to using (only) the name of the disease (COVID-19) whenever they can. If this helps in communications with Chinese health authorities, I do not mind and would even support this.
Raoul Groot, Ben Neuman, and Christian Drosten all responded to Ziebuhr, each affirming CSG’s decision to stick with SARS-CoV-2.
Drosten was in a WHO meeting (as was Bart Haagamans) and said Ziebuhr was “100% correct” in his “rendering of the situation”:
Dear John,
Bart and me joined a discussion in WHO while in the meeting yesterday. Your rendering of the situation is 100% correct. WHO entirely prioritizes on risk communication and inter-country sensitivities. Bart [Haagmans] and I made the point that an acronym like COVID will inevitably be confused with a virus name because acronyms (HBV, CMV) are commonly associated with virus names. This whole discussion was to no avail. They will stick to COVID19 now that it is out, and will try to speak of "the virus that causes COVID19". We will have to live with this situation.
Christian
Like Ziebuhr, Drosten accepted the WHO’s decision to say things like “the virus that causes COVID-19” for political reasons. It’s worth noting that Drosten was in a professionally beneficial situation at this point. He and Bart Haagmans were co-authors on a testing protocol that had been endorsed by the WHO and accepted by Eurosurvelliance. Him saying “We will have to live with this situation” isn’t as much discontentment or surrender as it is indifference. Given how “generous” the protocol was in getting positive results, it could be argued that less specificity and more generality in the virus & disease names served their interests well.13
In any case, Drosten may have been ready to “live with” the situation, but the Chinese virologists weren’t.
CSG v CCP
The debate continued via email on February 14 and 15, with John Ziebuhr representing CSG and Deyin Guo the Chinese virologists who opposed the virus and disease names.
As much as each side wanted to believe its position was strictly a matter of science, the issues raised by the Chinese in particular are hard to explain away as academic minutiae.
Ziebuhr to Deyin Guo, Shibo Jiang, and Shi Zhengli (CSG members copied) | February 14, 2020
Ziebuhr thanked the Chinese scientists for their “very thoughtful and balanced statement” and made three counter-points:
SARS in the virus name is not a reference to or derived from SARS the diseases, but from the coronavirus species severe acute respiratory syndrome-related coronavirus - SARS(r).
The WHO, not CSG is responsible for naming coronavirus diseases or other features/manifestations of those diseases. Transmissible acute respiratory syndrome (TARS) could be a good alternative to COVID-19 as a disease name, but that should be taken up with the WHO.
CSG’s decision about the name SARS-CoV-2 was purely scientific.
Guo to Ziebuhr (CSG members copied) | February 15, 2020
Guo affirmed the species classification but insisted
Any virus name with SARS in it would be “misleading.”
The virus deserved its own distinct name since 2019-nCoV & SARS-CoV differed significantly in viral genome, transmissibility, pathogenicity, & pathogenesis.
TARS-CoV should replace SARS-CoV-2 because it is a unique name that would help distinguish the virus’s properties.
Guo called the mismatch between the CSG’s virus name and WHO’s disease name “very confusing” and he’s not wrong. On February 8, 2020, the China National Health Commission (CNHC) named the disease associated with 2019-nCoV "Novel Coronavirus Pneumonia" (NCP). So the Chinese name explicitly tied the virus to a type of infection.14 The WHO name - Coronavirus Disease 2019 - did not.15
The Chinese were also upset that the CSG failed to consult virologists from mainland China. Guo wrote,
“To the best of our knowledge, none of the virologists from mainland of China attended the CSG's discussion on 2019-nCoV, and CSG had not consulted with virologists including the first discovers of the virus and first describers of the disease from mainland of China before making the decision. It is our wish that the CSG can take our opinion into the consideration.”
This might be the strongest point in the debate made by either side. It’s clear from Siddell & Davison’s article that researchers who discover a virus would normally be involved in naming it.
A few weeks earlier, STAT reported Ralph Baric said something similar:
Traditionally naming rights actually belong to the scientists who first isolate a virus, who will at some point propose a name to a study group of the International Committee on Taxonomy of Viruses, said Ralph Baric, a coronavirus expert who sits on that panel. That group’s next scheduled meeting is in May. It’s possible the WHO could work in conjunction with the committee to name the new virus.
