The future is always uncertain, but we’re living through an unusually tumultuous time. My last few posts have touched on this: applying a narrative where one doesn’t belong and appropriate capitalization of race terms.
In this post, I’m going to take a look at the use—or more accurately the misuse—of language to excuse, justify, and deny racism. Specifically, I’ll be discussing a cowardly construction in modern American English which has come to be called “the past exonerative tense.”
Language, like life, is full of little details that it’s better to get right than wrong.
One of my clients is a creative and talented person who I’ve worked with a number of times, and on a recent job I noticed an inconsistency in how he was (and I was) capitalizing a few terms. I’m not revealing anything proprietary here: part of the work involved a discussion of “Blacks” (or “blacks”) as a people, and while I thought I knew which way this one should go for consistency (and to follow current editing standards), I decided to hit the style guides and look for other opinions to see what the best practice recommendations are.
I began the process with a particular outcome in mind, but by the time I finished I had reversed my position. In fact, the arguments used and the general trend on this point thoroughly convinced me that one side of this style argument should be the standard. That appears to put me in opposition to most of the major style guides at this moment.
Here’s the “tl;dr” on whether you should capitalize Black and white when applied to racial or ethnic groups: capitalize Black, don’t capitalize white. Unless you want to be seen as dismissive of Blacks or a supporter of White supremacy.
Now, for the more detailed discussion of the issue, with many references for additional reading.
Let’s talk. I don’t usually get overly philosophical on this blog, but I think it’s time we have a chat about something. I’ll get to the details in a moment, but this is the main point: Life is not fiction. It does not have a narrative structure, a coherent plot, consistent characterization, or scripted villains and heroes. Most importantly, evildoers do not get their comeuppance and things don’t work out for the protagonist in the end.
You do yourself and all those around you a disservice by thinking this way and it’s high time someone figuratively slapped you across the face or shook some sense into you.
This list has been updated. Terms added (or expanded/modified): shedding, viral load, new normal, comorbidity, contributing factor, herd immunity, super-spreader, basic reproduction number, remdesivir, negative pressure/positive pressure, N95, filter types and ratings, wet market, bending the curve, ventilator.
I am presenting this as a repost to trigger notifications to subscribers who may have linked or shared to the earlier version. Full permission is given to share, link, or otherwise make this post available. Attribution is appreciated.
The short intro: In the current situation of global pandemic, it seems useful to collect as many related terms as possible in a single location, with clear and simplified definitions for non-specialists (I assume the specialists already know all of this). Any errors here are my own, and if you spot anything incorrect, please let me know. This will be updated as needed in the months ahead.
coronavirus – A family of viruses named for their crown(“corona”)-like structure of surface proteins. At least two dozen species are known. Some cause illness in humans, which can vary from common cold symptoms to dangerous respiratory infections. Most humans have been exposed to at least one coronavirus at some point in their lives.
COVID-19 – COronaVIrus Disease 2019. The disease caused by the SARS-CoV-2 virus.
SARS-CoV-2 – Severe acute respiratory syndrome coronavirus 2. The assigned name of the virus responsible for the current pandemic. Formerly “2019 novel coronavirus” or “2019-nCoV.” You might not encounter this term unless you’re digging deeper than typical media reports. It is often instead described as “the virus that causes COVID-19” or imprecisely as “the coronavirus.”
influenza (the flu) – Disease caused by the influenza virus. By most estimates, influenza infects several hundred million to more than one billion people each year. Worldwide, around three to five million are seriously affected and an estimated 300,000-650,000 die from the disease each year. A ballpark estimate of typical flu mortality is about 0.1% (about 1 person of every 1,000 infected will die). However, the flu virus is different every year and is sometimes much more deadly. Major pandemic flu outbreaks occur occasionally, resulting in many more deaths (1918: up to 100 million; 1957: 2 million; 1968: 1 million).
H1N1 – Influenza A virus subtype H1N1 (A/H1N1), the influenza variant responsible for a flu pandemic in 2009 and 2010, which caused around 580,000 deaths worldwide. Also known as “swine flu.” Both H1N1 and swine flu can refer to numerous disease variations. The 2009 H1N1 virus (“Pandemic H1N1/09”) has caused smaller outbreaks most years since, including one in India in February, 2020.
bird flu (H5N1) – An avian H5N1 influenza which has caused occasional outbreaks in humans. First identified in 1997, it is believed to have infected fewer than 1,000 people since (but has killed more than 450). It is highly contagious and deadly to birds. In humans it has not been highly contagious, but it is resistant to most treatments and has a high mortality rate, so it is viewed as a potential pandemic flu.
SARS – Severe acute respiratory syndrome, a disease caused by the SARS-CoV coronavirus (distinct from the SARS-CoV-2 virus). Between 2002 and 2004, the disease killed more than 8,000 people worldwide, most during an outbreak in Asia in the first half of 2003. The disease is believed to have originated in Guangdong province in China. No cases have been reported since 2004.
MERS – Middle east respiratory syndrome, a disease caused by the MERS-CoV coronavirus (also known as HCoV-EMC/2012). First identified in Saudi Arabia in 2012, the disease has caused more than 500 deaths worldwide since, the majority in Saudi Arabia. More than 200 cases were identified worldwide in 2019.
virus – A very simple form of life (some argue that viruses are not alive). Viruses infect other cells and use the existing machinery of those cells to produce more viruses, which then leave the cell and spread.
bacteria – Single-celled organisms. There are tens of thousands of known species and they outmass all other life on earth. Life on Earth as we know it can’t exist without them. Some are helpful (living on or in humans; used to make cheese or yogurt; etc.) but some species (estimated to be fewer than 100) cause disease (tuberculosis, cholera, bubonic plague, etc.). All bacterial illnesses combined probably kill more than 20 million worldwide each year.
Wuhan – 9th most populous city in China (approximately 11 million, 19 million in metro region; for US size comparison, this is similar to the New York City metropolitan region). Capital of Hubei province. City where the SARS-CoV-2 virus outbreak began.
