20H / 501Y.V2.
VOC 202012/02.
B.1.351.
These were the charming names that the scientists proposed for a new variant of the coronavirus that was identified in South Africa. The complicated sequences of letters, numbers and dots are deeply meaningful to the scientists who created them, but how could anyone keep them correct ? Even the easiest to remember, B.1.351, refers to an entirely different strain of the virus if a single spot is lost or misplaced.
The naming conventions for viruses worked, as long as the variants remained esoteric research topics. But now they are the source of anxiety for billions of people. They need names that come out of the language, without stigmatizing the people or places associated with them.
“The challenge is to find distinctive, informative names that do not involve geographical references and that are pronounceable and memorable,” said Emma Hodcroft, molecular epidemiologist at the University of Bern, Switzerland. “It sounds simple, but it’s actually a big question to try to convey all of that information.”
The solution, according to her and other experts, is to create a single system for everyone to use, but link it to more technical systems that scientists trust. The World Health Organization has brought together a working group of a few dozen experts to develop a simple and scalable way of doing this.
“This new system will give variants of concern a name that is easy to pronounce and remember and will also minimize the unnecessary negative effects on nations, economies and people,” said the WHO in a statement. “The proposal for this mechanism is currently undergoing a review by internal and external partners before it is finalized.”
The WHO’s main candidate so far, according to two members of the working group, is surprisingly simple: number the variants in the order in which they were identified – V1, V2, V3 and so on.
“There are thousands and thousands of variants and we need some way to label them,” said Trevor Bedford, an evolutionary biologist at Fred Hutchinson Cancer Research Center in Seattle and a member of the working group.
Naming diseases has not always been so complicated. Syphilis, for example, is taken from a 1530 poem in which a shepherd, Syphilus, is cursed by the god Apollo. But the compound microscope, invented around 1600, opened up a hidden world of microbes, allowing scientists to start naming them according to their shapes, said Richard Barnett, a historian of science in Britain.
Still, racism and imperialism have infiltrated disease names. In the 1800s, as cholera spread from the Indian subcontinent to Europe, British newspapers began to call it “Indian cholera”, describing the disease as a figure with a turban and mantle.
“Names can often reflect and extend stigma,” said Dr. Barnett.
In 2015, WHO published best practices for naming diseases: avoiding geographical locations or names of people, species of animals or food and terms that incite undue fear, such as “fatal” and “epidemic”.
Scientists have at least three competing nomenclature systems – Gisaid, Pango and Nextstrain – each of which makes sense in its own world.
“You can’t track something you can’t name,” said Oliver Pybus, an evolutionary biologist from Oxford who helped design the Pango system.
Scientists name variants when changes in the genome coincide with new outbreaks, but they call attention to them only if there is a change in their behavior – if they transmit more easily, for example (B.1.1.7, the variant seen for the first time) Britain), or if they circumvent, at least partially, the immune response (B.1.351, the variant detected in South Africa).
Encoded in mixed letters and digits are clues about the variant’s ancestry: the “B.1”, for example, denotes that these variants are related to the outbreak in Italy last spring. (Since the hierarchy of variants becomes too deep to accommodate another number and period, the younger ones receive the next available letter in alphabetical order.)
But when scientists announced that a variant called B.1.315 – two digits removed from the variant seen for the first time in South Africa – was spreading in the United States, the South African minister of health “got quite confused” between that and B.1.351, said Tulio de Oliveira, geneticist at the Nelson Mandela School of Medicine in Durban and a member of the WHO working group.
“We have to create a system that not only evolutionary biologists can understand,” he said.
With no easy alternatives available, people resorted to calling B.1.351 “the South African variant”. But Dr. de Oliveira begged his colleagues to avoid the term. (Look no further than the origins of this same virus: calling it the “China virus” or “Wuhan virus” fueled xenophobia and aggression against people of East Asian origin around the world.)
The potential damage is severe enough to deter some countries from presenting themselves when a new pathogen is detected within their borders. Geographical names also become obsolete quickly: B.1.351 is in 48 countries now, so calling it a South African variant is absurd, added Dr. de Oliveira.
And practice can distort science. It is not entirely clear whether the variant emerged in South Africa: it was identified there in large part thanks to the diligence of South African scientists, but marking it as a variant of that country could induce other researchers to ignore its possible path to South Africa. South from another country that was sequencing fewer coronavirus genomes.
In the past few weeks, proposing a new system has become a kind of sport for spectators. Some of the suggestions for name inspiration: hurricanes, Greek letters, birds, other animal names like red squirrel or aardvark and local monsters.
Áine O’Toole, a doctoral student at the University of Edinburgh who is part of the Pango team, suggested colors to indicate how the different mutation constellations were related.
“You could end up getting dusty pink or magenta or fuchsia,” she said.
Sometimes, identifying a new variant by its characteristic mutation can be sufficient, especially when the mutations are given freakish names. Last spring, Ms. O’Toole and her collaborators started calling D614G, one of the first known mutations, “Doug”.
“We kind of didn’t have a lot of human interaction,” she said. “That was our idea of humor in confinement # 1.”
Other nicknames followed: “Nelly” for N501Y, a common thread in many new worrying variants, and “Eeek” for E484K, a mutation believed to make the virus less susceptible to vaccines.
But Eeek appeared in several variants around the world simultaneously, emphasizing the need for variants to have different names.
The numbering system that WHO is considering is simple. But all new names will have to overcome the ease and simplicity of geographic labels for the general public. And scientists will need to strike a balance between labeling a variant quickly enough to avoid geographical names and cautiously enough that they don’t end up naming insignificant variants.
“What I don’t want is a system where we have this long list of variants, all with WHO names, but in fact only three of them are important and the other 17 are not important,” said Dr. Bedford.
Whatever the final system, it will also need to be accepted by different groups of scientists, as well as by the general public.
“Unless someone really becomes the lingua franca type, it will make things more confusing,” said Hodcroft. “If you don’t think of something that people can say and type easily, and remember easily, they will simply go back to using the geographical name.”