Covid-19 Vocabulary: Know your terms!
With much of human civilizations stuck at home in the wake of the pandemic caused by a novel coronavirus, the only news to report in most countries is that of how various countries are handling this crisis. This crisis has brought to light the importance of the health-care sector of our country as well as how such crises are covered by the media. In this age of social media, we have faster means to spread information as well as a large audience to assimilate the various developments across the globe (checkmate, Flat Earthers!).
So it is more important that we are able to understand the various scientific and other terms being bandied about in conversations, social media posts or mainstream media coverage. Whilst some differences are semantic or probably pedantic in nature, we need to understand the significance of each term. Let us explore the key differences we need to remember whilst understanding all the information bombarded at us:
Coronavirus or Covid-19?
Because of how things were initially reported, people often confuse the two terms and use it interchangeably. While at this point, there is not much difference in referring to the same thing, the fact is coronavirus is not a disease or a virus; it is a family of viruses that can cause different types of ailments, from very mild to highly severe. The name actually comes from the Latin word “corona”, which means “crown” or “halo”, and refers to the shape of the virus particle when viewed under a microscope.
So coronaviruses have actually been present in the past: the 2003 SARS outbreak in China (Severe Acute Respiratory Syndrome) and the 2015 MERS outbreak in South Korea (Middle East Respiratory Syndrome) which had lethal effects were the results of coronaviruses as well ( SARS-CoV-1 and MERS-CoV respectively). There are mild common colds caused by coronaviruses as well which quite a few have experienced and quickly recovered as well. Coronaviruses are most often caused by the animal to human transmissions and most of the symptoms are related to the respiratory system from common colds and coughs to pneumonia and SARS.
The particular virus that emerged in late 2019 is a novel or new coronavirus which we or our immunity systems have not seen before. It is related to the virus that caused the SARS outbreak in 2003. The term Covid-19 is a shortened form of COrona VIrus Disease- 2019 (year of origin) and not ‘Chinese Outbreak Virus In December- 2019’ as many would have seen in WhatsApp forwards (although you got to give props to whoever came up with that!)
So just remember: coronavirus is the family of viruses of which SARS-Cov-2 is the one that has caused Covid-19. Although the WHO are reluctant to use the virus name as it is because people might associate it with the virus SARS-Cov-1 which caused the 2003 outbreak.
Pandemic vs Epidemic
It is one of the most common mistakes to confuse the two, but make no mistake, these two are different and it can lead to major consequences:
EPIDEMIC is a disease that affects a large number of people within a community, population, or region.
PANDEMIC is an epidemic that’s spread over multiple countries or continents.
Also….
ENDEMIC is something that belongs to a particular people or country.
OUTBREAK is a greater-than-anticipated increase in the number of endemic cases. It can also be a single case in a new area. If it’s not quickly controlled, an outbreak can become an epidemic. [Source]
The usage of these terms should be taken care of, especially when you get yourself insured. The organizers of the annual Wimbledon Grand Slam (Tennis) cashed out 141 million USD having paid 2 million a year for almost two decades (specifically for a pandemic) after one of the ball-boys was found to have SARS virus in 2003. Many companies lost out on insurance claims as they did not specify pandemic as an event which would affect their productivity, with insurance companies invoking ‘Force De Majeure’ to avoid having to pay out all the companies rendering these insurers broke (fun fact: insurance companies also insure themselves in the event of paying out a major sum on a less likely event, ensuring that losses in the insurance industry are spread out amongst the companies).
R0
Another term which has entered the mainstream conscious, yet something that might not give us a clear picture of the developing disease. This is considered a measure for how infective a disease is. Pronounced as ‘R naught’, R0 tells you the average number of people who will catch a disease from one contagious person. It specifically applies to a population of people who were previously free of infection and haven’t been vaccinated.
Ideally you do not want a value greater than one for a disease, as a value of one or less implies the disease will not spread as much as it would when the value is greater than one. The calculation of R0 depends on infective period (time during which someone can transmit the disease), contact rate (which can be highly reduced with quarantine and social distancing) and mode of transmission.