Hubei – Province in central China; approximately 59 million total population. For a US size comparison, this is roughly the same as all of New England, New York, New Jersey, and Pennsylvania, combined.
wet market – A market that sells fresh (including live) meat and fish products, as well as produce and other perishable food items. Opposed to a dry market, which sells durable goods (usually non edibles). A better term might simply be “market” or “open-air market” or “traditional market.” While negatively associated with the current pandemic‘s purported origin in a Wuhan seafood market (now believed false), this kind of market can be found in most countries and has existed for most of human history. The term “wet market” is a retronym (that concept is explained here) and is fairly new; it was added to the OED only in 2016 with first use cited in 1978. Many calls have been made recently to shut down all wet markets worldwide, but these markets are still where much of the world does its food shopping.
WHO – World Health Organization. UN agency responsible for international public health. With broad responsibilities for many aspects of health and fewer than 10,000 full-time staff worldwide, the WHO often does not have the resources to be as effective as many people believe it is. It often fills more of an advisory, monitoring, and coordinating role.
CDC – Center for Disease Control and Prevention. The main US federal public health institute, within the Department of Health and Human Services. Their main focus is disease control and prevention (as the name would suggest).
NIH – National Institutes of Health. A US agency under the Department of Health and Human Services, with primary responsibility for biomedical and public health research.
NIAID – National Institute of Allergy and Infectious Disease. Part of NIH, NIAID conducts research in infectious, immunologic, and allergic diseases. It’s both a research agency and a funding agency for other research.
NHS – National Health Service. The publicly funded healthcare system in the United Kingdom.
PPE – Personal protective equipment. Broadly, any safety equipment meant to protect workers from injury or infection. It can apply to hazmat suits, fire fighter respirators, construction worker hardhats, etc. In the current context, PPE is anything used to protect health professionals or others from infection: face shields, N95 masks, latex gloves, and so on.
soap and water – What you should wash your hands with. Instructions are available in many places online. You should be doing this a lot: as soon as possible after contact with others or contact with surfaces touched by others where the virus might survive (shopping cart handles, gas pump nozzles, etc.). The reason this works is that soap can literally make the shell of many viruses—including SARS-CoV-2—dissolve, thus killing the organism. (I have seen only two handwashing boosters—the New York Times and Alton Brown—explain this effect, and if more people knew it they’d probably be better about their hand washing.) If you hadn’t been washing your hands regularly before this crisis…what’s wrong with you?
hand sanitizer – Alcohol-based liquid, gel, or foam used for hand cleaning. It is considered more effective than soap and water against many infectious agents (but less effective or ineffective against some, including norovirus and rabies). It is effective against coronaviruses. Previously, it had been recommended only when soap and water were not available, but it has become the preferred cleaner for many. Available formulations contain between 40% and 95% alcohol, with around 70% typical for retail varieties.
N95 – A common type of protective mask or respirator. Properly NIOSH N95 FFR: National Institute for Occupational Safety and Health N95 filtering facepiece respirator. An N95 device is capable of blocking at least 95% of very small particles, down to 0.3 microns. All N95 devices are meant for single-use only. N95 devices do not provide guaranteed protection—note that certification is at the 95% level. N95 devices are not effective when used by children or by adults with facial hair: the masks are sized for adults, and facial hair prevents a proper seal. Prior to this crisis, the majority of N95 devices were produced for construction and industrial use; if you’ve ever bought a package of masks from the hardware store when you needed to clean an attic or basement or for dusty yard work, they’re probably N95 rated. Standard surgical masks are not N95 devices: they do not filter out very small particles or provide a seal.
filter types and ratings – more information than most of us will ever need to know. NIOSH certifies filters with three letter ratings and three filtering levels, which combine for 9 different rating types: N95 is the lowest, P100 the highest.
N-class filters are not resistant to oil. R-class filters are oil-resistant. P-class filters are oil-proof (actually “strongly resistant” to oil). All these resistance ratings assume oily aerosols, not spills or other direct filter contact.
The filter levels are 95, 99, and 100 and describe the percent of particles which are blocked (100 is actually rated at the 99.97% level). The resistance ratings are all based on “worst case” tests. The time that a filter is effective is variable, from 3 minutes to 4 hours by standard regulations. The effective time varies by manufacturer and must be listed on each product. 3M, for instance, rates its R-class filters for 8 hours against oily mists, and its P-class filters for 40 hours.
social distance/social distancing – Recommended space to put between yourself and others to minimize contact and potential infection. By extension, the act of suspending normal social activity, due to this distance requirement. In common use, it’s the practice of effectively isolating oneself from others and suspending most normal social activity (see self-quarantine below). Previously, this term was mostly limited to anthropology and discussions of intimate space, personal space, social space, and public space, and described a literal distance measure, which was observed to be different across cultures. Social distance as currently practiced is an oxymoron, in that the two words are meant to mean essentially opposite things; you can’t conduct normal social activity at the distance we’re recommended to maintain.
quarantine – Isolating an infected individual or group from the general population to prevent further spread of a disease. Also isolating those potentially infected, until a specified period has elapsed, to confirm that they are infected or uninfected and prevent potential spread. Quarantine is usually an organized public health measure.
self-quarantine/self-isolation – Placing oneself in an isolated or restricted physical location to avoid contact with others, as a preventive measure when one has potentially been infected. Opposed to an actual quarantine, which is imposed on a person by an outsider. Self-quarantine is meant to limit the spread of disease by keeping an infected (or potentially infected) person away from others until their status is known and they have been treated (or shown to be uninfected). At this time, what a person describes as “self-quarantine” is just as likely to be “self-isolation,” which is done for the opposite reason: a (presumably uninfected) person isolates themselves to avoid contact with others and therefore avoid becoming infected. While the rationales are different, the practice is much the same and both can reduce the spread of a disease.