In view of this tradition, Guo’s proposition of a “trilateral negotiation on the naming issues” involving CSG, WHO, and “the Chinese side” seems entirely reasonable. Why the Chinese were not invited to collaborate in the naming process isn’t clear from any records I reviewed. (Certainly travel was not a barrier as email and video conferencing circumvent any distance barriers.)
Ziebuhr to Guo (CSG members copied) | February 15, 2020
In his final response, Ziebuhr replied to only Guo and copied the CSG members. His email captures the essential rationale for the SARS-CoV-2 name.
Dear Dr. Deyin Guo, dear colleagues,
I am sorry to learn that I was not able to get my point across, which is that the name SARS-CoV-2 links this virus to other viruses (called SARS-CoVs or SARSr-CoVs) in this species including the prototype virus of the species rather than to the disease that once inspired the naming of this prototype virus nearly 20 years ago. The suffix-2 is used as a unique identifier and indicates that SARS-CoV-2 is yet ANOTHER (but closely related) virus in this species. I'd like to thank you for your comments because they indicate that we may need to explain our line of reasoning even more clearly when it comes to publishing a more advanced version of our manuscript.
As you again link virus classification and naming to specific diseases (as was unfortunately done quite frequently in the pre-genomic era) rather than to sequence relationships of the respective virus with previously identified viruses, I would like to ask you whether your reasoning implies that researchers describing all the other viruses in that species were wrong when they named the viruses they discovered?
To my knowledge, the vast majority of these viruses has not been shown to cause a human disease called SARS and yet, they were called SARS coronaviruses or SARS-related coronaviruses in virtually all cases. I think it is accepted in the field that these viruses are genetically closely related but also differ in specific phenotypic aspects from one another, which is reflected (at the level of naming) by attaching pre- and suffixes to the (SARS-containing) virus name. When introducing the name SARS-CoV-2, the CSG followed the tradition established mainly by Chinese researchers to name viruses in this particular species.
With kind regards,
John Ziebuhr
In countering Guo’s arguments by appealing to longstanding practices in the field of virology - some established by Chinese researchers - Ziebuhr seems to be saying, “We are being consistent and following nomenclature protocol. We reject your idea that a departure from the protocol is warranted because SARS is the name of a disease that affected China.”
Ziebuhr and Guo were evidently unsuccessful in their efforts to persuade one another, because a few days later, on February 18, the Chinese team publicized their dissatisfaction with the virus name in a letter to The Lancet: A distinct name is needed for the new coronavirus. They insisted SARS-CoV-2 was “different from all other SARS-like or SARS- related coronaviruses, which are characterised mainly by their genome sequence.”16 The excerpt below captures the essence of their position:
“On the basis of special clinical, virological, and epidemiological characteristics and the uncertainty of the novel coronavirus, to avoid the misleadingness and confusion, and to help scientists and the public with better communication, we, a group of virologists in China, suggest renaming SARS-CoV-2 as human coronavirus 2019 (HCoV-19). Such a name distinguishes the virus from SARS-CoV and keeps it consistent with the WHO name of the disease it causes, COVID-19.”
What motivated the change in recommended name from TARS-CoV (in Guo’s email) to HCoV-19 is hard to say but it could’ve been a reaction to something Ziebuhr said. Also possible: TARS didn’t sound distinct enough from SARS or “transmissible” created an unwitting contrast with implicit claims about the transmissibility of viruses in general (e.g., this virus is transmissible but others aren’t).
The letter was published online February 19, the same day Nature Microbiology accepted the CSG’s manuscript for publication, leaving the conflict unresolved and public.
The Lancet Letter
February 19 was also the day a short and controversial statement later called “The Lancet Letter” was released.17
Detailing myriad problems with the content, tone, and timing of this statement (and all endorsers thereof) is beyond the scope of the analysis at hand, but a few features are relevant to the virus-naming games:
The virus is identified with the name given by the CSG: SARS-CoV-2.
The virus is affirmed as novel ('“novel coronavirus” “new viral threat”).
Five of the original signatories on The Lancet Letter (Drosten, Gorbalenya, Haagmans, Poon, and Perlman) were also on the CSG.
Unlike the CSG’s email discussion in January, or Ziebuhr’s emails to Guo, the letter emphasizes the severity and urgency of a COVID-19 disease “outbreak” in China.