Due to these factors, there is no universal value of R0 for this disease (which probably can only be determined after the whole pandemic has run it’s course). Yet it is not unreasonable to conclude that the value will definitely be greater than one, with concerns it could be as high as 6. With asymptomatic transmission and a high rate of infectivity, there are concerns that the actual number of patients are much higher than currently reported in many places.
Air Borne vs Aerosolised Transmission
People think of air borne transmission and immediately think the wind can carry the virus over to places abound. But that’s not exactly what it means: both terms are similar yet there are some key differences: droplet transmission happens mainly through coughs and sneezes and in most cases the gravitational forces carry the droplets downwards and it does not persist for long due to it’s relative heaviness. On the other hand, air transmissions refers to the persistence of smaller particles in the air for a duration of time before it dies out. Yet we must remember the number of viruses in the air decreases exponentially with time, so the viral load might not be sufficient for one to have the virus. For more details, WHO has published an article explaining the current understandings in more detail.
Pangolins
As coronaviruses are caused by the animal to human transmission and the first major outbreak happened in the city of Wuhan in the Hubei province, many suspected that the transmission to humans would have happened at the Wuhan wet market, where various products from vegetables to meat to even more exotic produce (compared to the rest of the world) like bats are sold. The 2003 SARS pandemic also had its origins at a wet market. Many would automatically suggest bats as a source as they are known to have viruses that would overwhelm the human immune system. But more recent analysis suggests that the bats transmitted it to pangolins who then transmitted it to humans.
Though many think of them as reptiles, pangolins are actually mammals. They are the only mammals wholly-covered in scales and they use those scales to protect themselves from predators in the wild. If under threat, a pangolin will immediately curl into a tight ball and will use their sharp-scaled tails to defend themselves. Pangolins are in high demand in countries like China and Vietnam. Their meat is considered a delicacy and pangolin scales are used in traditional medicine and folk remedies. All eight pangolin species are protected under national and international laws. But there is still growing international illegal trade in pangolins. [Source]
With reports that lions and tigers have developed symptoms of Covid-19 after contact with asymptomatic zookeepers in New York, it is clear that even animals have to maintain social distancing (just as we know what it’s like to be cooped up and not allowed to go away like zoo animals!)
Asymptomatic or Presymptomatic?
With the novel coronavirus being studied rigorously and it being a new one, there is a bit of confusion of how infective and lethal the virus can be. Some suggest that a lot more people have been infected with the virus and may never show symptoms of the virus. This condition is said to be asymptomatic and such people can still act as ‘silent spreaders’ of the disease. This word is not to be confused with the mathematical term ‘asymptote’ which refers to a type of graphical curve.
The word asymptomatic gives a false sense of notion, however, that many people will never have it. There is a chance that the infection doesn’t spread at all, but symptoms can develop in humans within 1–14 days of incubation (time from entering the human system to causing symptoms). Some patients have also developed symptoms as late as 24 days from getting the virus. That phase is when people are presymptomatic ( of-course we only determine that once the person displays symptoms).
Scanning vs Testing
In the initial stages of the virus spread, in most countries, most of the containment efforts were limited to simply having the passengers from abroad pass through a thermal scanner to check for abnormal temperature. These people were not tested, but rather they just checked for obvious symptoms of the disease like a high fever. But we later found out that even asymptomatic cases can transmit the disease too.
Testing is different in that it checks for the presence of the virus in the patient regardless of the symptoms displayed by the person. Many testing methodologies have been developed and most of them analyse nasal (nose) or throat swabs of the patients to detect the virus. Test results can vary from a few hours to a couple of days depending on the test used. Many countries are looking to acquire rapid testing kits which can give outcomes of the test faster.
Efficacy, Specificity and Sensitivity
Yet with testing, there are some measures used to determine whether a test should be deployed on a massive scale:
Sensitivity (also called the true positive rate, the recall, or probability of detection in some fields) measures the proportion of actual positives that are correctly identified as such (e.g., the percentage of sick people who are correctly identified as having the condition).
Specificity (also called the true negative rate) measures the proportion of actual negatives that are correctly identified as such (e.g., the percentage of healthy people who are correctly identified as not having the condition).