travel ban – Any measure meant to restrict potentially infected travelers from infecting others in a (presumably) non-infected location. Travel bans are considered to have some effectiveness in the early stages of an epidemic, and are best used in conjunction with quarantine measures. Travel bans also seem to be more effective when they prevent persons travelling from an infected area, rather than blocking travel to a location from other areas. Travel bans are generally considered ineffective during a pandemic, as the assumption is that most locations already have been infected by that time, whether or not the disease has yet been detected in a given location.
shelter-in-place (vs stay-at-home) order – Previously a measure invoked during major natural disasters (floods, hurricanes, blizzards) or during a terrorist attack. In a natural disaster, it’s meant to minimize risk to people by keeping them out of harm’s way while allowing maximum mobility for rescuers by keeping roads clear. In attack situations, it’s meant to minimize risk to a maximum number of people by reducing the number of people on roads, in public places, gathered at schools and other soft targets, etc. In the current crisis, shelter-in-place is effectively a type of large scale, distributed public quarantine, meant to limit the circulation of people (and therefore of infection) and the gathering of large numbers of people in single locations. This is not exactly the same as a stay-at-home order, but the end result is similar. These orders are often voluntary, or apply only to government workers or specific businesses or industries, although larger orders are now in effect in some places.
emergency declaration/state of emergency – Varies by city or state, but essentially allows the executive branch to take extraordinary measures not usually legally available to them. In Massachusetts, for example, by declaring a state of emergency the governor was able to suspend normal school attendance regulations, limit public gatherings, and stop all out-of-state travel by government employees, among other measures. These declarations are temporary in most cases, but can be extended. Their constitutionality and legality are often immediately challenged. Despite the ominous and authoritative tone used with such announcements, their enforcement would often be ineffective without voluntary acceptance by the majority of the population. The penalties for violating them are often relatively minor; in Massachusetts, the penalty for violating the directives of an emergency decree is currently a maximum of up to a year in jail and up to a $300 fine (unless the violation is an established crime with a separate statutory penalty).
essential business/essential employee – Those businesses, and their workers, deemed essential to the continuation of necessary services. The list varies by location and can be so broad as to include nearly any business that makes a good argument. This obviously includes hospitals, doctors, public safety officials, and so on. In Massachusetts, it also includes grocery store workers, garbage collectors, and auto repair shops (as it should). It also includes liquor stores, however, and one local bike shop was surprised when their town government declared them essential (the logic being that they provide service to bike commuters in the area, some of whom are essential employees, so servicing them is essential).
“flatten the curve” – sometimes also “bend the curve.” A phrase meant to describe how certain actions can change the way that a disease spreads, so that society (and especially the health care system), can better handle an epidemic. So named because measures such as quarantines, social distancing, travel bans, and improved hygiene are expected to change the course of an epidemic from an abrupt spike that overwhelms the system to a broader (“flatter”), more evenly-distributed mound (“curve”). Although this flatter curve runs out much longer (typically months instead of weeks), it often results in roughly the same amount of total infections. The critical expected difference is that by flattening the curve, the health care system will retain the capacity to treat most of the victims, thereby limiting the severity of many cases and reducing the overall fatality rate. The phrase is frequently misused by those who don’t understand the mechanisms or outcomes involved.
antibiotics – Drugs used to treat bacterial infections. Not all types work on all bacteria, and bacteria can develop resistance. Antibiotics are ineffective against viruses.
antivirals – Drugs used to treat viral infections. Antivirals act on different mechanisms; most are effective against only one or a few viruses but some act more broadly. They usually only reduce the length of an infection or reduce symptoms and are not used as preventatives.
vaccine – A vaccine is a substance used to immunize a person (or animal) against a disease by triggering an immune response (“teaching” the immune system to recognize an infection and attack it). Each vaccine targets a particular disease, which can be bacterial or viral. Some vaccines are more effective than others; seasonal flu vaccines vary greatly in effectiveness, for example. There is no vaccine for COVID-19 at this time.
tamiflu – Oseltamivir. An antiviral medication used against the flu. It is recommended for those at high risk of flu complications, to be taken within 48 hours of exposure. It is not generally administered as a preventative, but can be in some cases. Most flu strains to date have little or no resistance to tamiflu. Tamiflu has been suggested by some as a treatment for COVID-19, but this is not effective: it targets a specific molecule on the influenza virus which is not present on the SARS-CoV-2 virus.
ibuprofen – Advil or Motrin. An over-the-counter drug which reduces pain, fever, and inflammation. In mid March, the French Ministry of Health suggested that ibuprofen might make COVID-19 worse and warned to avoid it. This was based on the alleged experience of four patients (only one of which could later be identified as a real case). The idea was supported by weak and indirect speculation of which biological mechanisms might have made some early COVID-19 victims in China susceptible to the disease. These claims were unsupported by the evidence. After a day or two of confusion, WHO and most public health agencies clarified that use of ibuprofen is not a risk factor of COVID-19.
acetaminophen (paracetamol) – Tylenol. It’s used for pain, fever, and inflammation and can treat some COVID-19 symptoms, but is not a cure or a prophylactic.
chloroquine – Chloroquine is a cheap and effective drug used to treat malaria. It might have some effectiveness against SARS and chikungunya. It’s also used by some patients with rheumatoid arthritis and lupus. Preliminary research suggests that it might be effective against COVID-19. Hydroxychloroquine is a related drug with similar effects.
Favipiravir – Also Avigan. An antiviral drug developed in Japan. It has been approved for use there against influenza, but only under emergency conditions as it has some potentially dangerous side effects. It may also be effective against other viral diseases, including Ebola, Zika, and rabies. A limited study in patients infected with COVID-19 in China suggests that it could be effective against that disease as well.
remdesivir – an antiviral drug suggested as a possible preventative or treatment for COVID-19. Data on the value of the drug are limited. Prior to this pandemic, it had been shown to be effective in laboratory tests against other viruses but had not been approved for use. The hope for this drug stems from the fact that 7 critical patients were put on the drug and all survived the infection. It is unclear if the drug alone was responsible, or if it worked in combination with other treatments, or if this was a lucky coincidence, but more research is being done. The drug is only available in intravenous form and only in limited quantities—it had previously been made available only for several hundred patients involved in clinical trials—and should not be considered a reasonable treatment option at this time. Side effects of remdesivir are not known.
ventilator – Medical device used to mechanically breathe for a patient. A ventilator is not a treatment, merely a life-support measure. A ventilator usually operates as a positive pressure device to deliver air and then cycles to allow the patient to exhale normally, but ventilators can also exhale for a patient. Use of a ventilator carries an increased risk of pneumonia and other conditions.
intubate – Medical procedure to place a tube down a patient’s airway to allow a ventilator to operate.
extubate – Removal of a breathing tube from a patient.
negative pressure / positive pressure – you might occasionally encounter this during the discussion of medical treatments or the function of some masks. In a treatment context, and in simplest terms, negative pressure pushes in toward the user, positive pressure pushes out from the user. A positive pressure room continuously pumps air (usually filtered) away from the patient, usually someone with a compromised immune system. No germs enter this room, but they are pushed out. A negative pressure room allows outside air in, then filters it before returning it to the environment. Both can be considered “clean rooms” although in different ways. A negative pressure room is more appropriate for someone with a contagious disease. A positive pressure room is usually more appropriate for industrial clean room work.
When used to describe PPE, a negative pressure respirator is one that (usually) relies on the user’s own breathing to draw air in through the mask filter (this can also be done mechanically). Common N95-type masks are negative pressure. Positive pressure respirators supply internal pressure to the respirator and use some pump, fan, or self-contained gas supply to do this.
Extracorporeal membrane oxygenation (ECMO) – A medical device to help those with severe breathing problems stay alive. It gets oxygen into the body when the lungs can’t do the job. In a way, you can think of it as dialysis for the lungs. Dialysis acts as an external kidney, while ECMO acts like an external lung. Dialysis removes metabolic waste from blood; ECMO removes carbon dioxide and adds oxygen. This is meant as a temporary treatment for critical patients, and is not meant as a long-term or permanent solution. ECMO might be used when a normal ventilator is ineffective.
herd immunity – longstanding epidemiological concept which explains that if a large enough portion of a population is immune to a disease (inherently, by vaccination, or by previous exposure) this will prevent the majority of the population from falling ill if an outbreak occurs. The idea of herd immunity rose to prominence during this pandemic when British authorities briefly adopted it as their primary measure of control which would, in this case, have allowed the disease to run virtually unchecked through the population; it also assumed that the fatality rate would be extremely low (an uncertain assumption) and that being infected once would prevent future infections (not yet determined). The amount of exposure to achieve immunity to this disease is also not yet known (the UK projected 60%), making the plan even shakier. This plan was abandoned after only a few days. Sweden is the only country currently pursuing a herd immunity strategy, with more precautions than the UK proposed. This would still require allowing more than 6 million people to become infected and implies that in a best case scenario more than 6,000 would die (worst case: 200,000 or more). Whether this is a viable solution or foolishness is not yet clear.
epidemic – A rapid spread of disease to a large number of people in a small period of time. What qualifies as “rapid,” “large,” and “small” is different for different diseases.
pandemic – A large scale epidemic. The technical definition is fuzzy: the WHO no longer uses a strict definition. A pandemic is generally understood to be an epidemic of an infectious disease which crosses international boundaries or reaches multiple continents and affects a large number of people (or livestock). The WHO sometimes uses the phrase “global outbreak” as a condition when declaring a pandemic.
basic reproduction number (R0) – a measure of how well a disease spreads in the population. This number is used mostly for modelling and estimates, and should not be considered a reliable measure of how many people “will” catch a disease. In simple mathematical terms, infections with R0 greater than 1 are expected to spread but those with less than 1 are not expected to. The higher the number, the more a disease is expected to spread. COVID-19’s estimated R0 is still very broad: between 1.4 and 3.9. This partially explains the large spread of potential infections and fatalities given in most estimates. For comparison, flu strain R0 values vary from slightly less than 1 to nearly 3; the common cold has an estimated R0 of 2-3; chickenpox has an R0 of 10-12.
super-spreader (superspreader) – in the context of this pandemic, a super-spreader is an infected individual who infects a great many other people. For any disease, a basic reproduction number (R0) can be calculated which reveals the average number of other people that an infected individual will spread the disease to. Some small number of individuals (no more than 20%) cause far more infections than this; these are the super-spreaders. There is no specific qualification for a super-spreader: the number of infections varies by disease. For instance, for SARS a super-spreader is generally accepted to be a person who infected 8 or more others. A specific number has not been proposed for COVID-19. However, some super-spreader events are known: a preacher in India appears to have infected at least 19 others; an attorney in New York caused at least 20 other infections; an infected guest at a party in Connecticut may have infected several dozen people; a patient in South Korea potentially spread the infection to several hundred.
comorbidity – when two or more chronic diseases are present in a patient at the same time. If a person has, for instance, high blood pressure and diabetes, they are considered comorbidities. It can also apply to serious mental health issues, such as depression or social anxiety, or a combination of physical and mental health problems. In COVID-19 discussions, you might sometimes hear a health professional mention a greater risk of complications for those with comorbidities.
viral load – a measure of the amount of active virus in an infected individual. A higher viral load is generally assumed to mean a more severe infection and a greater chance of passing the disease to others. For a disease that has been studied very well for a long time, such as HIV/AIDS, viral load information is very useful. Useful viral load data for COVID-19 is not readily available at this time. It has been theorized that a relatively low viral load is enough to spread the disease, but preliminary research from both China and Italy found little or no difference in viral load between mild and severe cases. Recent observations during the US stage of the pandemic, however, suggest that the severity of the disease might be tied to viral load, and that a high viral load increases the potential for an infection to develop more quickly, to be more severe, and to be more likely to be fatal.
shedding – when an infected individual releases active viruses into the environment. This could be through one or more ways: expelling, exhalation, excreting, etc. The amount of virus shed can vary by a factor of one million from one infected individual to the next. The more virus shed, the more infectious an individual is likely to be. A person might be infected with a virus for some time before beginning to shed. Useful details on viral shedding for COVID-19 are not yet available. Shedding and viral load are related.
