COVID-19 is not a virus, but SARS-CoV-2 is

For about two weeks we lived with, published using, and talked about, a disease-causing virus called the “novel coronavirus”. That name was always going to create problems like, what do we call the next one? After calling it the novel coronavirus, the World Health Organization (WHO) decided to refine the virus name. From around January 12th, they started calling it the 2019 novel coronavirus, 2019-nCoV. January 30th saw the WHO name the disease 2019-nCoV acute respiratory disease or 2019-nCoV-ARDS.[1] But then in February, they changed that disease name to 2019 coronavirus disease or COVID-19.[3] And the guys who are actually supposed to name viruses finally gave 2019-nCoV a new name; severe acute respiratory syndrome coronavirus 2: SARS-CoV-2 (It’s a shame HCoV-19 missed out[4]).[5] As a result, understanding of the names is now a complete and utterly misunderstood mess at every level. Let’s dive into that and see if we can come up with some every day uses.

Written by Ian M Mackay and Katherine E. Arden

In normal conversation and when trying to be very clear communicating, it’s okay to just use “COVID-19”, the disease, as an overarching name for the whole problem. It’s also okay to use “the new coronavirus” if you can’t remember the specific name. Just don’t refer to COVID-19 as if it is a virus. This is all pedantic I know, nonetheless, there is no reason we can’t learn new things and try and understand this pandemic.

Confusing the matter

The WHO has chosen to not use the official virus name SARS-CoV-2 because…

From a risk communications perspective, using the name SARS can have unintended consequences in terms of creating unnecessary fear for some populations, especially in Asia which was worst affected by the SARS outbreak in 2003.

World Health Organization (WHO) [3]

Okay. Sure. The WHO offer two examples of how they have decided to communicate with the public.

“the virus responsible for COVID-19” or “the COVID-19 virus”

World Health Organization (WHO) [3]

Again, okay. The first one is a perfectly good workaround. The second though, while it may – to the author – imply we are talking about the virus that causes COVID-19, it really is just too economical with words.

A virus isn’t a disease, a disease isn’t a virus

An infectious disease is one you can catch from someone or somewhere else. But disease isn’t just one “thing” (I am not going to discuss “syndrome” here)

The word “disease” can be defined as a state of non-normal health characterised by two or more of the following criteria: recognized causal agent, identifiable group of signs and symptoms, consistent anatomic alterations.

Disease is a bucket term into which we pour the specific signs and symptoms, usually accompanied by how we test for the cause. We can add descriptions of the clinical course and outcomes. What disease is not though, is a virus. A virus – in the case of the disease called COVID-19 – is the cause of the signs and symptoms.

A virus is a distinct and transmissible agent that replicates and leads to all those things happening, in some direct or indirect fashion. A virus can be specifically tested for. How it causes disease can be examined and described.

Measures of the disease – cell counts, breathing rate, presence of pneumonia – can also be captured. But none of these is the virus.

When we test a sample of mucous or urine or stool or blood, we are looking for the virus or the effect of the virus. We are not looking for the disease. The disease is described by a doctor examining the patient also considering they test results. The Doctor then makes a diagnosis on the basis of those examinations and their judgment.

Some examples of confused understanding

Below are a few snippets from around the web. These weren’t hard to find but it’s worth noting that things have improved.


This is confusing. Is this meant to say that the disease (COVID-19) is caused by a coronavirus? More words are needed if so. It reads as though the two terms are interchangeable and that is scientifically and medically incorrect.[2]

No time at all! A disease doesn’t sit on a surface. A virus does. And the virus is called SARS-CoV-2.

No, it isn’t officially known as that at all. The virus is officially known as SARS-CoV-2.

Halfway there. They did test positive for the coronavirus (SARS-CoV-2), but COVID-19 is not an alternative name for the coronavirus, it’s the name for the disease that happens as a result of infection with the coronavirus.

People have SARS-CoV-2 infection, and that leads to COVID-19. They have an infection by an infectious agent, not an infection by the disease which results from infection.

Double no. We test the swab for the influenza virus and the SARS-CoV-2 virus. We do not use a swab to detect influenza or COVID-19. These are diagnoses from a Doctor.

