The World Health Organization (WHO) is to rethink the way it classifies and describes international epidemics after continued backlash over its decision to call the new coronavirus outbreak a pandemic. WHO Director General Tedros A. Ghebreyesus has publicly signaled support for a more nuanced approach, saying the current system of declaring a public health emergency is too blunt.

“There could be some intermediate situation, not just yes (red) or no (green),” Tedros said. He suggested a warning (yellow) stage to describe a public health emergency – something “serious enough but not really red.”

Geneva-based WHO remains in discussion whether to use a more graded approach to capture different levels of severity, rather than binary terminology, with regards to how it communicates its risk assessment of disease outbreaks in the future. This includes use of the term pandemic as well as PHEIC (public health emergency of international concern) declarations.

The WHO’s emergency committee on the new coronavirus, which is made up of independent experts, recommended that the agency “continue to explore the advisability of creating an intermediate level of alert” between PHEIC or no PHEIC. Such measures would enable the WHO to dial up the severity of its messaging to prompt global cooperation on issues such as funding and drug development across the public health/scientific community, without raising unnecessary public alarm.

The WHO has declared PHEICs on five occasions in the past, including the West Africa Ebola outbreak in 2014 and the Brazil Zika virus outbreak in 2016. A PHEIC is declared when an outbreak poses a risk to more than one country and requires a coordinated international response, including calls for increased funding and resources, recommendations to countries aimed at preventing or reducing cross-border spread of disease and boosting public health measures.

While the characterisation of COVID-19 as a pandemic does not trigger any formal change in what the WHO does or recommends countries to do, some public health experts said it might prompt governments to move more swiftly to make interventions, such as banning social gatherings or travel. The agency was nevertheless concerned about “the alarming levels of spread and severity” of the new coronavirus, which emerged in December last year. Now known to cause the infectious respiratory disease COVID-19, the virus has spread from China to more than 100 countries and infected over 156,400 people. COVID-19 has claimed at least 5,800 lives already and more are expected to die from the virus.

Despite the figures, there is a key part of the WHO’s message when it did ultimately call COVID-19 a pandemic, “We cannot say this loudly, clearly, or often enough: all countries can still change the course of this pandemic. This is the first pandemic that can be controlled,” Tedros reminded.