contributing factor – “something that helps cause a result – Merriam-Webster” In the current context, this is a frequently used term when discussing what else might cause a person to be infected by the disease, to experience more severe symptoms, or to be at greater risk of death. Age, existing illnesses, and gender have been noted as actual or potential contributing factors, among others. In discussing COVID-19-related fatalities, this point arises often: Was the disease itself responsible for a particular death? Or was it simply a contributing factor in speeding the death of an already-ill person? This might seem to be hairsplitting, but this becomes a concern when different health agencies and governments use different definitions when reporting fatalities. In previous disease outbreaks, there have been accusations of artificially reducing figures by not counting cases in which a victim was already affected by another condition.
existential threat – Term used to describe a threat so great that it could end the existence of the thing being threatened, usually a business, industry, state, society, species, or other large entity. Not usually appropriate when referring to the existence of an individual or small group. Nuclear war is often thought of as an existential threat; climate change is as well. The term is used both literally and metaphorically; for instance, bitcoin has frequently been described as an existential threat to physical currency, or to national central banks, or to the traditional economy; Amazon and online shopping have been tagged as existential threats to brick-and-mortar retailers; Uber and Lyft are an existential threat to public transportation systems, and so on.
This is an overused phrase much of the time, often coined when the simple single-word “threat” is more appropriate. COVID-19, however, might live up to the label.
14 days, 6 feet, etc. – Numbers. When it comes to recommendations about quarantine periods (10 or 14 days), social distancing (3 feet or 6 feet or 2 meters), and so on, people must keep in mind that these numbers are often either only a best guess . There is little hard data, for instance, to prove that 3 feet or 4 feet or 6 feet is the best social distance—but we can safely say that ‘farther is always better.’ At what distance is infection impossible? At what distance is the risk of infection 1% vs. 3% vs. 5%? Even when all the factors are known, who determines which combination of distance and level of risk are broadly acceptable? Judgement, estimation, and outright guesses are involved, as well as what leaders believe their people will tolerate. Recommendations related to time are often similarly unclear, and are based on best guesses from the available data. Why is 14 days used as a quarantine benchmark when some people show severe symptoms within two days of exposure? It’s the best (and safest) guess. Some people might become infectious more quickly than others, or remain infectious much longer. Most numbers used in discussions and directives during this crisis are not yet based on rigorous evidence, but rather a mix of incomplete current data and those practices which have previously been shown to be effective. They are usually pitched to err on the side of caution and improved public health.
new normal – a cliché phrase. This moment is not the “new normal.” As someone else accurately pointed out (I paraphrase): “This is not the new normal. We’re in the middle of a crisis. We won’t have any idea what the new normal is until this is all over.” [It is my opinion that anyone using this phrase to describe the current moment should be slapped upside the head and educated about their mistake (not necessarily in that order).]
covidiot – A derogatory term or insult. The meaning is still in flux, and seems to be used most commonly in one of two senses, both to describe an individual. One sense is of a person who ignores calls for social distancing and recklessly gathers with others in large numbers. The other sense is nearly the opposite: someone who unnecessarily hoards food, toilet paper, hand sanitizer, etc., or otherwise overreacts to health warnings, taking steps which might benefit that person personally (hoarding) but which are probably unnecessary and indirectly harm others. There are other ways this word has been used, but these are the most common.
There you have it at this time—April 3rd, 2020. Unlike most posts on this site, I plan to update this one as necessary: when I notice an important new term that should be here, I’ll add it. I expect there will be more new words and phrases over time, including entirely new coinages (such as “covidiot”). If you know of a term which should be added, leave a comment or send a note. If you notice some error in a definition, also note it. I am not an expert, I’m just trying my best. As I assume all of us are.
At this time it seems to me that while most of these terms will be with us for the duration of this crisis—whatever that duration might be—I don’t get the sense that many of them will continue in common use. They’ll all still be there in the literature and the historical record, of course, and the terms that came out of health care or research specialties will continue to be used there. But many of these terms will recede back into relative obscurity.
There’s one exception, though. “Flattening the curve” strikes me as having many of the ingredients necessary to establish itself. It was already in use in various technical specialties, but is now widely known. It’s just broad enough that people will be able to use it to describe many things in life, from an infection graph to a personal finance plan to a dieting dilemma. It has the potential to be adapted for use throughout the language, in all sorts of ways, predictable and unpredicted. The individual words even combine to create a nice cadence when spoken aloud, which gives it an edge over nearly every other term on this page. It will have a lot of competition when the end of 2020 rolls around, but I’m already putting it on my short list for Word of the Year.
I have occasionally taken the time to work up a page dedicated to related definitions (here, here, and here, to link a few). In the current situation of global pandemic, it seems useful to collect as many related terms as possible in a single location, with clear and simplified definitions for non-specialists (I assume those folks already know all of this). I’ve done that below. I’ve made an effort to keep all humor and politics out of this, and hope I’ve succeeded. Any errors here are my own, and if you spot anything incorrect, let me know. You can feel free to share this with others who might find it useful. This will be updated as needed in the months ahead.
coronavirus – A family of viruses named for their crown(“corona”)-like structure of surface proteins. At least two dozen species are known. Some cause illness in humans, which can vary from common cold symptoms to dangerous respiratory infections. Most humans have been exposed to at least one coronavirus at some point in their lives.
COVID-19 – COronaVIrus Disease 2019. The disease caused by the SARS-CoV-2 virus.