There is no COVID-19 virus. There is the virus called SARS-CoV-2 and there is the disease called COVID-19. With a few extra words, this could have been fine.

No, they haven’t. They had been tested for the virus, SARS-CoV-2 because that’s what the test is designed to detect. The test does not detect signs, symptoms, syndrome, disorder or disease.

No. They had tested positive for the virus, SARS-CoV-2 because that’s what the test is designed to detect. The test was done because the person was showing signs and symptoms of the disease, COVID-19, and may have had contact with another case or travelled from outside Australia.

How can we use the words?

Here are a few example uses of the two labels, which may give you a feel for the difference.

The virus

  • I just got tested for SARS-CoV-2
  • That person is infected with SARS-CoV-2
  • SARS-CoV-2 was detected in their throat swab
  • They tested positive for SARS-CoV-2
  • The novel coronavirus (SARS-CoV-2) was in the community
    If you spell out SARS-CoV-2 earlier
  • SARS-CoV-2 attaches to the ACE2 molecule
  • SARS-CoV-2 is an RNA virus with a lipid membrane

The disease

  • I was just diagnosed with COVID-19
  • A dry cough is a sign of COVID-19
  • COVID-19 was widespread in the community
  • COVID-19 can be severe in children and in adults
  • The virus causing COVID-19 can survive on surfaces for 48-72 hours
  • the new disease (COVID-19) was named by the WHO and caused by SARS-CoV-2

More clear now?

Hopefully, that makes a bit more sense. Feel free to send me some other examples in the comments below.

This isn’t the only example of different virus and disease names though. Some other examples include:

  • Human immunodeficiency virus (HIV) which causes AIDS
  • Herpes simplex virus (HSV) which causes cold sores
  • Varicella-zoster virus which causes chickenpox
  • Rhinoviruses which cause the common cold

There are also some more logical examples like:

  • Measles virus which causes measles
  • Dengue viruses which can cause dengue haemorrhagic fever
  • Influenza viruses which cause influenza

Since we’re all likely to have some time to think in the near future, why not use a bit of that time to get this straight?

References

  1. Novel Coronavirus(2019-nCoV) | Situation Report – 10
    https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200130-sitrep-10-ncov.pdf?sfvrsn=d0b2e480_2vVaw1sZo59856yl6UCuQjHSdWo
  2. https://www.homeaffairs.gov.au/news-media/current-alerts/novel-coronavirus
  3. Naming the coronavirus disease (COVID-19) and the virus that causes it [accessed 23MAR2020]
    https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it
  4. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2
    https://www.nature.com/articles/s41564-020-0695-z

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48 thoughts on “COVID-19 is not a virus, but SARS-CoV-2 is”

  1. I suggest it helps memory to recall COVID-19, the disease, contains the D for disease, ergo, CO[rona]VI[rus]D[isease]-[20]19. As the ICTV points out on its homepage, “For an outbreak of a new viral disease, there are three names to be decided: the disease, the virus and the species. The World Health Organization (WHO) is responsible for the first, expert virologists for the second, the ICTV for the third.”

    1. what i don’t understand about using COVID 19 instead of SARS 2 for the disease name, if a disease name is thought to be needed, what purpose is it that COVID accomplishes? What does it tell us about this disease? Just the virus name itself is more than adequate to give the person using the term some knowledge of what the term means–severe acute respiratory syndrome, or SARS, which was what SARS CoV was called publicly, it’s what WHO called it, everyone called it that. Why isn’t the second outbreak of SARS called SARS 2?

      Can anyone explain what the problem with SARS 2 was for the public to call what we’re dealing with? It’s an intelligent name, it communicates meaning about the specific disease that has caused such widespread destructive effects. It not only conveys the general nature of the disease, that it’s respiratory and acute, but also that it is the second outbreak. What important information to have! Is it just me who thinks that the public being informed is a good thing? Are there people who think that’s a bad thing?

      The name give by WHO for the disease, which has virtually supplanted public use of SARS 2 which the public never has used because the authority told them to use something else, but what they were told to use is uninformative and unintelligent, it’s confusing, misleading, you went over it in your answer. This disease name is CORONAVIRUS Disease. What does that tell anyone? What is “coronavirus?” what does that mean, in terms of this disease that has impacted societies all over the world and canceled normal life?

