When President Trump referred to the “Chinese virus,” the media were quick to point out problems with this terminology, lambasting it as xenophobic and racist. But as new variants appear, some media outlets are doing the same thing: talk of the “British,” “Brazilian,” and “South African” Covid-19 variants abounds. Even scientific journals are using this terminology.
But labeling viral variants by their geographic origin is incorrect. Just as the “China virus” should be called SARS-CoV-2 or the novel coronavirus, so too should new variants be described by their proper nomenclature: B.1.1.7, not “U.K. variant” and P.1, not the “Brazilian variant.”
As we face an influx of novel virus variants, it’s worth revisiting the problems with geographic-based virus nomenclature.
The impulse to label viruses and other pathogens according to their alleged geographic origins is not new. Think of the Spanish flu, German measles, Middle Eastern respiratory syndrome, Brazilian purpuric fever, and others. Ebola was named after the river in the Democratic Republic of the Congo near where the virus was first identified; the Zika virus was first identified in the Zika Forest in Uganda.
The tendency to name pathogens and diseases in this fashion seems almost as contagious as the organisms themselves.
At first glance, this geographic mode of naming pathogens may seem sensible. After all, it’s important to identify the origins of disease-causing organisms to monitor and control their spread. Political commentator Bill Maher defended the term “Chinese flu” as a factual descriptor, arguing that China should be blamed for the virus.
But these arguments miss the larger stakes of disease nomenclature. As the World Health Organization cautioned in 2015, including geographic locations in disease names has various problematic implications. Not least among them: Those eager to avoid having diseases named for their countries might cover up the appearance of new ones, as many are suggesting China did in the early days of this pandemic.
Geographic naming of pathogens and diseases can also foster a false sense of security. Labeling a virus as “foreign” may lead to the sense that it can be avoided by simply cutting off travel from the country in question, though public health authorities caution against disease management approaches that attribute contagious illnesses to a particular location.
Early in the pandemic, President Donald Trump was quick to ban travel to countries that had large Covid-19 outbreaks, such as Italy, South Korea, and China. But as America’s Covid-19 numbers demonstrate, cordoning approaches to pandemic management are grossly insufficient, given the density and interconnectedness of the human population.
Geography-based disease names can also lead to stigma and prejudice towards specific ethnic or racial groups, as it has for Asian Americans during the Covid-19 pandemic. Stigma causes more than just hurt feelings: It kills.
Take the case of HIV, perhaps the most stigmatized and feared modern virus. When it was first described in 1981, the disease it caused was called gay-related immunodeficiency, or GRID. Others called it gay cancer. Much like the geography-based labels for coronavirus variants, the terms GRID and gay cancer attributed this illness to a specific demographic.
The Centers for Disease Control and Prevention stopped using the term GRID in 1982, but the association between HIV and the gay community had been cemented, and persists today, even though it is now known to affect individuals of any sexuality.
This naming had immense implications. At a time when sodomy laws prevailed and gay marriage was illegal, an HIV diagnosis was a matter of profound stigma. This naming also made diagnosis difficult outside the gay community: If the disease was “gay-related,” how would someone who wasn’t gay have it?
The nomenclature has ramifications to the present day. HIV is the only infectious disease for which many states require explicit patient consent for testing, a step that slows diagnosis and treatment and keeps the AIDS epidemic from abating. Patient reticence to seek testing is particularly tragic given that, if HIV patients receive an early diagnosis and consistent treatment, they can expect to lead normal lives with normal lifespans.
While this fear certainly did not come from the term GRID alone, that nomenclature amplified the stigma.
Using geography- or demography-based names for organisms or diseases is problematic for another reason: It is often wrong. Britain may have been the first to report the B.1.1.7 variant of SARS-CoV-2, the virus that causes Covid-19, but that doesn’t mean the variant originated there. Instead, it’s possible that the virus was first detected in Britain because of the country’s particularly robust system of virus surveillance and genetic testing. This has happened before. During the terrible influenza outbreak of 1918-1919, Spain was the first country to report the virus, not because the virus originated in Spain but because, thanks to the country’s neutral stance in World War I, its press was operating unfettered by the wartime restrictions facing many other countries.
As the world grapples with a stream of new coronavirus variants, we should not lose sight of the larger implications of naming diseases and the pathogens that cause them. Call them by their scientific names, such as B.1.1.7, or say “the variant spreading in the U.K.”
Don’t label pathogens or diseases as if they have nationalities (or sexualities, in the case of HIV). Naming viruses and variants according to their alleged country or demography of origin has historically proven effective at generating misinformation and prejudice, not medically meaningful interventions.
Katie Baca is a historian of science and medicine and preceptor in expository writing at Harvard University. Susana Bejar is an internal medicine physician in New York City.