Also in contrast to the CSG email discussions, the letter asserts a definitive causal link between SARS-CoV-2 and COVID-19 and makes statements about origin that were (and still are) unproven.
The letter is a political statement, not a scientific one, and explicitly stresses uniformity of viewpoint (“we sign…in solidarity…” “we speak in one voice”) and action (“protect global health” “global collaboration in the fight against this virus”).18
Because a Chinese translation was also published, it’s safe to assume a primary audience for the statement was Chinese authorities & scientists, including the virologists who directly challenged CSG. Whether an olive branch, self-serving chess move (a.k.a., sham sacrifice), or something else entirely, the timing of the Lancet Letter within the sequence of events involving the virus name is conspicuous.
“Do Not Use SARS-CoV-2”
Meanwhile, parallel to the conflict between Chinese virologists and CSG, the WHO and China were conducting a Joint Mission on the COVID-19 outbreak. Led by WHO senior advisor Bruce Aylward and Wannian Liang of the Chinese Health Commission, it involved experts from China, Germany, Japan, Korea, Nigeria, Russia, Singapore, and the U.S. in a nine-day investigation that culminated in a report published on February 28, 2020. Writers of the report would have to decide what to call the virus.
By this point, Nature had accepted the CSG’s final manuscript, The Lancet Letter was public, Chinese virologists opposed to SARS-CoV-2 had not changed their minds, and the WHO had published a webpage explaining why the agency wasn’t saying SARS-CoV-2 (excerpt below):
What name does WHO use for the virus?
From a risk communications perspective, using the name SARS can have unintended consequences in terms of creating unnecessary fear for some populations, especially in Asia which was worst affected by the SARS outbreak in 2003.
For that reason and others, WHO has begun referring to the virus as “the virus responsible for COVID-19” or “the COVID-19 virus” when communicating with the public. Neither of these designations are intended as replacements for the official name of the virus as agreed by the ICTV.
The WHO’s choice to make only generic reference to “the virus,” versus a name it had been given, was political in nature and deferent to China’s position, but the excuse about “creating unnecessary fear” is inconsistent with other official statements the agency had made.
If WHO really was concerned about not stoking fear, then why did Director General Tedros Ghebreyesus say on February 11, 2020 that the virus was “the number one enemy of the whole world, and the whole of humanity”?
Similarly, the WHO didn’t want to scare Asian populations that had experienced the 2003 SARS event by using SARS in the virus name, yet was fine with Ghebreyesus saying viruses can be “more powerful in creating political, economic and social upheaval than any terrorist attack”? Not only do such statements have the power to unnerve all living people, they discredit WHO’s stated reasons for rejecting “SARS” in its communications.
Within two weeks of Ghebreyesus’s hyperbolic claims, Bruce Aylward and Maria Van Kerkhove were working on the Joint Mission report with two other collaborators. Emails obtained by USRTK show the two discussing the naming issue on February 23, 2020.
Van Kerkhove tells the group she’s made edits to the report that include removing “nCoV” in order to “be consistent with our nomenclature.”
Aylward replies,
“Yes but definitely do not use SARS-Co-2. I am not signing anything with that in it. I prefer we use nCoV – intentional. I’m not going to be a part of that mess.”
While not explicitly mentioning Chinese opposition to the CSG name choice, both he and Van Kerkhove were likely aware of the conflict.
Van Kerkhove says she’ll use “the COVID-19 virus” throughout the report, since it’s the phrase WHO had already endorsed. In another allusion to Chinese resistance to the virus name, she adds, “China agrees with this as well.”
A few hours later, a nervous Aylward emails Van Kerkhove again.
On 23 Feb 2020, at 10:46, AYLWARD, Raymond Bruce .J <aylwardb@who.int> wrote:
Maria - I thought about nomenclature a bit more. given all the translation problems and deep history of this country with SARS, I want us to be really really clear. I'd like that we either use "the novel Coronavirus" everywhere or 'the COVID virus' or - preferably - add a disclaimer footnote the 1st time we use nCoV that explains that ‘while the Joint Mission understands that this nomenclature has been superseded by SARS-COV2, however the term nCoV is used here to ensure absolute clarity given this country's unique history with both diseases and viruses.'
