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Tag: colleague Katherine Wu

  • The Coronavirus-Naming Free-for-All

    The Coronavirus-Naming Free-for-All

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    These days, it’s a real headache to keep tabs on the coronavirus’s ever-shifting subvariants. BA.2, BA.4, and BA.5, three Omicron permutations that rose to prominence last year, were confusing enough. Now, in addition to those, we have to deal with BQ.1.1, BF.7, B.5.2.6, and XBB.1.5, the version of Omicron currently featuring in concerned headlines. Recently, things have also gotten considerably stranger. Alongside the strings of letters and numbers, several nicknames for these subvariants have started to gain traction online. Where once we had Alpha and Delta and Omicron, we now have Basilisk, Minotaur, and Hippogryph. Some people have been referring to XBB.1.5 simply as “the Kraken.” A list compiled on Twitter reads less like an inventory of variants than like the directory of a mythological zoo.

    The nicknames are not official. They were coined not by the World Health Organization but by an informal group of scientists on Twitter who believe Omicron’s many rotating varieties deserve more widespread conversation. The names have, to an extent, caught on: Kraken has already made its way from Twitter to a number of major news sites, including Bloomberg and The New York Times. Unofficial epithets have come and gone throughout the pandemic—remember “stealth Omicron” and the “Frankenstein variant”?—but these new ones are on another level of weirdness. And not everyone’s a fan.

    The names associated with the coronavirus have been a fraught conversation since the pandemic’s earliest days, as scientists and public-health figures have tried to use terms that are comprehensible and hold people’s attention but that also avoid pitfalls of inaccuracy, fear-mongering, or xenophobia and racism (see: Donald Trump referring to the coronavirus as “the Chinese virus” and “kung flu”). The official names for variants and subvariants—names such as SARS-CoV-2 B.1.1.7—come from the Pango naming system, which was fashioned by evolutionary biologists in the early months of the pandemic to standardize variant-naming practices. As baffling as they can seem, they follow a clear logic: Under the system, B refers to a particular COVID lineage, B.1 refers to the sublineage of B lineage, B.1.1 refers to the first sublineage of the B.1 sublineage, and so on. When the names get too long, a letter replaces a string of numbers—B.1.1.529.1, for example, becomes BA.1.

    These official names do not exactly roll off the tongue or stick in the memory, which became a problem when new variants of concern started to arise and the world began groping for ways to talk about them. In May 2021, the WHO instituted its now-familiar Greek-letter naming system to stamp out the geographic associations that were gaining prominence at the time. B.1.1.7, B.1.351, and B.1.617—which were being referred to respectively as the U.K. variant, the South African variant, and the Indian variant—became Alpha, Beta, and Delta. But then, alas, came Omicron. Rather than giving way to yet another new Greek-letter variant, Omicron has spent more than a year branching into sublineages, and sublineages of sublineages. As a result, the nomenclature has devolved back into alphanumeric incomprehensibility. Seven different Omicron sublineages now account for at least 2 percent of all infections, and none accounts for more than about 40 percent (though XBB.1.5 is threatening to overwhelm its competitors).

    It’s great news that the ways in which the coronavirus has been mutating recently haven’t been significant enough to produce a whole new, widespread, and possibly far more worrisome version of itself that the world has to contend with. But it also makes talking about the virus much more annoying. Enter T. Ryan Gregory, an evolutionary biologist at Canada’s University of Guelph who is one of the leaders of a small, informal group of scientists that have taken it upon themselves to name the many subvariants that the WHO does not deem worthy of a new Greek letter. The names—Hydra, Cerberus, Centaurus—originated on Twitter, where Gregory compiled them into a list.

    Their value, Gregory told me, is that they fill the space in between the Greek and Pango systems, allowing people to discuss the many current Omicron variants that do not justify a new Greek letter but are still, perhaps, of interest. You can think of it in the same way we do animal taxonomy, he said. Calling a variant Omicron, like calling an animal a mammal, is not particularly descriptive. Calling a variant by its Pango name, like calling an animal by its Latinate species designation, is highly descriptive but a bit unwieldy in common parlance. When we speak of farm animals that moo and produce milk, we speak not of mammals or of Bos taurus but of cows. And so BA.2.3.20 became Basilisk.

