Naming Diseases

There are times when I envy fire PIOs (and trust me, it’s not often, as I’ve seen fire responses). The times that most easily come to mind are when naming a wildland fire. Where it starts, no matter how ridiculous the name of the place, is what it’s called. (Except for little fires, one of which was called Samantha, after one chief’s daughter.) Hurricanes and cyclones, while more rare than wildland fires, get very specific names. And just this year, the Weather Channel corporation started naming winter storms (and believe you me, I’ve got something to say about that).

Now contrast that with our friends in health. We’ve got this new bug popping around in the Middle East and a bit in the UK, and we don’t know what to call it. Most folks in the media are either calling it coronavirus or SARS-like. As you can see from the CDC link above, they’re calling it “novel coronavirus.” (Which, between you and me, isn’t very helpful, given that every new coronavirus out there–and there are tons–is novel.)

I recently asked the wonderful Helen Branswell of the Canadian Press what some of the scientists were calling it. Her response? The even more confusing hCoV-EMC or EMC2012.

This isn’t the first time we’ve had this problem either. A lifetime ago (when I was Jimmy Jazz) I wrote about this same exact problem with the H1N1 flu pandemic. You remember the disaster that name was: swine flu, swine-origin influenza A virus (S-OIV), H1N1 flu, novel H1N1 influenza A virus. And yet, even after all of those etymological gymnastics, the name wasn’t very descriptive. In fact, the chances that some other flu is out there that meets all of the descriptive criteria laid forth in every one of those names is actually pretty good.

And then, my reason for complaining. About a week ago, the WHO started tweeting to reporters and members of the public to dissuade folks from calling the new coronavirus that is currently in the news SARS-like or SARS-like. Mike Coston covered it exceptionally well.

And this is where I think (for the first time ever, probably) I disagree with Mike. The new term, nCoV, is only more precise and more descriptive than some term the media used. It is not precise or descriptive. And furthermore, the reason the media was using SARS-like in their reporting was because they needed some description that the public could understand and relate to. They were using plain language, as opposed to the gobbledygook that most of us in health (and the WHO is the worst offender) use all of the time.

Which leads me back to my original point. Our naming conventions (if one could so generously call them conventions), have been demonstrated to and continue to cause confusion. The National Hurricane Center got raked over the coals earlier this year for their linguistic contortions around Hurricane Sandy (which I’ve already talked about once) in an effort to adhere to the science of the storm and not the needs of the public. And that was after one single storm! Yet we in public health continue to confuse the issue and the public.

Do we start naming pandemics? Develop criteria for watches and warnings? Designate some central authority to start listing out each new Salmonella outbreak in an attempt to differentiate between the half dozen we see every year? Honestly, I don’t know, but I do know that our failure to act in the best interest of the public is shameful, and will–if it hasn’t already–cost lives.

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Profile Photo Andrew Krzmarzick

Hey Jim – Great conversation to have. As a citizen, I do appreciate when things are named. That personification seems to give it life – a life that people pay attention in ways that they might not if what they’re hearing sounds too technical or complicated. And when they feel like they know what they’re up against, they can take action – the kind of action that public officials want them to take in response to the information they are receiving.

Profile Photo Jim Garrow

Thanks so much for reading, Andrew!

Names are so powerful. They do more than personify things, they anthropromophize things. The absolute best example of this is the War on Terror. An amorphous ongoing battle against a shadowy, nearly impossible to define enemy was given “war” status just by the ability to give it a name.

In fact, there are some who believe that until things are named they don’t really exist. (They obviously exist, but are undefinable, and therefore non-understandable.) Basically, if you can’t tell me what disease I should be looking out for, how can I adequately look out for it?