Medical Examiner

What Happens When We Run Out of Greek Letters for Variants?

It was a whole journey to come up with the system we’re using now.

A nurse wearing personal protective equipment inserts a COVID testing swab into a woman's nostril.
A registered nurse administers a COVID-19 test to a person July 14, 2021 in Los Angeles, California, where cases have been rising due to the highly transmissible Delta variant. . Mario Tama/Getty Images

Delta surges, alpha remains a concern. Gamma is less transmissible, while beta is more contagious. A few weeks ago, scientists were concerned about epsilon, which is potentially able to evade antibodies from vaccines; On Monday Texas saw its first case of lambda.

These are all variants of the coronavirus, of course, though some have received less time in the spotlight than others. Anyone who’s familiar with the Greek alphabet—Percy Jackson fans, frat house frequenters, what have you—might be wondering how we got to “lambda” already, the 11th letter, since scientists are assigning variants nicknames in order of the Greek alphabet. Where’s kappa—is it just not a problem? Is iota quietly circulating somewhere on the globe? And what’s going to happen when the virus keeps mutating and we run out of Greek letters—what will we call those variants?

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Towards the end of 2020, public health experts at the World Health Organization decided that they needed to develop a classification system for emerging coronavirus variants, to “prioritise global monitoring and research” and inform public health responses to the pandemic. They decided on two broad categories: Variants of Interest and Variants of Concern. For a while, the scientific names, which are strings of numbers, were used within this system, even among regular people. Remember hearing about B.1.1.7? It’s a mouthful. Many variants ended up with a moniker centered on where it was discovered: “the U.K. variant,” for example. But nicknaming viruses after where they were found can cast unfair stigma on a region (and may have been discouraging government officials from reporting the discovery of new variants).

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The WHO convened a group of researchers and nomenclature and virus taxonomic experts to come up with something easier for the public to use. In May, it announced it’d be issuing letters from the Greek alphabet as “simple, easy to say and remember” labels for COVID variants. (The number system is still in use among researchers.) All identified variants that earn a VOI or VOC designation get a Greek letter, though usually only variants that are identified as VOCs become well-known to the public. Alpha, beta, gamma, and delta are classified as VOCs, while their lesser-known cousins eta, iota, kappa, and lambda are all VOIs. Theta, zeta, and epsilon were once listed as VOIs but have been downgraded to the “alerts for further monitoring” category of variants, a category full of variants whose “epidemiological impact is unclear.” Members of this category are far enough away from the limelight that most variants in it just have numbers.

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But the Greek alphabet isn’t an entirely perfect naming system, even for its intended purpose of making concerning phenomenon easier for the public to discuss. Take it from the World Meteorological association, which turned to the Greek alphabet to name hurricanes during the 2020 season. The organization turned the Greek alphabet when they ran out of a prepared list of more typical hurricane names—Arthur, Bertha, Fay, et cetera— but quickly found it too confusing of a backup plan. It “got in the way” of helping the public identify and track them, says the New York Times. The letters were apparently confusing—especially ones that sound similar, like zeta, eta, and theta—and some of them proved difficult to translate into languages other than English, which makes spreading reliable information across communities difficult. It remains to be seen if variant names will end up colliding in this confusing way, too.

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Then there’s the fact that new variants keep emerging—and the Greek alphabet is finite. When a variant is eventually dubbed omega, what will its successor be named? (Despite the apparent popular belief that zeta is the last letter in the Greek alphabet, it’s actually omega.) The answer is vague: something from a new series of names, as WHO coronavirus lead Maria Van Kerkhove told Stat News. Before landing on the Greek alphabet, the organization’s expert panel had also considered drawing variant names from a list of portmanteaus or Greek gods/goddesses, but both ideas were nixed. The challenge is to create a system that is both accessible and easily adopted by the public while also avoiding words that would lead to stigmatization. Still, it’s proven difficult to create a naming system that has no risk of creating enemies: Delta airlines reportedly refuses to refer to the delta variant by name. Among employees, it is simply referred to as “the variant.”

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