SARS-CoV-2 – Severe acute respiratory syndrome coronavirus 2. The assigned name of the virus responsible for the current pandemic. Formerly “2019 novel coronavirus” or “2019-nCoV.” You might not encounter this term unless you’re digging deeper than typical media reports. It is often instead described as “the virus that causes COVID-19” or imprecisely as “the coronavirus.”
influenza (the flu) – Disease caused by the influenza virus. By most estimates, influenza infects several hundred million to more than one billion people each year. Worldwide, around three to five million are seriously affected and an estimated 300,000-650,000 die from the disease each year. A ballpark estimate of typical flu mortality is about 0.1% (about 1 person of every 1,000 infected will die). Howver, the flu virus is different every year and is sometimes much more deadly. Major pandemic flu outbreaks occur occasionally, resulting in many more deaths (1918: up to 100 million; 1957: 2 million; 1968: 1 million).
H1N1 – Influenza A virus subtype H1N1 (A/H1N1), the influenza variant responsible for a flu pandemic in 2009 and 2010, which caused around 580,000 deaths worldwide. Also known as “swine flu.” Both H1N1 and swine flu can refer to numerous disease variations. The 2009 H1N1 virus (“Pandemic H1N1/09”) has caused smaller outbreaks most years since, including one in India in February, 2020.
bird flu (H5N1) – An avian H5N1 influenza which has caused occasional outbreaks in humans. First identified in 1997, it is believed to have infected fewer than 1,000 people since (but has killed more than 450). It is highly contagious and deadly to birds. In humans it has not been highly contagious, but it is resistant to most treatments and has a high mortality rate, so it is viewed as a potential pandemic flu.
SARS – Severe acute respiratory syndrome, a disease caused by the SARS-CoV coronavirus (distinct from the SARS-CoV-2 virus). Between 2002 and 2004, the disease killed more than 8,000 people worldwide, most during an outbreak in Asia in the first half of 2003. The disease is believed to have orignated in Guangdong province in China. No cases have been reported since 2004.
MERS – Middle east respiratory syndrome, a disease caused by the MERS-CoV coronavirus (also known as HCoV-EMC/2012). First identified in Saudi Arabia in 2012, the disease has caused more than 500 deaths worldwide since, the majority in Saudi Arabia. More than 200 cases were identified worldwide in 2019.
virus – A very simple form of life (some argue that viruses are not alive). Viruses infect other cells and use the existing machinery of those cells to produce more viruses, which then leave the cell and spread.
bacteria – Single-celled organisms. There are tens of thousands of known species and they outmass all other life on earth. Life on Earth as we know it can’t exist without them. Some are helpful (living on or in humans; used to make cheese or yogurt; etc.) but some species (estimated to be fewer than 100) cause disease (tuberculosis, cholera, bubonic plague, etc.). All bacterial illnesses combined probably kill more than 20 million worldwide each year.
Wuhan – 9th most populous city in China (approximately 11 million, 19 million in metro region; for US size comparison, this is similar to the New York City metropolitan region). Capital of Hubei province. City where the SARS-CoV-2 virus outbreak began.
Hubei – Province in central China; approximately 59 million total population. For a US size comparison, this is roughly the same as all of New England, New York, New Jersey, and Pennsylvania, combined.
wet market – A market that sells fresh (including live) meat and fish products, as well as produce and other perishable food items. Opposed to a dry market, which sells durable goods (usually non edibles). A better term might simply be “market” or “open-air market” or “traditional market.” While negatively associated with the current pandemic‘s purported origin in a Wuhan seafood market (now believed false), this kind of market can be found in most countries and has existed for most of human history. The term “wet market” is a retronym (that concept is explained here) and is fairly new; it was added to the OED only in 2016 with first use cited in 1978.
WHO – World Health Organization. UN agency responsible for international public health. With broad responsibilities for many aspects of health and fewer than 10,000 full-time staff worldwide, the WHO often does not have the resources to be as effective as many people believe it is. It often fills more of an advisory, monitoring, and coordinating role.
CDC – Center for Disease Control and Prevention. The main US federal public health institute, within the Department of Health and Human Services. Their main focus is disease control and prevention (as the name would suggest).
NIH – National Institutes of Health. A US agency under the Department of Health and Human Services, with primary responsibility for biomedical and public health research.
NIAID – National Institue of Allergy and Infectious Disease. Part of NIH, NIAID conducts research in infectious, immunologic, and allergic diseases. It’s both a research agency and a funding agency for other research.
NHS – National Health Service. The publicly funded healthcare system in the United Kingdom.
PPE – Personal protective equipment. Broadly, any safety equipment meant to protect workers from injury or infection. It can apply to hazmat suits, fire fighter respirators, constructon worker hardhats, etc. In the current context, PPE is anything used to protect health professionals or others from infection: face shields, N95 masks, latex gloves, and so on.
soap and water – What you should wash your hands with. Instructions are available in many places online. You should be doing this a lot: as soon as possible after contact with others or contact with surfaces touched by others where the virus might survive (shopping cart handles, gas pump nozzles, etc.). The reason this works is that soap can literally make the shell of many viruses—including SARS-CoV-2—dissolve, thus killing the organism. (I have seen only two handwashing boosters—the New York Times and Alton Brown—explain this effect, and if more people knew it they’d probably be better about their hand washing.) If you hadn’t been washing your hands regularly before this crisis…what’s wrong with you?
hand sanitizer – Alcohol-based liquid, gel, or foam used for hand cleaning. It is considered more effective than soap and water against many infectious agents (but less effective or ineffective against some, including norovirus and rabies). It is effective against coronaviruses. Previously, it had been recommended only when soap and water were not available, but it has become the preferred cleaner for many. Available formulations contain between 40% and 95% alcohol, with around 70% typical for retail varieties.
N95 – A common type of protective mask or respirator. Properly NIOSH N95 FFR: National Institute for Occupational Safety and Health N95 filtering facepiece respirator. An N95 device is capable of blocking at least 95% of very small particles, down to 0.3 microns. All N95 devices are meant for single-use only. N95 devices do not provide guaranteed protection—note that certification is at the 95% level. N95 devices are not effective when used by children or by adults with facial hair: the masks are sized for adults, and facial hair prevents a proper seal. Prior to this crisis, the majority of N95 devices were produced for construction and industrial use; if you’ve ever bought a package of masks from the hardware store when you needed to clean an attic or basement or for dusty yardwork, they’re probably N95 rated. Standard surgical masks are not N95 devices: they do not filter out very small particles or provide a seal.
social distance/social distancing – Recommended space to put between yourself and others to minimize contact and potential infection. By extension, the act of suspending normal social activity, due to this distance requirement. In common use, it’s the practice of effectively isolating oneself from others and suspending most normal social activity (see self-quarantine below). Previously, this term was mostly limited to anthropology and discussions of intimate space, personal space, social space, and public space, and described a literal distance measure, which was observed to be different across cultures. Social distance as currently practiced is an oxymoron, in that the two words are meant to mean essentially opposite things; you can’t be conduct normal social activity at the distance we’re recommended to maintain.
quarantine – Isolating an infected individual or group from the general population to prevent further spread of a disease. Also isolating those potentially infected, until a specified period has elapsed, to confirm that they are infected or uninfected and prevent potential spread. Quarantine is usually an organized public health measure.
self-quarantine/self-isolation – Placing oneself in an isolated or restricted physical location to avoid contact with others, as a preventive measure when one has potentially been infected. Opposed to an actual quarantine, which is imposed on a person by an outsider. Self-quarantine is meant to limit the spread of disease by keeping an infected (or potentially infected) person away from others until their status is known and they have been treated (or shown to be uninfected). At this time, what a person describes as “self-quarantine” is just as likely to be “self-isolation,” which is done for the opposite reason: a (presumably uninfected) person isolates themselves to avoid contact with others and therefore avoid becoming infected. While the rationales are different, the practice is much the same and both can reduce the spread of a disease.
travel ban – Any measure meant to restrict potentially infected travelers from infecting others in a (presumably) non-infected location. Travel bans are considered to have some effectiveness in the early stages of an epidemic, and are best used in conjunction with quarantine measures. Travel bans also seem to be more effective when they prevent persons travelling from an infected area, rather than blocking travel to a location from other areas. Travel bans are generally considered ineffective during a pandemic, as the assumption is that most locations already have been infected by that time, whether or not the disease has yet been detected in a given location.
shelter-in-place (vs stay-at-home) order – Previously a measure invoked during major natural disasters (floods, hurricanes, blizzards) or during a terrorist attack. In a natural disaster, it’s meant to minimize risk to people by keeping them out of harm’s way while allowing maximum mobility for rescuers by keeping roads clear. In attack situations, it’s meant to minimize risk to a maximum number of people by reducing the number of people on roads, in public places, gathered at schools and other soft targets, etc. In the current crisis, shelter-in-place is effectively a type of large scale, distributed public quarantine, meant to limit the circulation of people (and therefore of infection) and the gathering of large numbers of people in single locations. This is not exactly the same as a stay-at-home order, but the end result is similar. These orders are often voluntary, or apply only to government workers or specific businesses or industries, although larger orders are now in effect in some places.
emergency declaration/state of emergency – Varies by city or state, but essentially allows the executive branch to take extraordinary measures not usually legally available to them. In Massachusetts, for example, by declaring a state of emergency the governor was able to suspend normal school attendance regulations, limit public gatherings, and stop all out-of-state travel by government employees, among other measures. These declarations are temporary in most cases, but can be extended. Their constitutionality and legality are often immediately challenged. Despite the ominous and authoritative tone used with such announcements, their enforcement would often be ineffective without voluntary acceptance by the majority of the population. The penalties for violating them are often relatively minor; in Massachusetts, the penalty for violating the directives of an emergency decree is currently a maximum of up to a year in jail and up to a $300 fine (unless the violation is an established crime with a separate statutory penalty).
essential business/essential employee – Those business, and their workers, deemed essential to the continuation of necessary services. The list varies by location and can be so broad as to include nearly any business that makes a good argument. This obviously includes hospitals, doctors, public safety officials, and so on. In Massachusetts, it also includes grocery store workers, garbage collectors, and auto repair shops (as it should). It also includes liquor stores, however, and one local bike shop was surprised when their town government declared them essential (the logic being that they provide service to bike commuters in the area, some of whom are essential employees, so servicing them is essential).
“flatten the curve” – A phrase meant to describe how certain actions can change the way that a disease spreads, so that society (and especially the health care system), can better handle an epidemic. So named because measures such as quarantines, social distancing, travel bans, and improved hygiene are expected to change the course of an epidemic from an abrupt spike that overwhelms the system to a broader (“flatter”), more evenly-distributed mound (“curve”). Although this flatter curve runs out much longer (typically months instead of weeks), it often results in roughly the same amount of total infections. The critical expected difference is that by flattening the curve, the health care system will retain the capacity to treat most of the victims, thereby limiting the severity of many cases and reducing the overall fatality rate. The phrase is frequently misused, or invoked as a sort of mantra of salvation by those who don’t understand the mechanisms or outcomes involved.
antibiotics – Drugs used to treat bacterial infections. Not all types work on all bacteria, and bacteria can develop resistance. Antibiotics are ineffective against viruses.
antivirals – Drugs used to treat viral infections. Antivirals act on different mechanisms; most are effective against only one or a few viruses but some act more broadly. They usually only reduce the length of an infection or reduce symptoms and are not used as preventatives.
vaccine – A vaccine is a substance used to immunize a person (or animal) against a disease by triggering an immune response (“teaching” the immune system to recognize an infection and attack it). Each vaccine targets a particular disease, which can be bacterial or viral. Some vaccines are more effective than others; seasonal flu vaccines vary greatly in effectiveness, for example. There is no vaccine for COVID-19 at this time.
tamiflu – Oseltamivir. An antiviral medication used against the flu. It is recommended for those at high risk of flu complications, to be taken within 48 hours of exposure. It is not generally administered as a preventative, but can be in some cases. Most flu strains to date have little or no resistance to tamiflu. Tamiflu has been suggested by some as a treatment for COVID-19, but this is not effective: it targets a specific molecule on the influenza virus which is not present on the SARS-CoV-2 virus.
