March 4, 2021

B.1.135? B.1.1.7? Why the coronavirus variants names don't make sense—and how we can do better.

Daily Briefing

    The increasingly "convoluted strings of letters, numbers, and dots" used to identify the novel coronavirus variants—such as B.1.135 and B.1.1.7—are difficult for even health experts to keep track of, let alone the average layperson, Apoorva Mandavilli and Benjamin Mueller write for the New York Times. So why do we use such complex naming conventions—and what might be an easier alternative?

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    Background

    The World Health Organization (WHO) in 2015 published best practices for disease naming, which advised that scientists should refrain from using geographic locations or people's names, animal species or food, and any terms that could cause "undue fear," such as "epidemic."

    But in an effort to avoid such problematic names, according to the Times, scientists have come to use long, technical names that make little sense to the outside world.

    For the novel coronavirus variants specifically, any with the "B.1" label indicates that the variant is related to the outbreak in Italy in spring of last year. Scientists have since identified numerous versions of the B.1 variant—but they typically make headlines only when they present a change in the virus' behavior: for example, when a variant appears to be more readily transmissible than the original virus (as with B.1.1.7, the novel coronavirus variant first identified in Britain) or if a variant seems less vulnerable to the immune response (as with B.1.351, the variant first identified in South Africa).

    And when a given label becomes too cumbersome to accommodate an additional letter or dot, Mandavilli and Mueller write, newer variants are labeled with the next available alphabetical letter.

    However, this approach has spurred confusion even among health experts dealing with the novel coronavirus, the Times reports. For instance, when scientists first announced B.1.315 was spreading throughout the United States—a variant just two digits different from B.1.351, which was first identified in South Africa—even South Africa's health minister "got quite confused," Tulio de Oliveira, a geneticist at the Nelson Mandela School of Medicine, said.

    In response, people have started calling B.1.351 "the South African variant," an approach that de Oliveira has pushed back against. Not only can identifying a virus by a geographic location feed into racism and xenophobia, but they quickly become obsolete: B.1.351 is currently in no fewer than 48 countries, de Oliveria explained.

    Further, such an approach can undermine scientific understanding of the variants. For instance, although B.1.351 was first identified in South Africa, it may not have originated from there—and labeling it as such could make researchers overlook its entry path from another country or region. 

    'A really big ask'

    According to the Times, this technical approach to naming variants was fine so long as variants "remained esoteric topics of research"—but amid this global pandemic, when reporting on and tracking variants is critical, we need "names that roll off the tongue, without stigmatizing the people or places associated with them," Mandavilli and Mueller write.

    As Emma Hodcroft, a molecular epidemiologist at the University of Bern, explained, "What's challenging is coming up with names that are distinct, that are informative, that don't involve geographic reference and that are kind of pronounceable and memorable. It sounds kind of simple, but it's actually a really big ask to try and convey all this information."

    According to Hodcroft and other experts, the solution to the problem is devising one naming convention that everyone can use that can also be linked to the more technical names researchers require for their work. And to help meet that goal, WHO has established a working group of several dozen experts—including de Oliveira—to generate a new, scalable naming system.

    "This new system will assign variants of concern a name that is easy to pronounce and recall and will also minimize unnecessary negative effects on nations, economies and people," WHO said in a statement. "The proposal for this mechanism is currently undergoing internal and external partner review before finalization."

    According to two members of the WHO group, the "leading candidate…is disarmingly simple": simply numbering the variants in the order they were first identified, such as V1, V2, and V3.

    But in the meantime, experts have enjoyed giving the variants a variety of creative, more casual nicknames based on each variant's characteristic mutation—an imprecise but engaging "spectator sport" for scientists. For instance, Áine O'Toole, a doctoral student at the University of Edinburgh who is part of the Pango team, and colleagues last spring started calling D614G—one of the first-known mutations—"Doug," followed by "Nelly" for N501Y and "Eeek" for E484K.

    Ultimately, whatever naming system for the novel coronavirus is finalized will have to "overcome the ease and simplicity of geographic labels for the general public," Mandavilli and Mueller write—and be one that both different groups of scientists and the public will accept.

    "Unless one really does become the kind of lingua franca, that will make things more confusing," Hodcroft said. "If you don't come up with something that people can say and type easily, and remember easily, they will just go back to using the geographic name" (Mandavilli/Mueller, New York Times, 3/2).

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