    To decide whether a new lineage deserves its own name, Gregory told me, he and his colleagues consider both evolutionary factors (how different is this lineage from its predecessors, and how concerning are its mutations?) and epidemiological factors (how much havoc is this lineage wreaking in the population?). They’re trying to make the process more formal, but Gregory would prefer that the WHO take over and standardize the process.

    That, however, is unlikely to happen. When I asked about this, Tarik Jasarevic, a WHO spokesperson, told me that the organization is aware of the unofficial names but that, for the moment, they’re not necessary. “Virologists and other scientists are monitoring these variants, but the public doesn’t need to distinguish between these Omicron subvariants in order to better understand their risk or the measures they need to take to protect themselves,” he said. The WHO’s position, in other words, is that the differences between one Omicron subvariant and another simply haven’t mattered much in any practical sense, because they shouldn’t have any effect on our behavior. No matter the sublineage, vaccines and boosters still offer the best protection available. Masks still work. Guidance on testing and isolation, too, is the same across the board. “If there is a new variant that requires public communication and discourse,” Jasarevic told me, “it would be designated a new variant of concern and assigned a new label.”

    The WHO isn’t alone in objecting. For Stephen Goldstein, an evolutionary virologist at the University of Utah, the new names are not just unnecessary but potentially harmful. “It’s absolutely crazy that we’re having random people on Twitter name variants,” he told me. For Goldstein, dressing up each new subvariant with an ominous monster name overplays the differences between the mutations and feeds into the panic that comes every time the coronavirus shifts form. In this view, distinguishing one Omicron sublineage from another is less like distinguishing a wolf from a cow and more like distinguishing a white-footed mouse from a deer mouse: important to a rodentologist but not really to anyone else. To go as far as naming lineages after terrifying mythical beasts, he said, “seems obviously intended to scare the shit out of people … It’s hard to understand what broader goal there is here other than this very self-serving clout chasing.”

    Gregory told me that fear and attention are not his group’s aim. He also said, though, that his group is thinking of switching from mythological creatures to something more neutral, such as constellations, in part to address concerns of whipping up unnecessary panic. When it comes to XBB.1.5, some of that panic certainly already exists, whipped up by less-than-nuanced headlines and Twitter personalities who feast on moments like these. Whether or not the name Kraken has contributed, the fear is that XBB.1.5 might be a variant so immune-evasive that it infects everyone all over again or so virulent that it amps up the risk of any given infection. So far, that does not seem to be the case.

    As my colleague Katherine Wu reported in November, we are likely (though by no means definitely) stuck for the foreseeable future in this Omicron purgatory, with its more gradual, more piecemeal pattern of viral evolution. This is certainly preferable to the sudden and unexpected emergence of a dangerous, drastically different variant. But it does mean that we’re likely going to be arguing about whether and how and with what names to discuss Omicron subvariants for some time to come.

    Whichever side you come down on, the state of variant-naming pretty well encapsulates the state of the pandemic as a whole. Hardly anything about the pandemic has been a matter of universal agreement, but the present nomenclatural free-for-all seems to have taken us somewhere even more splintered, even more anarchic. We’re not just arguing about the pandemic; we’re arguing about how to argue about the pandemic. And there’s no end in sight.

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    Jacob Stern

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  • Are We Really Getting COVID Boosters Every Year Forever?

    Are We Really Getting COVID Boosters Every Year Forever?

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    School is in session, pumpkin spice is in season, and Americans are heading to pharmacies for what may soon become another autumn standby: your annual COVID shot. On Tuesday, the White House announced the start of a “new phase” of the pandemic response, one in which “most Americans” will receive a COVID-19 vaccine just “once a year, each fall.” In other words, your pandemic booster is about to become as routine as your physical exam or—more to the point—your flu shot. One more health-related task has been added to your calendar, and it’s likely to remain there for the rest of your life.