Note that the terms “positive” and “negative” don’t refer to the value of the condition of interest, but to its presence or absence; the condition itself could be a disease, so that “positive” might mean “diseased”, while “negative” might mean “healthy”. [Source]
Well, just goes to show sometimes negative tests are good!
Another term used in reports is the word efficacy: it is not used in the context of testing, but with regards to the various treatments used for the disease. It is defined as the ability of a product or treatment to provide a beneficial effect.
Flattening the Curve
The reason lockdowns and restrictions are being implemented world-wide isn’t neccesarily to minimize the spread of the virus (because of potential future waves) but rather to ease the load on the hospitals and health centers of the country.
This is a commonly shown graph explaining how we cannot over run the health system of our country. There is only so much resources (doctors, nurses, medical practitioners, ventilators, masks and others) that we can procure. Once that threshold is crossed, we will reach a stage like in Italy where doctors will have to make decisions on whose lives are worth saving, referred to as triage. It is something that no medical practitioner wishes to do, yet in such situation they are left with little choice but to pull the plug off people on ventilators to save others. To avoid that we must take measures such that this and medical professionals losing their lives to the diseases does not happen.
Different Types of Masks
The question of whether to wear a mask or not is still a burning question. On one hand, concerns about the virus persisting in air creates the instinct within people that they need to hoard masks. On the other hand, we have frontline medical professionals using makeshift masks in the absence of medically approved ones.
But now more people are being encouraged to make cloth based home-made masks. Whilst it doesn’t provide full protection, with the virus having a diameter of 100nm (less than the spectrum of light visible to humans and easily passing through cloth), it is better than nothing.
We also have surgical masks which are disposable, loose-fitting face masks that cover your nose, mouth, and chin. They’re typically used to protect the wearer from sprays, splashes, and large-particle droplets and prevent the spread of potentially infectious respiratory secretions from the wearer to others.
The most talked about one is N-95 masks. It is highly effective in filtering out more than 95 percent of any bacterial or viral matter. But it is highly dependent on face shape and requires some level of customisation and supervision to be used to it’s full potential.
Isolation vs Quarantine
Another set of terms which can be easily mixed up: but remembering the difference is pretty simple: if you are not infected and asked to stay home to avoid contracting the virus or in case you are suspected to have the virus, you are quarantined. Most people are home quarantined, that is, asked to stay home.
Isolation, on the other hand, means that a patient who has the virus is referred to a special facility and separated from the general population.
Here is something to know a bit more about this difference:
https://www.cdc.gov/quarantine/quarantineisolation.html
Social distancing is another popular term which is used and is basically a protocol people have to follow in order to minimize the risk of being infected. This includes avoiding groups and maintaining a distance of 1–2 m between people (which is difficult in high-density areas).
Active and Recovered
When a person has tested positive for the Covid-19 virus, the person is considered an active case and depending on the severity of the virus, will be receiving treatments for the same. Once a patient has tested negative twice having contracted the virus, the patient is considered as a recovered one. With that being said, sometimes even two negative tests is not a fool-proof guarantee of full recovery, with 91 cases in South Korea having tested positive after two negative tests (although it is expected that even two negatives can give a false result, considering this has happened after hundreds of thousands of cases).
Vaccines, Antibodies and Treatments
The resolution to this health crisis, based on history and other studies, would be in the following scenarios:
1.Herd Immunity: This refers to when enough of the population in a region or country has been infected by the virus such that in the near to distant future, the coronavirus has no new host to reside in because the host has acquired immunity and has developed antibodies to fight the virus, meaning the spread of the disease is very much diminished. The risk is of course that there is a cost to be paid in terms of the death toll. Sweden and the United Kingdom are examples of nations who have gone with that approach, with the latter backing out after realizing the number of patients to be hospitalized cannot be handled in order to continue with this strategy (the strategy was devised in response to a disease assuming that the infectivity and lethality of the disease would be similar to the 2009 Swine Flu pandemic).