ibuprofen – Advil or Motrin. An over-the-counter drug which reduces pain, fever, and inflammation. In mid March, the French Ministry of Health suggested that ibuprofen might make COVID-19 worse and warned to avoid it. This was based on the alleged experience of four patients (only one of which could later be identified as a real case). The idea was supported by weak and indirect speculation of which biological mechanisms might have made some early COVID-19 victims in China susceptible to the disease. These claims were unsupported by the evidence. After a day or two of confusion, WHO and most public health agencies clarified that use of ibuprofen is not a risk factor of COVID-19.
acetaminophen (paracetamol) – Tylenol. It’s used for pain, fever, and inflammation and can treat some COVID-19 symptoms, but is not a cure or a prophylactic.
chloroquine – Chloroquine is a cheap and effective drug used to treat malaria. It might have some effectiveness against SARS and chikungunya. It’s also used by some patients with rheumatoid arthritis and lupus. Preliminary research suggests that it might be effective against COVID-19. Hydroxycholoquine is a related drug with similar effects.
Favipiravir – Also Avigan. An antiviral drug developed in Japan. It has been approved for use there against influenza, but only under emergency conditions as it has some potentially dangerous side effects. It may also be effective against other viral diseases, including Ebola, Zika, and rabies. A limited study in patients infected with COVID-19 in China suggests that it could be effective against that disease as well.
ventilator – Medical device used to breathe for a patient.
intubate – Medical procedure to place a tube down a patient’s airway to allow a ventilator to operate.
extubate – Removal of a breathing tube from a patient.
Extracorporeal membrane oxygenation (ECMO) – A medical device to help those with severe breathing problems stay alive. It gets oxygen into the body when the lungs can’t do the job. In a way, you can think of it as dialysis for the lungs. Dialysis acts as an external kidney, while ECMO acts like an external lung. Dialysis removes metabolic waste from blood; ECMO removes carbon dioxide and adds oxygen. This is meant as a temporary treatment for critical patients, and is not meant as a long-term or permanent solution. ECMO might be used when a normal ventilator is ineffective.
epidemic – A rapid spread of disease to a large number of people in a small period of time. What qualifies as “rapid,” “large,” and “small” is different for different diseases.
pandemic – A largescale epidemic. The technical definition is fuzzy: the WHO no longer uses a strict definition. A pandemic is generally understood to be an epidemic of an infectious disease which crosses international boundaries or reaches multiple continents and affects a large number of people (or livestock). The WHO sometimes uses the phrase “global outbreak” as a condition when declaring a pandemic.
existential threat – Term used to describe a threat so great that it could end the existence of the thing being threatened, usually a business, industry, state, society, species, or other large entity. Not usually appropriate when referring to the existence of an individual or small group. Nuclear war is often thought of as an existential threat; climate change is as well. The term is used both literally and metaphorically; for instance, bitcoin has frequently been described as an existential threat to physical currency, or to national central banks, or to the traditional economy; Amazon and online shopping have been tagged as existential threats to brick-and-mortar retailers; Uber and Lyft are an existential threat to public transportation systems, and so on.
This is an overused phrase much of the time, often coined when the simple single-word “threat” is more appropriate. COVID-19, however, might live up to the label.
14 days, 6 feet, etc. – Numbers. When it comes to recommendations about quarantine periods (10 or 14 days), social distancing (3 feet or 6 feet or 2 meters), and so on, people must keep in mind that these numbers are often either only a best guess or they are arbitrary. There is little or no data, for instance, to prove that 3 feet or 4 feet or 6 feet is the best social distance—we can only safely say that ‘farther is better.’ At what distance is infection impossible? At what distance is the risk of infection 1% vs. 3% vs. 5%? Even when all the factors are known, who determines which combination of distance and level of risk are broadly acceptable? Judgement, estimation, and outright guesses are involved, as well as what leaders believe their people will tolerate. Recommendations related to time are often similarly unclear, and are based on best guesses from the available data. Why is 14 days used as a quarantine benchmark when some people show severe symptoms within two days of exposure? Some people might become infectious more quickly than others, or remain infectious much longer. Most numbers used in discussions and directives during this crisis are not yet based on rigorous evidence, but rather a mix of incomplete current data and those practices which have previously been shown to be effective. They are usually pitched to err on the side of caution and improved public health.
covidiot – A derogatory term or insult. The meaning is still in flux, and seems to be used most commonly in one of two senses, both to describe an individual. One sense is of a person who ignores calls for social distancing and recklessly gathers with others in large numbers, often publicly. The other sense is nearly the opposite: someone who unnecessarily hoards food, toilet paper, hand sanitizer, etc., or otherwise overreacts to health warnings, taking steps which might benefit that person personally (hoarding) but which are probably unnecessary and indirectly harm others. There are other ways this word has been used, but these are the most common.
There you have it at this time—March 26th, 2020. Unlike most posts on this site, I plan to update this one as necessary: when I notice an important new term that should be here, I’ll add it. I expect there will be more new words and phrases over time, including entirely new coinages (such as “covidiot”). If you know of a term which should be added, leave a comment or send a note. If you notice some error in a definition, also note it. I am not an expert, I’m just trying my best. As I assume all of us are.
At this time it seems to me that while most of these terms will be with us for the duration of this crisis—whatever that duration might be—I don’t get the sense that many of them will continue in common use. They’ll all still be there in the literature and the historical record, of course, and the terms that came out of health care or research specialties will continue to be used there. But many of these terms will recede back into relative obscurity.
There’s one exception, though. “Flattening the curve” strikes me as having many of the ingredients necessary to establish itself. It’s just broad enough that people will be able to use it to describe many things in life, from an infection graph to a personal finance plan to a dieting dilemma. It has the potential to be adapted for use throughout the language, in all sorts of ways, predictable and unpredicted. The individual words even combine to create a nice cadence when spoken aloud, which gives it an edge over nearly every other term on this page. It will have a lot of competition when the end of 2020 rolls around, but I’m already putting it on my short list for Word of the Year.