B.
Van Kerkhove may have known what Aylward meant by China’s “deep” history with SARS and “unique” history with diseases and viruses, but he doesn’t elaborate. In response, she agrees with Aylward that the report should not use SARS-CoV-2.
From: Dr VAN KERKHOVE, Maria Sent: Sun, 23 Feb 2020 02:55:08 +0000 To: AYLWARD, Raymond Bruce Cc: Dale Fisher; Zhou, Weigong (CDC/DDID/NCIRD/ID) Subject: Re: REVISED ASSESSMENT ETC.
Hi Bruce,
We are in complete agreement. We will NOT be using SARS-CoV-2 in this report and will use Novel Coronavirus (COVID-19) throughout. I want us to be consistent with using COVID-19 throughout the mission report as this is consistent with all of WHO reporting – in WHO press, information products, technical guidance, letters to Ma, etc.
We really should not introduce another term “nCoV” because there will be another Novel coronavirus (“nCov”) in the future. You can have a look when I send you the next version. I am editing quite heavily.
Two points are worth making out of deference to common sense and the nature of report-writing:
There is nothing unusual or suspicious about Van Kerkove wanting consistent terminology that reflects what WHO was already saying via other media, on its website, etc. That’s standard for & in any organization.
Minimizing the number and nature of terms for the virus is reasonable, efficient, and respectful of readers. Van Kerkove doesn’t say this, but COVID-19, SARS-CoV-2, and 2019-nCoV each contain hyphens and a mix of numerals & upper/lower-case letters. Trying to use all three terms could create confusion and complicate readability. Someone in her position and level of bureaucracy knows these things from experience, if not intuitively.
That said, it’s clear from the interaction between Van Kerkove and Aylward that the ostensible reason for not using “SARS-CoV-2” in the report is keeping China happy i.e., being culturally/politically sensitive. “Letters to Ma” likely refers to Chinese businessman Jack Ma, whose foundation (and former company Alibaba) initiated the ‘Handbook of Covid-19 Prevention and Treatment, a document circulated by the WHO and published on ResearchGate in March 2020. Why the WHO was writing him letters - and what those letters were about - is a mystery.
The Joint Mission’s final report used “the novel coronavirus disease (COVID-19)” and “the COVID-19 virus” and makes no mention of the name SARS-CoV-2, ICTV, or the Coronavirus Study Group (CSG). A footnote on page 3 reads,
“In the Chinese version of this report, COVID-19 is referred to throughout as novel coronavirus pneumonia or NCP, the term by which COVID-19 is most widely known in the People’s Republic of China.”
Shockingly, it appears the WHO dealt with the mismatch between their name and China’s name for the illness thought to be caused by SARS-CoV-2 by affirming to the CCP that it was just another kind of pneumonia while simultaneously presenting it as a more expansive “coronavirus disease” to the rest of the world — all without naming the causal agent explicitly.19
Such a move couldn’t have been a mistake. That it occurred less than two weeks before the WHO declared a pandemic makes it seem strategic, even if it wasn’t.
CSG’s Final Word
On March 2, 2020, the paper Alexander Gorbalenya had started in January in the service of a virus classification & naming task presented as urgent was finally published in Nature Microbiology as a Consensus Statement. From an academic standpoint, this officially gave 2019-nCoV a new name.
Unfortunately “the science” of CSG’s March 2 statement was not the science of its February 5 preprint.
Jonathan Engler (individually and with Martin Neil) compared the initial and eventual versions of the manuscript and found portions that were in the pre-print were absent in the published version that give the impression CSG had few to no doubt about the virus’s novelty.
Astute readers of both versions are apparently supposed to think virology had changed in a few short weeks—or that the differences are insignificant and there is no scientific conflict whatsoever between the two iterations.
My analysis of events involved in the (re)naming of 2019-nCov chronology emails, reports, position statements, events, etc., support what Neil & Engler inferred was the case when they said,
“Together the assignment of the word ‘novel’ and the use of the name looks like the result of contentious political process or social construct, presented as a scientific one where all uncertainty, doubt and dispute have been stripped out.”
As far as I can tell, the decision to characterize the virus as novel and call it SARS-CoV-2 was the result of a “contentious political process” and did develop (quickly) through “social construct” rather than via open, rigorous scientific debate involving all relevant parties, including the virologists who “discovered” the virus.
