Amid the constant flow of new findings, breaking news and widespread fear surrounding SARS-CoV-2, the virus that causes COVID-19, a flurry of vocabulary words has turned some important briefings into a dash to the dictionary. The difference between the terms may sound benign, but the implications could be life-altering for millions.
Terms such as lockdown and shelter-in-place incited fear after looking at the examples set by other countries such as China and Italy, after confusion temporarily surrounded the terminology of a pandemic earlier in the outbreak.
Citizens have been urged to practice social distancing while others have been put in quarantine and others yet have been isolated. What’s the difference?
A nurse puts on protective gear in the isolation area of Honved Hospital in Budapest, Hungary, Monday, March 16, 2020. All future inpatients and outpatients must go through a health screening, which consists of having their body temperature taken and filling in a medical questionnaire before they can enter the hospital to minimize the risk of transferring the novel coronavirus infection. (Zoltan Balogh/MTI via AP)
Further yet, knowing the meanings of values such as case fatality rate, mortality rate and attack rate can help you be better informed while knowing the difference between containment and mitigation can help you better understand policies.
Knowing the meanings of the different words and using the correct terms is important for individuals to be best informed and communicate effectively in this age of misinformation. Here is your guide:
The WHO says an epidemic can simply be defined as an occurrence of health-related events in a specific region that exceeds the normal expectancy. Because of the different factors surrounding population, previous experience, exposure, time and location (among many other variables), the number of cases needed to qualify for an epidemic varies.
Dr. Tedros Adhanom Ghebreyesus, Director General of the WHO, spent numerous weeks in February and early March saying COVID-19 had ‘pandemic potential’ but stopping short of using the official term before officially making the assessment on March 11.
A pandemic is recognized officially as a worldwide spread of a new disease. The recognition of COVID-19 as a pandemic was initially held up due to uncertainty surrounding the global scope of the virus’s impact. A pandemic refers to how many parts of the world deal with the rate of a disease and doesn’t say anything about the disease’s seriousness.
Tedros Adhanom, Director General of the World Health Organization, left, meets with Chinese President Xi Jinping before a meeting at the Great Hall of the People in Beijing, Tuesday, Jan. 28, 2020. (Naohiko Hatta/Pool Photo via AP)
There have been many different utilities of the word lockdown, but during the current coronavirus pandemic, the standard set by countries like China, Italy and France shows a lockdown as a government-imposed ban on any movement inside the country and the closing of all non-essential businesses. This month, police squads in Rome have checked citizens’ documents and imposed fines for individuals that did not have valid excuses, even those out on walks or seen taking pictures outside.
Prior to COVID-19, the term ‘Lockdown’ was used to respond to a threat such as a shooting or bombing while ‘Shelter-in-Place’ was used for environmental concerns such as hurricanes or chemical spills. Those differences have been muddied with the coronavirus.
California Gov. Gavin Newsom announced a shelter-in-place, or stay-at-home, order on March 19, mandating social distancing and enforcing home isolation. However, in media briefings, Newsom also said residents can still take walks and have restaurant meals delivered, urging people to use common sense. He also said he didn’t expect police presence and law enforcement to be necessary and instead relied on social pressure to enforce the severity of the order.
According to the WHO, the idea of flattening the curve is for collective action to be taken in order to slow the number of new cases. This is important in order to give people better access to proper care. Social distancing practices are intended to accomplish this and to slow transmission and spread the infections as thinly as possible over time so health systems can cope.
Illinois Gov. J.B. Pritzker listens to a question after announcing a shelter in place order to combat the spread of the Covid-19 virus, during a news conference Friday, March 20, 2020, in Chicago. (AP Photo/Charles Rex Arbogast)
While it is generally up to individual states and municipalities to determine what qualifies as an essential vs. nonessential business, the Department of Homeland Security issued a guidance on workers who are essential to infrastructure. Those businesses include grocery markets, pharmacies, convenience stores, sanitation services, healthcare operations, daycare centers, gas stations, banks, post offices and transportation services, among others.
Businesses that are recreational in nature are generally considered nonessential. These include theaters, gyms, museums, casinos, sports venues and others.
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Travel bans imposed by governments and businesses around the world have consistently touted the need to cut down on nonessential travel, whether it is by car or plane. The specifics of the definition can differ by organization. In order to keep faculty healthy, some universities like Colorado State have deemed essential travel to solely be travel that is required to preserve the safety or results of a research activity that cannot be postponed.
An MTA employee sanitizes surfaces at the Classon Ave. and Lafayette Ave. subway station with bleach solutions due to COVID-19 concerns, Friday, March 20, 2020, in the Brooklyn Borough in New York. New York Gov. Andrew Cuomo is ordering all workers in non-essential businesses to stay home and banning gatherings statewide. (AP Photo/John Minchillo)
People who are at risk of COVID-19 due to potential exposure are recommended by health experts to self-quarantine for at least 14 days in order to determine whether or not they will become ill and contagious. Self-quarantining involves staying at home at all times, not having visitors, staying at least 6 feet away from all people in your household and not sharing things like towels and utensils.
Self-isolation is necessary for individuals who have been confirmed to have COVID-19. Isolation is a health care term that means keeping infected people away from the uninfected.
Social distancing is deliberately increasing the physical space between people in order to avoid spreading illnesses. Also known as physically distancing, examples of social distancing practices include working from home, closing schools, canceling in-person meetings or hangouts and visiting others electronically rather than in person. In guidelines set by the Centers for Disease Control (CDC), social distancing means maintaining a distance of about 6 feet from others.
People stand spaced apart while waiting outside a Massachusetts Registry of Motor Vehicles location, Tuesday, March 24, 2020, in Boston. People observe social distancing out of concern about the spread of the coronavirus. (AP Photo/Steven Senne)
Case fatality rate (CFR), or the fatality ratio, is the proportion of people who died from a disease among the total infected population. It is different from mortality rate in that CFR only measures against the total infected number, where as mortality rate is the measure of deaths in a total population.
The attack rate is a helpful measurement to determine the frequency of deaths and the speed of spread in a specific population. In the United States, this has been helpful to examine which states have observed the quickest spread. It is calculated by the number of people infected by the total number of people at risk (or the total population of that specific area).
Containment is the effort by a community to determine who is infected and isolate them in order to contain the threat while keeping the healthy population separated.
United States Surgeon General Dr. Jerome Adams said on March 8 that the country was shifting from a containment strategy to a mitigation focus. A mitigation effort means that the focus is no longer solely on getting rid of the virus, but more so on limiting its effect and severity.
“Now we’re shifting into a mitigation phase, which means we’re helping communities understand, ‘You’re going to see more cases. Unfortunately, you’re going to see more deaths.’ But that doesn’t mean we should panic,” Adams told CNN.
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