Could a pandemic have been avoided if Covid-19 had been called Sars 2?

“What’s in a name? That which we call a rose/By any other name would smell as sweet.” Shakespeare’s line raises some thorny questions in science: by giving something a particular name, might we restrict how we think about it? Particularly as more information comes to light?

Sars 2 — a bigger sequel

In the early days of Covid-19, the virus that causes the disease was often referred to as “the new coronavirus”. More technically, it was known as Sars-CoV-2 — the pandemic virus that has infected millions of people around the world and caused enormous societal and economic upheaval and suffering.

The Sars in that name refers to Severe Acute Respiratory Syndrome, and in the early 2000s, the “classic’” Sars coronavirus, Sars-CoV (Sars-CoV-1), appeared in humans. There were thousands of reported cases and it resulted in more than 750 deaths worldwide. That Sars coronavirus was relatively well contained, at least compared to the current pandemic virus (Sars-CoV-2), because it was not as infectious, explains Prof Paul Moynagh, director of the Kathleen Lonsdale Institute for Human Health Research at Maynooth University.

“With the original Sars, the virus replicated deep in the lungs, so it wasn’t that easy for the virus to get out of the lungs and spread to other people,” Moynagh adds. “A really important difference with the pandemic Sars-CoV-2 is that the virus that emerged in 2019 replicates in the upper airways and accumulates in the throat, and this meant it could be more easily spread in coughs and other secretions, so it was more infectious.”

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In effect, it became apparent early on that the Covid-19 virus was a little like Sars-2, the sequel — a related but different coronavirus that can infect more people. However, even after Sars-CoV-2 got its official name on February 11th, 2020, it was often referred to in public communications as “the virus responsible for Covid-19″ or “the Covid-19 virus”. Had we used Severe Acute Respiratory Syndrome or Sars in general parlance that early, might it have focused attention sooner on measures to tackle it? We will never know.

Not immune to broader remit

The Covid-19 pandemic has shone a public spotlight on the immune system. But the immune system itself could probably do with a name update because there is far more to it than patrolling our bodies for potential agents of disease.

“We know the immune system is there to provide immunity from illness, to protect us from dangerous things that can attack us and cause disease, like bacteria, viruses, fungi and parasites — this is true, but that is a limited view,” says Prof Lydia Lynch, associate immunologist at Brigham and Women’s Hospital and Harvard Medical School in the US. “The immune system is much broader than that, and understanding its wider role could lead to much-needed medicines for diseases that are hard to treat today.”

Lynch describes the immune system’s broader role in the body as detecting entropy and keeping a lid on it. Entropy?

“By entropy, I mean disorder,” she says. “That disorder could be caused by an infectious agent entering the body, but it could also be due to processes that arise within the body, and this is where research is discovering new things about how the immune system helps to keep things in order. Think about how, over time, weeds overtake a neglected garden or an abandoned car rusts. The immune system is the ‘professional caretaker’ in the body that keeps an eye on things and maintains the body in good order.”

The immune system tackles disorder through a process called acute inflammation, which activates protection and repair in the body. But Lynch explains that when inflammation is switched on inappropriately — such as against food, which is foreign to our body but not dangerous — or if it runs chronically and doesn’t switch off, then cells and tissues can become damaged.

This type of chronic inflammation has been found lurking in the background of a range of conditions, including cardiovascular disease, rheumatoid arthritis, diabetes, inflammatory bowel disease, Alzheimer’s disease, some cancers and even depression, notes Lynch, whose own research focuses on the links between obesity and inflammation

“Knowing about how the immune system works — or doesn’t — in keeping order can help us identify new ways to tackle the disease processes,” she says. “We are already seeing successes in using the immune system against rheumatoid arthritis and cancers, which are forms of disorder in the body, and I think understanding the immune system’s job in detecting and fighting disorder will continue to play a role in developing treatments for many other diseases.”

Brain-busting nomenclature

One of the more surprising discoveries about the immune system (or disorder-fighting system) in recent years is its levels of activity in the brain, which was previously thought to be more “sealed off” from its general circulation. Then again, our understanding of the brain has expanded vastly in recent decades. For Prof Shane O’Mara, professor of experimental brain research at Trinity College Dublin, a big development is a move away from thinking that specific regions of the brain are tied solely to specific functions.

“We hear people talking about a particular brain region being responsible for a particular function, but the more we look, the more we see that the division of labour is not that neat,” he says. “So the terminology no longer reflects the evidence for many functions in the brain.”

O’Mara’s research looks at memory. Traditionally the field has focused on the “hippocampal formation” or hippocampus in the brain, two seahorse-shaped regions on each side of the brain, lying at the temples.

“People with damage to the hippocampus experience problems with memory, so we know this part of the brain has a central role in memory,” says O’Mara. “But increasingly the research is finding that the hippocampal formation is also crucial for imagination, it is involved in navigating the physical world and is activated by movement.”

The more we look, the more we see that multiple areas of the brain are involved in responses and actions, and if one part of the brain is damaged, other parts may ‘take up’ new functions to compensate and keep the show on the road, he adds. “The brain is this big, messy organ, and the language we use to describe how the brain works needs to change to reflect that.”

New terms for space travellers

As the field of space exploration grows, our language probably also needs to change, notes Dr Niamh Shaw. For example, does the term astronaut need to be more tightly defined in an era of “civilian” space flight?

Shaw believes that “astronaut” is a powerful word and should be limited to those people who have trained to be one. An engineer and scientist, Shaw has had a lifelong dream to travel to space and wishes to do so as an artist. She has written and performed several plays about her quest to go to space, and has worked as an artist-in-residence at CIT Blackrock Castle Observatory.

“There is a public perception of an astronaut as being someone who goes to space but I think we need to differentiate between astronauts who are recruited by space agencies and civilians who travel to space,” says Shaw. “We are seeing rapid growth in the numbers of civilians travelling to space as passengers — but for me an astronaut is someone who has trained to make that journey, often giving decades of their life to it. Then, when they go to space, they are the custodians of the work of many, many others.”

“That needs a particular mindset and set of skills, a vocation, selection and training with a space agency and a huge level of sacrifice — many astronauts make their own funeral arrangements before a space flight. I don’t have the skills of an astronaut, so even if I did go to space, I would not use that word to describe myself.”

Shaw, whose memoir Dream Big describes her journey from growing up in Dundalk to being a globe-trotting space expert, likes to view the bigger picture of the space sector. “You can be involved as a scientist, an engineer, a communicator, we need lots of brains and imaginations to work together,” she says. “Then some people, whether they are civilians or trained astronauts, can go to space. That, for me, is incredibly exciting.”