      In the beginning before the virus was named by the scientists with the recognized authority to name it, the media was calling it ‘the corona virus,’ and sometimes, the wuhan virus, or the wuhan corona virus. I remember it being explained by media report as the name of a family of viruses, a variety of different virus types. So, it wasn’t a specific name for this virus because it was a generic name for a whole family of viruses. it told nothing specific about the disease or the virus that new show audiences were watching unfold. the report said scientist were still working on that. This was in January. Finally they told us it should be called Covid 19, that was weeks later. i found the term confusing hard to remember, like the name of a video game. it was hard to type too. There was nothing about what kind of virus it was, or what kind of disease it was, but it seemed to be being offered as if it did provide meaningful information.

      There was no clarification of the generic term, the corona virus family. Eventually i learned that the scientists had named it SARS CoV 2. SARS! wow. it’s a SARS virus. That’s important. why was it being obscured in the media, and by WHO? It wasn’t just me asking this. It was especially being asked in the scientific and medical press. It made no sense. What was the matter with calling it SARS, second outbreak? i remember the spokesperson for WHO answered by saying that China didn’t want it to be called SARS because of how bad the previous SARS was over there, in 2003, and this would cause people to become very fearful. That seemed like a weird answer, but at least it was an answer.

      Also i’ve heard them say that sometimes a disease name is given when the virus name is too hard for the public to say–but that wasn’t the case with SARS 2. He also said a disease name is sometimes needed to give the public more of a concept of what kind of disease it is, like AIDS compared to HIV. AIDS was chosen, he said, because it told the public what kind of disease it was, meaning, what happens to you if you get it, you get immune deficiency. But Coronavirus disease doesn’t tell you anything at all, it would confuse the public much more than SARS 2, which i don’t think is confusing at all. Why be misleading by using a name of a viral family with no information on the specific type of virus it is?

      As another person commented here, in all my decades of life i’ve never seen this happen before, the strange behavior and avoidance of informing the public. The virus and threat of disease is bad enough without this kind of confusing communication about it, pretending it’s perfectly clear, and all of us following along because it’s been decided and so, that’s what you do, in order to communicate.

  2. Does everyone who tests positive for the virus also contract the disease? If not, does anyone know if and where I can find statistics on that in particular? If there are no statistics, shouldn’t there be ? and has/is there any effort being taken to create such statistics for informational purposes amongst the world; those who have been personally affected the virus, the disease, both or neither alike.

    1. PCR-based tests. Those postulates were devised before PCR. We have enough data to show that SARS-CoV02 cases COVID-19.

  3. Dr Mackay,

    Do we know for a fact that SARS-COV-2 is a novel virus or is it possible that it is actually 2004 SARS mutated? If the answer was already posted and i missed it i apologize. I tried the CDC and WHO websites to find answers but it is difficult to find any reliable information, especially considering that at the time I am writing this according to CDC MERS, also came from bats…

    Thank you Dr,

    Chris.

      1. Dr Mackay, could you clarify what you mean in view of the findings of the ICTV CVSG that Sars CoV 2 is not a distinct viral species but is a strain of Sars CoV 2003?

        i have read this in a wikipedia article titled ‘Severe acute respiratory syndrome coronavirus 2,’ under Phylogenetics and Taxonomy, which i’ll excerpt here. i want to understand if what you said is something different from what they are talking about as i understand it. Am i misunderstanding what they are saying here?

        “….On 11 February 2020, the International Committee on Taxonomy of Viruses announced that according to existing rules that compute hierarchical relationships among coronaviruses on the basis of five conserved sequences of nucleic acids, the differences between what was then called 2019-nCoV and the virus strain from the 2003 SARS outbreak were insufficient to make them separate viral species. Therefore, they identified 2019-nCoV as a strain of Severe acute respiratory syndrome-related coronavirus.[2]….”

        the source is
        Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. (March 2020). “The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2”. Nature Microbiology. 5 (4): 536–544. doi:10.1038/s41564-020-0695-z. PMC 7095448. PMID 32123347.

