The names for COVID variants are a confusing alphabet soup. Here's why it got so muddled

Last week, a COVID-19 variant known as FL.1.5.1 was responsible for an estimated 13% of infections, according to virus tracking data from the Centers for Disease Control and Prevention. But despite a surge in COVID-19 cases this summer that continues to rise as the school year starts, you may not have even heard of this variant. FL.1.5.1 is an alias for XBB.1.9.2.1.5.1, which descends from Omicron and is colloquially called Fornax. If you're confused about what this variant soup of names means and why you should care, you're not alone.

The World Health Organization (WHO) has criteria for determining which variants rise to a high enough threat level to warrant a Greek letter designation like Alpha, Delta or Omicron. Whether a variant rises to the level of a Greek letter designation or not, every variant gets a numeral name in the Pango naming system related to its genetic makeup, like XBB.1.5, which has driven the vast majority of infections in 2023 in the U.S.

The virus has mutated thousands of times and will continue to do so, but not every mutation is advantageous or makes things worse for humans. Only some strains transform in such a way that they become notably more infectious or problematic. Most fade away without doing much harm and some likely exist but aren't even on our radar.

In 2021, more than a dozen "variants of concern" or "variants of interest" were considered to pose enough of a threat to be assigned Greek letters. But no Greek letter designations have been given since Omicron was named in November 2021, partly because the WHO changed its designation system to no longer give letters to the lower severity classification, variants of interest.

"Since March 2023, WHO only gives names to new variants of concern," the WHO told Salon in an email. "This is true even if the new variant stems from Omicron."

Some scientists are calling for an updated naming system that lowers the bar for what the WHO considers a "variant of concern," so that we can move on from Omicron and get people, many of whom have checked out of the pandemic, to pay attention to it again, said Victoria Easton, Ph.D., a virologist at the University of Leeds. 

"If you just label it as Omicron, it's like this is unchanging, and it's kind of to be forgotten," Easton told Salon in a phone interview. "But it really shouldn't be, because it's still current."

Omicron has been the top-circulating family of COVID-19 variants since it came on the scene in 2021 and shows no signs of disappearing one and a half years after it was first identified. None of its mutations have been genetically different enough or spread enough severe illness to warrant moving on from Omicron to the next Greek letter, Pi, according to the WHO's system.

Yet some waves caused by different variants within Omicron were larger than other lineages that did get the Greek designation, including BA.2 and BA.5 in April and August 2022 respectively. Vaccines have had to be updated twice because Omicron variants have been so different, and 1,700 variants and recombinants have been discovered that all fall under the Omicron umbrella, said T. Ryan Gregory, Ph.D., an evolutionary and genome biologist at the University of Guelph in Canada.

"But [we] are not given a way to communicate clearly about variants now that the Greek letter system has become stuck on Omicron for nearly two years," Gregory told Salon in an email.

Because many Pango designations never make it to a degree of severity the WHO determines warrants a Greek letter, a group of virus trackers has come up with their own way of talking about variants, nicknaming the ones they think are most concerning with names like Fornax, which are based on astronomical objects. (Fornax is a constellation in the southern hemisphere.)

The fact that the current system is enough to make anyone's head spin gives the public a reason to ignore new variants, which can be harmful, Gregory said. The idea is to make the information on COVID variants more accessible so the public can engage with it.

"The fact that the only choices for communicating about a variant were to call it 'Omicron' (not very informative) or to use the technical name (not very accessible) meant that we needed to have something in between, similar to 'common names' in biology," Gregory said.

What he means is that if you had to identify which animal was going through your garbage, you'd call it a raccoon, rather than saying it was "a mammal" or Procyon lotor. 

"Same for variants," Gregory said. "We have the group name, 'Omicron,' and the technical species names (e.g., 'EG.5.1'), but we didn't have accessible common names."

On the other hand, public health systems have to balance keeping the public informed with overwhelming them with information. Pandemic fatigue is real, and when the emergency was declared "over," many people threw in the towel, stopped masking and tuned out. Sounding the alarm for every new variant that is detected could cause unnecessary anxiety. Plus, it's sort of like "crying wolf," said Jeremy Kamil, Ph.D., an associate professor of microbiology and immunology at Louisiana State University Health Shreveport. 

"What I really respect is that the WHO is being sort of thrifty about not burning its credibility," Kamil told Salon in a phone interview. "I'd rather have people complaining that we're not naming enough than that we're naming too many. It's like if you sound a fire alarm all the time, people will stop evacuating the building quickly."

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Although the severity of the pandemic is lower than it was in its earlier years, largely due to increased immunity and vaccines, that doesn't mean it has disappeared. As of Thursday, COVID data showed hospitalizations have increased by two-thirds across the country since June, though they are still about one-quarter of the levels recorded at the same time last year. Deaths are continuing to decrease, but the rate of infection is once again climbing, and recent variants like FL.1.5.1, along with EG.5 and BA2.86 are being monitored by the CDC. 

BA.2.86 caught virus hunters' attention because it is about as genetically different from Omicron as Omicron was from the original COVID strain first detected in Wuhan, China in late 2019. The WHO was quick to label it a "variant under monitoring," but because it has only been detected in very few cases (at least 13 cases in 7 countries), it hasn't yet reached the level of transmission that warrants a new Greek letter. Vaccine manufacturers have said vaccines coming out this fall will still work against BA.2.86, along with EG.5 and FL.1.5.1.

Of all the variants in circulation, BA.2.86 is a "clear candidate" for a Greek letter designation if it begins to spread widely — although it could also burn itself out like some prior strains that were also highly mutated, Kamil said. The next strain, if named Pi, could be something highly mutated like this, or something like Delta that had just enough mutations to escape the dominant antivirus responses that prevent the virus from infecting most of us, he added. 

"Until one of them packs a real punch to cause a seismic shift in the pandemic, maybe it doesn't need a Greek name," Kamil said. "I think you could debate either side and there's not necessarily a right answer."

It's unclear what the "next Omicron," will look like, but scientists agree it's probably only a matter of time before it does. And it's important for the public to be tuned in when that day comes.

"This virus is still a problem," Kamil said.