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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11 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.”

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