With recent reporting increasingly focusing on COVID-19's omicron variant, many are wondering how new strains will be named if the World Health Organization reaches the end of the Greek alphabet.
The vast majority of recently diagnosed COVID-19 cases in the United States are attributable to variants of the original virus, with more than 98% of all cases detected between Aug. 22 and Nov. 27 classified as the B.1.617.2, or delta, variant of the initial virus, according to the Centers for Disease Control and Prevention.
As the coronavirus continues to mutate and new strains emerge, here's how the WHO may name future variants.
HOW COVID-19 VARIANTS ARE NAMED
The WHO announced in May that it would use Greek letters to name new variations that required additional attention from medical officials.
The organization chose this naming system after convening several experts to discuss the best methods. These discussions included "experts who are part of existing naming systems, nomenclature and virus taxonomic experts, researchers and national authorities," the WHO said in a press statement.
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WHICH VARIANTS ARE NAMED
The WHO applies its naming system to variants that medical officials consider "Variants being Monitored," "Variants of Interest," or "Variants of Concern."
"Variants being Monitored" are variants that could have a "potential or clear impact on approved or authorized medical countermeasures." Epidemiologists closely monitor these variants and may eventually change their status to a "Variant of Interest" or "Variant of Concern" depending on how they evolve. As of December, the CDC and the WHO identify the following variants as "Variants being Monitored":
- Alpha
- Beta
- Gamma
- Epsilon
- Eta
- Iota
- Kappa
- Mu
- Zeta
"Variants of Interest" show markers in their genetic code that have been associated with some potentially risky changes in their makeup. While "Variants of Interest" may not pose an increased risk to most people, their existence requires "enhanced sequence surveillance, enhanced laboratory characterization, or epidemiological investigations" to determine the risk level.
As of December, the CDC and the WHO have not identified any variants as "Variants of Interest."
"Variants of Concern" are variants for which there is "an increase in transmissibility, more severe disease, significant reduction in neutralization by antibodies," or other medical elements that may affect the ability to combat the virus. These variants typically require additional action from lawmakers and medical officials to mitigate the effects on the public.
As of December, the CDC and the WHO have identified the following as "Variants of Concern":
- Delta
- Omicron
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WHY THE WHO SKIPPED SOME GREEK LETTERS
As of December, the WHO has labeled 13 COVID-19 variants with the Greek alphabet. However, it skipped the 13th (Nu) and 14th (Xi) letters before adopting the 15th letter, Omicron, for the latest variation.
"Two letters were skipped — Nu and Xi — because Nu is too easily confounded with 'new,' and Xi was not used because it is a common surname," a WHO spokesperson told the Washington Examiner.
Xi, which is also the surname of Chinese President Xi Jinping, would have breached 2015 guidelines implemented by the WHO that suggest avoiding "causing offense to any cultural, social, national, regional, professional or ethnic groups."
As of December, the Greek alphabet has nine letters remaining, allowing the WHO to name at least nine additional variations before it considers an alternative protocol.
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WHAT HAPPENS WHEN THE WHO RUNS OUT OF LETTERS
A WHO spokesperson told the Washington Examiner that there is "no plan in place yet on what to do at the end of the Greek alphabet."
Among the suggestions offered by the Washington Examiner staff are the use of the Cyrillic alphabet; bat breeds, a reference to the virus reportedly originating in bats; and going back and using xi and nu.
The omicron variant, first discovered in South Africa last week, has prompted concern among government officials. President Joe Biden restricted travel from the region in an attempt to prevent the strain's transmission just days before the U.S. diagnosed its first and second cases of COVID-19 caused by the variant.
There have been nearly 48.5 million cases of COVID-19 in the U.S., and 780,131 deaths have been attributed to the virus, according to the CDC.