        Also, it doesn’t say here whether the strain would be termed a ‘novel’ strain. A new strain is a novel strain. Would that be a meaningful designation? i know that ‘novel’ in reference to viruses is a scientific term–rather than just saying something is “new.” The way the word ‘novel’ is emphasized so strongly in public media references to SARS CoV 2 gives me the idea that it’s a very important designation in that context. But since it isn’t known to have existed before, it’s by definition a new strain. I wonder how long a strain or a virus can exist before it’s no longer called new. i think you touched on this in your most welcome commentary.

  4. Its so stupid and confusing. WHO decided WHO gets to name viruses and diseases? They didnt want to call it SARS because that might scare people…but they also have been doing their best to scare people. But then they do call the virus SARS 2 essentially, but its important to not call the disease that. This is confusing and dangerous on multiple levels. SARS, MERS, and the current outbreak should all be called SARS. Coronavirus causes SARS. Simple, straightforward, and easy. No other disease in history has been treated this ridiculously. Could you imagine if plague outbreaks were called BuPlaD-42 BuPlaD-47 and BuPlaD-94? Thats what this is.

    1. Stop Calling it Covid – that’s your user name? haha. i share your discomfort, it’s kind of like newspeak in 1984 where the authorities erase words from the vocabulary and from the mind. i don’t agree that your formulation, ‘coronavirus causes SARS. simple, straightforward and easy.’ For me, you are using ‘coronavirus’ as if it’s a meaningful term in the context of communicating clearly about the specific virus and/or viral disease we’re dealing with. Coronavirus as i think you know, is the name of a family of diseases, more to the point, a family of virus types, or species, which include a variety of different viruses with their diseases. Not all are respiratory. Calling the current SARS strain “the coronavirus” or “coronavirus” is using the term in a way that is, as you said ‘confusing’ and i also think, as you said, dangerous, just in the sense that it is disinforming, it teaches the public to call it something that has no meaning. Maybe i’m missing something but what meaning does ‘coronavirus’ have when used to specify the virus that is said to justify shutting down the US economy and various other aspects of normal social interaction, including those that are enjoyable and uplifting. A nonspecific word, a word who’s meaning is general, referring to a variety of viruses, is given to the public and they’re told to use this to specify the virus that’s impacting them. what does a person’s mind do with that? i’m guessing they don’t think about it. if that’s what’s desired by the authorities, then i call that dangerous. The way i would put what you said would be the sudden acute respiratory disease, from the corona virus family, is caused by the sudden acute respiratory syndrome corona virus, and this is the second outbreak which is a mutation of the virus causing the first outbreak. This new strain of SARS is in some ways different from the first one in 2003, for example, the first one was more deadly. The new one is far more infective, human to human contact is easier and so it spreads much more than the first one. But they are very similar, causing respiratory and other debilitating viral symptoms, body aches, weakness, high fever along with a variety of respiratory symptoms.

      My point is that using SARS to talk about the epidemic virus doesn’t shut the mind down. it raises questions, it promotes conversation, thought, and learning, the opposite of what ‘coronavirus’ promotes. Other than ‘what does it actually mean?’

  5. Dear Authors MacKay and Arden, I am an amateur researcher with an interest in economics, behavioral science and politics. Could you please elaborate on the testing for both SARS-CoV-2 and Influenza in the same test? 1) In particular is there a known correlation between the presence of SARS-CoV-2 and Influenza in the same patient? 2) As I look at your helpful description above where you say: “SARS-CoV-2 attaches to the ACE2 molecule (and) SARS-CoV-2 is an RNA virus with a lipid membrane,… what is Seasonal Influenza’s identifying nature? 3) If both viruses are present in a test, are we sure both are being reported as such to the databases used by the CDC and John Hopkins? 4) Is there an estimate for a false positive rate as relates to the test(s) yet for SARS-CoV-2. Thank you

    1. I too would love more clarity on the questions above also. We need proper explanations from experts and statistical analysis resources made available that are accurate :). I would also love your thoughts on the preventative HCQ + Zinc etc treatments being administered globally by 1000’s doctors worldwide. Love the site too.

  6. Your explanation is excellent, however it does not illustrate the underlying cause of the confusion between Covid-19 and SARS-CoV-2 strongly enough ! The reason this useless Covid-19 term was spread(very effectively) was to hide the real virus SARS-CoV-2 from the general public. If they had exposed the true viral cause, the potential outrage of the public might have become uncontrollable. The general populace would have demanded to know why the ‘Irresponsible Criminals’ in the US, reduced Research Grants for the past 5 years and never developed a very effective vaccine for Influenza since 2006. There are 197 different strains of Influenza but only 137 have been identified.

    To spend billions of dollars for a Border Wall with Mexico or to engage China in a Trade War was apparently more important than science and health. A single C-17 Globemaster Military Aircraft cost exceeds the dollar amount of US Research Grants for the past Ten Years !

    1. We have a community of doctor’s and scientists for that. Trade was just for fair trade and drug and human trafficing is used at the border. Stop deflecting the origin of a virus that has caused major worldwide ecomonic and health disasters. It accomplises nothing at this point.

  7. Hi, thanks for your article.
    I came across a few patents and papers about SARS-COV2 (and SARS-COV3 another topic entirely)
    https://patents.google.com/patent/CN101503700A/en?oq=CN101503700A
    https://academic.oup.com/clinchem/article/52/7/1446/5627058
    Also a video making reference to the Wuhan biolab at the focus and epicentre of the outbreak.
    https://m.youtube.com/watch?v=bpQFCcSI0pU
    Are these papers and patents related to the Wuhan lab, authors who work(ed) there, and to the circumstances of the pandemic? I would like to know if it’s the same virus or something else that’s being tested for and what the true relationships between these items and events are. Ta.

  8. My daughter’s Value was positive for SARS-CoV-2, NAA; Standard Range: Not Detected and Flag: AA…..all from The same test so what exactly does it all mean. The test was done at the ER. She was sent home with results called in to her the next afternoon then sent via email.

  9. I have HSV Type 2, would this virus stop me getting the SARS-COV-2? Can two virus’s live in the same body?

  10. Hello Doctor,
    Is the distiction between Sars CoV-2 and other Corona viruses due to a Furin Cleavage and the number of nucleotides?
    Thanks wyatt

    1. Nope. All CoVs are genetically distinct – they each have unique nucleotide sequences in their genetic material or “genomes”.

  11. So what I’m understanding is you could test positive for SARS-CoV-2 and Still not have Covid-19 if there is no symptoms? Because one is a virus and the other is what it does to you and if it does nothing then you just have the virus and not the disease?

  12. The subspecies name for the 2003 SARS epidemic is SARS-CoV. For 16 years the SARS virus mutated in bats and pangolins to create a second subspecies, SARS-CoV-2 which causes COVID-19.

    The species name of SARS-CoV and SARS-CoV-2 is SARS. It is correct to call the virus that causes COVID-19, SARS. Using the subspecies designation is a bit cumbersome.

    1. yes, thanks. unless i am remembering this wrong, the species name is severe acute respiratory syndrome-related coronavirus. it seems to be the word ‘related’ that distinguishes the term as a species of corona virus.

      i rarely hear this mentioned anymore, but i think that the number 2 simply means it’s the second outbreak of SARS (the subspecies, SARS CoV). Both outbreaks are SARS CoV. i don’t think that being the second outbreak would distinguish the subspecies of the second outbreak as a novel virus.

      I have seen it distinguished not as a different virus but as a new strain of the 2002 subspecies, with differences due to mutation as you say or as i think you said.

      I think cumbersome is a very good word, it works or me. When it takes so much effort and so many words to communicate publicly the name of a recurrence of a virus first seen in 2002, the intelligibility of communication suffers and and breaks down.

      i don’t know anyone who is able to have a conversation about Covid-19 except for people who use the term grammatically as if it’s the cause rather than the effect of the disease, in other words, it’s virtually used grammatically to imply the pathogen, the virus. Then communication moves smoothly but misleading in the process so that the possibility that the result of the communication will not be factual or well informed.

  13. Although I understand the difference between the virus and the disease, there doesn’t seem to be a clear understanding of how to diagnose Covid-19.

    If you have the virus, is it possible to not have Covid-19. If so, what does that mean?

    1. It isn’t a single disease – COVID-19 can manifest in many ways, from asymptomatic infection through to death. Having disease manifestations and testing positive for SARS-CoV-2 = COVID-19

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