The final paper does strip out the uncertainty & doubt conveyed in the pre-print — which is unfortunate if for no other reason because makes the science of virology seem less messy and tentative than it actually is.20
Insofar as the emails are concerned, the most straightforward indications that CSG didn’t think 2019-nCoV was novel are John Ziebuhr saying “new” twice in his first email, and the group members’ general attitude toward the virus being discussed. The Chinese virologists did think it unique enough to give a non-SARS name, yet couldn’t really deny the species and never characterized it as “new,” but as distinct with aspects that were still evolving and unknown. The WHO apparently thought it was novel (see pre-print, Figure 4, panel A) but the exact basis of that belief isn’t clear in the paper or from public records.
Only the authors of the Consensus Statement know what feedback the reviewers sent and the real reasons certain changes were made.21 Circumstantial evidence strongly suggests there was heavy political pressure to support what the WHO, if not also the oppositional Chinese virologists, wanted to be able to say.
In the context of a purported global health emergency, it seems rather unethical to pretend something is novel and remarkable and deadly when no such evidence of those traits exists — and the thing hasn’t been established as the causal agent. The CSG virologists would probably say the disease aspect wasn’t within their remit - and never is. The final paper says as much (in Box 1): “Virus naming is not necessarily connected to disease but rather informed by other characteristics.”22
Who then was responsible for proving that an agent like 2019-nCoV was actually spreading or transmitting between people and actually causing a disease and/or a remarkable disease that adds health risks to one or more groups of people? Anyone?
Shortly after the CSG’s Nature paper was released, on March 6, 2020, a group of scientists from U.S. & Chinese institutions published SARS-CoV-2 is an appropriate name for the new coronavirus. It was both a response to Guo, Zhengli, et al, and a statement of support for CSG.
They wrote,
“We believe that the naming of SARS-CoV-2 by the Coronavirus Study Group [CSG] is aligned with the goals of the International Committee on Taxonomy of Viruses [ICTV] to facilitate good practice and scientific exchange. Given that SARS-CoV-2 is already being used in the scientific literature, a name change at this stage would cause confusion in the scientific community. With all the uncertainties about this newly emerged pathogenic virus, we suggest keeping SARS-CoV-2 as its name.”
Given the timing and circumstances, it’s no surprise an ad hoc group materialized to say, “We believe in the name/naming process used and want to keep SARS-CoV-2!” Even if their letter contains sound virological science, its sudden appearance was a political science move.
Unsurprisingly, when the WHO issued a COVID-19 pandemic declaration five days later, on March 11, 2020, none of the agency’s spokespeople, social media posts, or press releases used SARS-CoV-2.
Endgame: Virus-That-Shall-Not-Be-Named?
In non-chess terms, “endgame” means the ultimate goal or purpose for doing something; a desired outcome.
After looking closely at the events surrounding and following the naming of 2019-nCoV, I’m left with the impression that the endgame for the WHO may have been a Virus-That-Shall-Not-Be-Named, at least temporarily. In the first two months of 2020, the WHO appears to have been focused on a disease of dubious [in]distinction and was actively avoiding having to associate that disease with a viral agent that included SARS in the name, using the pretext of cultural sensitivity.
When the agency assigned COVID-19 a code in its International Classification of Diseases taxonomy in late March 2020, it used emergency codes (U07.1, U07.2), from the Codes for Special Purposes chapter, versus creating codes in the Respiratory Diseases chapter. Much could be said about that decision and placement, but with respect to virus-naming, what’s most notable is a disease name followed by “virus identified”/”virus not identified”.
Neither the ICD-10 catalogue (image above) nor the coding guidelines issued on April 16, 2020 and April 20, 2020 give a sense of what “laboratory testing” is testing for, and the test result does not need to be supported by clinical signs/symptoms in order for a case, hospitalization, or death to be coded U07.1, virus identified.
The lack of specificity affords an indefensible amount of latitude and plausible deniability for the WHO’s assertion that a new cause of death had come onto the scene — and did so at the time positive tests for other viruses like flu were vanishing (and/or being vanished).
It’s also striking to revisit what officials and media were calling SARS-CoV-2 in spring 2020, after it had been named by CSG. Over and over, it’s “the coronavirus” and “the coronavirus pandemic.” (A few U.S. examples below; the same was true all over the world.) As late as November 2020, Senator Ron Johnson was saying “the Coronavirus pandemic” and “the coronavirus” in a formal statement.
There’s no question SARS-CoV-2 is a pain to typeset and clunky to read/write, yet it’s hard to ignore the sound and appearance of a concerted and coordinated script regarding what to call the thing alleged to be killing tens of thousands of people as the flu/flu shot season was winding down in the northern hemisphere.23
The non-specificity is also a potential “out”. One can easily imagine a former public health official, prime minister, or legislator testifying, “I never said ‘SARS-CoV-2’ was doing anything. I said coronavirus.”
If you don’t name it, then no one can claim that it - or that anything having to do with it - was your fault. Was that the intent of the SARS-CoV-2 Name Game?
WHO knows.
Timeline: The Naming of SARS-CoV-2
Key events related to names for the coronavirus the World Health Organization (WHO) initially called 2019-nCoV. Timeline supports and extends content in “The SARS-CoV-2 Name Game” article. Some documents and details related to the naming/coding of COVID-19 also included. Subject to ongoing revision.
My thanks to for links to documents I had missed and details about individuals that enhanced my understanding, and to and for answering questions about their reading of the CSG’s manuscripts.
There were no reviewers of this article. All errors of interpretation or in matters of fact (scientific or otherwise) are my own and I am happy corrections or amend the content as/if warranted. I welcome feedback from readers with scientific knowledge and expertise related to biology/virology who will read the CSG discussion with a different set of lenses than I did.
Alt., the grander global scam
“Is it racist to call coronavirus ‘the Wuhan Virus’? GOP congressman’s self-quarantine tweet sparks a debate” https://www.washingtonpost.com/nation/2020/03/09/coronavirus-wuhan-virus-gosar/
a.k.a, Wuhan-Hu-1, Wuhan Human-1, WH Human-1, or WHCV. Arguably, “Wuhan Seafood Market pneumonia” biases people against seafood and seafood markets more than it does a racial/ethnic group or region. Corona beer sales weren’t affected by “corona virus,” however, so seafood sales would likely withstand the hate.
“It’s been sequenced. It’s spread across borders. Now the new pneumonia-causing virus needs a name” https://www.statnews.com/2020/01/23/its-been-sequenced-its-spread-across-borders-now-the-new-pneumonia-causing-virus-needs-a-name/
Motivated by a conversation with
, I submitted a records request to UNC on April 29, 2020 for “All emails and attachments sent to and from Ralph Baric between Jan 20, 2020 and Feb 29, 2020, with the subject line “virus name.” UNC supplied responsive records on June 3, 2024. I don’t know if all of the emails I received have been released previously by another entity or individual. Those that have been I linked to the source which published first. As would be expected in any decision-making process involving competing interest and views, there were doubtless interactions between smaller groups and individuals that aren’t captured by the emails obtained from UNC.Per the WHO best practices in disease-naming: “Severe” is appropriate to use for diseases with a very high initial case fatality rate (CFR), recognising that the CFR may decrease as an event progresses. “Novel” can be used to indicate a new pathogen of a previously known type, recognising that this term will become obsolete if other new pathogens of that type are identified.
Readers with more knowledge than I have can better assess the technical aspects of what Drosten is saying toward the end of his email.
To the question of whether there is an association between geographically-based disease names and negative views of a racial/ethnic group, a creative study conducted in 2020 found no evidence that the names "Wuhan Virus” and “China Virus” had a negative impact on individual’s attitudes toward Chinese individuals or perceptions of the virus.
The group’s Consensus Statement published on March 2, 2020 says “sisters” and emphasizes that SARS-1 and SARS-2 are not descendants. I interpret this to mean that one did not come from the other like a grandson descending from a grandfather but am unsure what the implications are time-wise, as sisters don’t have to be close in age.
The delay between the Feb. 7 upload and public release on Feb 11 was due to internal checks that the bioRxiv team conducted at the time. (Personal communication. Email from A. Gorbalenya to J. Hockett on July 5, 2024.)
The agency’s website gives February 11th as the day the virus was named. I take issue with the language used and wrote an email to the WHO requesting a change.
Zvengli et al’s mention of “all proposed names” suggests that they were made aware of other names CSG had discussed, versus only SARS-CoV-2.
I hear Drosten saying, “The WHO’s gonna do what the WHO’s gonna do. Confusion between COVID and the virus name is bound to occur no matter what. The ship has sailed. All the same to me. Let’s move on.”
Chinese communications explicitly link the virus to pneumonia, e.g., “the novel coronavirus pneumonia epidemic” (footnote added 7/23/24)
The WHO disease name isn’t exclusive to pneumonia. Worse, the laundry list of symptoms - including having no symptoms at all - that the WHO and health agencies in various countries used to describe and defend the etiology of the disease went far beyond pneumonia and isn’t mutually exclusive from other respiratory illnesses. (Related views here and here.)
Why does it matter if genomic sequences are distinct/different - and what are the implications for disease/illness, if any?
Which could help explain why John Ziebuhr and other CGS members didn’t co-sign.
Plus, there was and is no evidence that the “spread” of the virus was impacting all-cause mortality in Wuhan or anyplace else in the world.
The same would be true for any paper in a scientific field that is less than forthcoming about what is known/unknown and disputed/undisputed.
Reviewers listed are Ron Fouchier, Stuart Siddell, and Jens Kuhn. I requested the feedback from one of the authors on the Nature paper and was told it isn’t available for me to see.
I can’t tell: Is a process of classifying & naming coronaviruses divorced from robust knowledge of/clinical experience with illness or disease thought to be caused by that virus a “good thing” or a “bad thing”? Should we think of it as akin to a new book being assigned a Library of Congress catalogue number without the Assigners having read the book - only inspected its properties and read a summary? Or is it more like a viticulturist having/being responsible for different kinds of knowledge about/experiences with grapes & wine than are winemakers or sommeliers?
Which is to say that those most vulnerable to death via respiratory infection would’ve been dead by mid-March 2020, leaving me to wonder yet again how SARS-CoV-2 could drop like a bomb on New York City and be blamed for the deaths of 21,000 people.
"After the first positive test for 2019-nCoV in the U.S. was announced on January 21, Dutch virologist & gain-of-function fan Ron Fouchier urged coronavirus researcher Ralph Baric to come up with a better, more workable name for the virus."
Contrary to popular mythology about Gain of Function as a tool to create potentially uniquely nefarious virus strains it is in fact the process used for ALL virology that cannot culture and grow RNA virus from humans or millions of bat's ass. RNA has high replication errors & low fidelity so they CRISPR cobble together PCR consensus sequences that are grown as DNA in E.coli then that is purified to an RNA synthetic virus in a purity and concentration that could never exist in nature & drop that in cell culture or passage through animals to find the NEXT FLU Shot.
Most fun way to tackle this is by search terms and for relevance here try "SARS-CoV" "vaccines" "pre-pandemic" "decision making" "stockpile" and my favorite "however" where summary admits petrie dish pure clones may not reflect "wild type virus" and human immune systems.
Gain of Function is the methodology for all virology & vaccinology they have no real world basis.
https://web.archive.org/web/20161206155142/http://www.gryphonscientific.com/wp-content/uploads/2016/04/Risk-and-Benefit-Analysis-of-Gain-of-Function-Research-Final-Report.pdf
Risk and Benefit Analysis of Gain of Function Research
This work was conducted under NIH Contract# HHSN263201500002C with Gryphon Scientific from March 20, 2015 to December 15, 2015. Revisions were made until April 2016
https://web.archive.org/web/20161206155142/http://www.gryphonscientific.com/wp-content/uploads/2016/04/Risk-and-Benefit-Analysis-of-Gain-of-Function-Research-Final-Report.pdf
Good deep dive on this topic. Very interesting. As a virologist I was not happy with them choosing "SARS-CoV-2" as the name of the virus in early 2020. I said then that it was a poor choice as it would just scare people unnecessarily because the illness was not as deadly as they were making it out to be. I recall when the hantavirus first emerged in the Southwest US in the early 90's they called it "Sangre De Cristo" virus after the mountain range where the illness was first discovered. The local population was very upset about this and the name was soon changed to "Sin Nombre" virus meaning "without a name."