    From a certain standpoint, this regimen makes a lot of sense. The pandemic’s biggest surges so far have come in the winter, and a fall booster could go a long way toward mitigating the next of those surges. What’s more, the new plan greatly simplifies COVID-vaccination regimens, both for the public and for providers. “It has been bewildering in many cases to understand who is eligible for a booster, how many boosters, when, which boosters, how far apart,” Jason Schwartz, a vaccine-policy expert at Yale, told me. “I think that has held down booster uptake in some really discouraging ways.” In a sense, White House COVID-19 Response Coordinator Ashish Jha told me, the new plan just codifies the way things already worked: The last time low-risk Americans became eligible for another shot was last fall. (The elderly and immunocompromised have operated on a different schedule and will likely continue to do so, Jha said.)

    Still, some public-health experts worry that the White House is jumping the gun. Back in April, a number of them told Stat News’s Helen Branswell they were concerned that the U.S. would adopt such a policy without the data needed to support it. When the White House made its announcement on Tuesday, many felt their concerns had been vindicated. “We’ve had twists and turns and surprises every single step of the way with COVID, and the idea that we’re going to have one shot and then we’re done is not really consistent with how things have worked in the past,” Walid Gellad, a professor at the University of Pittsburgh School of Medicine, told me. The plan, in his view, glosses over considerable uncertainties.

    For one thing, it assumes that the virus will follow an annual schedule with peaks in the fall and winter—not unlikely, but also not a given. For another, we still don’t have a firm grasp on the magnitude or duration of the benefits offered by the new Omicron-specific vaccine. For all we know, Gellad told me, the added protection afforded to someone who gets the shot tomorrow may have largely dissipated by New Year’s Eve.

    And that’s not to mention the massive uncertainty presented by the specter of future variants. In a briefing Tuesday, Jha acknowledged that “new variant curveballs” could change the government’s plans. But the announcement itself includes no such caveats, which some public-health experts worry could cause problems if course corrections are needed down the line. For all we know, new variants could necessitate more frequent updates, or, if viral mutation slows, we might not even need annual shots, Paul Thomas, an immunologist at St. Jude Children’s Research Hospital, in Tennessee, told me.

    If the routine the White House describes sounds a lot like flu shots, that’s no accident. The announcement explicitly recommends that COVID vaccines be taken between Labor Day and Halloween—“just like your annual flu shot.” That comparison, though, is part of what concerns critics, who worry that the shift into a more flu-like framework will entail the adoption of a vaccines-only approach to COVID prevention. Many of the interventions that have proved so effective over the past two and a half years—masking, distancing, widespread testing—have not traditionally been a major part of our flu-season protocols. If we treat COVID like flu, the thinking goes, such interventions risk falling even further by the wayside. The announcement, which makes no mention of any other prevention tactics, doesn’t offer much reassurance to the contrary.

    But that reading, Jha told me, is “just clearly wrong.” Although vaccines are “the central pillar of our strategy,” he said, testing, masking, and improving indoor air quality are all important as well. But as my colleague Katherine Wu has written, the country has been relying more and more on vaccines—and less and less on the other interventions at our disposal—for some time. Even if you do read the new policy as an abnegation of masking, ventilation, and the like, it may not functionally be much of a departure from the status quo.

    For now, Thomas said, the White House’s plan makes sense—as long as it stays sensitive to changing circumstances. “We keep learning new things about this virus,” he told me. “The rate of mutation is changing. The spread through the population is changing.” And as such, he said, our response must be flexible.

    The White House announcement seems like a good-faith attempt to balance competing priorities: on the one hand, the need to communicate uncertainty and acknowledge complexity; on the other, the need to keep the message from getting so complex that it confuses people to the point that they tune it out entirely. In this case, the administration seems to have come down on the side of simplicity. That could be a mistake, Gellad says—one that public-health authorities have made over and over throughout the pandemic. “When you try and make things simple and understandable and present them without sufficient uncertainty,” he told me, “you get into trouble when things change.”

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    Jacob Stern

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