2. Treatment: Despite what the United States President Donald Trump has repeatedly claimed, there is no magic drug that can cure all cases of Covid-19. While some studies have shown that hydroxychloroquine (sold in the United States as Plaquenil) has had positive effects on those who have severe symptoms, it remains to be seen whether this can be scaled to all patients. The anti-malarial drug works by taming the over-active immune system (where the immune system starts attacking the healthy cells in a bid to kill the virus and causes damage to the body). There is also the side-effect of the drug that can cause heart rhythm problems, severely low blood pressure and muscle or nerve damage. So the usage of this particular drug is on a case-by-case basis depending on patient history. Other solutions or forms include:
a. Cocktail of Anti-Viral drugs: Various pre-existing and approved anti-viral drugs are used in various forms. One such example from Thailand:
The doctors combined the anti-flu drug oseltamivir with lopinavir and ritonavir, antivirals used to treat HIV, Kriengsak said, adding the ministry was awaiting research results to prove the findings.[Source]
b. Plasma treatment: The treatment injects antibody-rich plasma from people who have recovered from the novel coronavirus into people who have severe cases of COVID-19, the disease caused by the virus. Antibodies are proteins in blood that fight specific bacteria and viruses.
c. New drugs are also being developed to specifically deal with the virus and makes use of the genomic sequence of the virus to generate an antidote for the same. However these will take longer to develop and scale, with tests needed to see if it works and without side-effects. Many countries have research labs dedicated for the development of the same.
3.Vaccines: Eventually we need some form of resistance to fight off the virus, and this is where vaccines come in. The pandemic has led to record fast development of vaccines from understanding the virus to developing a form which can be tested on humans. Some of them have bypassed animal testing which is a standard procedure in most cases and Bill Gates has put in billions of dollars on seven different vaccines. Yet an approved vaccine is months away because we need to test whether it produces antibodies within those tested, how long will this immunity last and whether there are any side effects to this. The question is whether herd immunity would have been achieved by the time we deploy this vaccine to the masses (also the vaccine needs to be scaled for billions of people).
Recession vs Depression
Many national economies have been damaged due to the restricted movement of people and goods as a result of enforcement of large scale lockdowns, prompting suggestions that the on-going economic slowdown will be further accelerated. The question is whether this will be a shorter-term one like a recession or something that has an impact for years to come.
A recession is widespread economic decline that lasts for at least six months (two quarters). A depression is a more severe decline that lasts for several years. For example, a recession lasts for 18 months, while the most recent depression lasted for a decade.
There have been 33 recessions since 1854. There’s only been one depression since then, the Great Depression of 1929. It was actually a combination of the recession that lasted from August 1929 to March 1933, and the one from May 1937 to June 1938. [Source]
Either way, we have seen many layoffs, cancelled jobs and many people face an uncertain immediate future. Prayers to everyone who has had difficulties and let us hope they can overcome the crisis.
Universal Basic Income vs Emergency Payouts
Finally, with many having lost their jobs or sources of income as a result of the lack of activity in the economy, one of the ideas that for long has been seen as a utopian dream is now discussed in the mainstream. The idea of people having a fixed income paid for by the government which can be used to buy products and keep the economy running has been proposed by a few, and arguably brought to the mainstream in recent times by the ex-Democratic Presidential candidate Andrew Yang.
While there is bipartisan support for a one-time payout to the public who have severely been affected in the US, there is not much support to make this a full-time scheme. But some countries like Spain are considering that. With automation potentially having the ability to severely reduce the number of manufacturing jobs and beyond, UBI is something that more governments will need to consider in the automated future.
To conclude, let us appreciate the role of everyone who has worked a day in and out to ensure the outbreak does not have more damage on us: from doctors, health workers, nurses and medical professionals acting as the first line of defence against the virus, essential workers like the sanitation workers, grocery store workers and transporters of essential goods to those enforcing lockdowns (yes, not everyone in the police are evil and they spend their time having to enforce laws). Let us also acknowledge the work done by people in debunking false theories and preventing the spread of wrong information.
The times might seem desperate and we might have the feeling of hopelessness, but humans have never been more prepared to tackle a virus as we are today. So let the experts do what it takes to ensure we get through this crisis stronger and humanity emerges stronger from this.
Finally, for those who have lost hope in humanity and need a dose of good news, here is Jim Halpert (aka John Krasinski) showing it is good in humanity:
