On January 21, 2020, a man from Washington state, who had traveled to Wuhan, China, was diagnosed with a novel coronavirus. Just a day earlier, Japan, South Korea, and Thailand also reported their first cases of the virus. Since then there have been 1.4 million cases of the virus, including more than 380,000 reported cases in the United States.
Over the past few months our lives have changed radically. We’ve had to learn new ways of interacting and working. We’ve had to change how we educate our children and minister to our communities. And many of us have had to adjust to the technical vocabulary used by the media and government to help us understand what is going on in the world.
But while we have heard dozens of new terms used in the past several weeks, we are often unclear on their precise meaning, or assume the colloquial sense applies in the context of the coronavirus crisis. Before we can know the best way to show love to our neighbors, we need to be able to make sense of our current situation. Doing that, though, requires understanding the conversations going on around us. Because TGC has published dozens of articles on the coronavirus (and will likely produce dozens more before the crisis passes), we thought it would be helpful to create a glossary to help you better understand what these terms mean and how they are used.
Here are two dozen terms and concepts you should know to understand the COVID-19 crisis.
SARS-CoV-2 — Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the official name of the virus that causes novel coronavirus disease 2019 (COVID-19). Viruses are named based on their genetic structure to facilitate the development of diagnostic tests, vaccines, and medicines, while diseases are named to enable discussion on disease prevention, spread, transmissibility, severity and treatment. Because using the name SARS can have unintended consequences in terms of creating unnecessary fear for some populations (due to the SARS outbreak in 2003), the World Health Organization (WHO) has begun referring to the virus as “the virus responsible for COVID-19” or “the COVID-19 virus” when communicating with the public.
COVID-19 — The name of the disease caused by the novel coronavirus, SARS-CoV-2, and is short for “Coronavirus Disease 2019.”
Coronavirus — According to the Centers for Disease Control (CDC), human coronaviruses are common throughout the world, and scientists have identified seven different coronaviruses that can infect people and make them sick. There are four common coronaviruses (229E, NL63, OC43, and HKU1), and three additional coronaviruses have also been identified since 2002: MERS-CoV (the coronavirus that causes Middle East Respiratory Syndrome, or MERS), SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS), and the 2019 Novel Coronavirus (2019-nCoV). Most coronaviruses infect animals, but not people. In the future, though, one or more of these other coronaviruses could potentially evolve and spread to humans, as has happened in the past. As the CDC notes, we still don’t understand why only certain coronaviruses are able to infect people.
Containment — The various activities taken to slow the spread of a condition, usually for the purpose of making preparations before it becomes an epidemic or pandemic. As applied to COVID-19, containment included measures taken to slow the spread of the virus rather than intended to stop the complete spread of the disease.
Mitigation — Efforts to reduce the severity or seriousness of a condition. In a pandemic, mitigation strategies may include a variety of approaches, from encouraging handwashing to creating new vaccines.
Close contact — In the context of COVID-19, close contact refers to a person who may be at risk of infection because of their proximity or exposure to a known case. Exact definition of close contact differs by disease. For COVID-19, the CDC defines a close contact as anyone who has been within six feet of a person infected with the virus for a prolonged period of time, or has had direct contact with the infected person’s secretions.
Social distancing — Measures taken to reduce person-to-person contact in a given community, with a goal to stop or slow down the spread of a contagious disease. Measures can include working from home, closing offices and schools, canceling events, avoiding public transportation, or staying six feet away when in public.
Asymptomatic transmission — When a person is infected with a pathogen but displays no signs or symptoms. The coronavirus is believed to be spread by this type of transmission, and some experts warn that undetected, asymptomatic patients could create fresh transmission routes once lockdowns are eased.
Contact tracing — The process of identifying, assessing, and managing people who have been exposed to a contagious disease to prevent onward transmission.
Antibody Test — The human immune system will try to fight off foreign substances, such as viruses, by making antibodies to attack that specific intruder. An antibody test for coronavirus is a type of blood test that can detect if a person has had coronavirus before and has since recovered. The test works by testing blood for coronavirus antibodies to see if they have overcome the virus and gained some immunity to it.
Antigen Test — An antigen is a structure within a virus that triggers the immune system’s response to fight off the infection. An antigen test is similar to an antibody test, expect it detects the presence (or absence) of an antigen rather than antibodies.
Flattening the curve — Attempting to slow the spread of a virus (such as through social distancing) to reduce the peak number of cases and related demands on hospitals and infrastructure.
Cordon sanitaire — Borrowed from French for “sanitary cordon,” was originally in reference to a line of military posts or other barriers enclosing a community stricken by an infectious disease. Used today to refer to measures preventing anyone from leaving a defined geographic area, such as a community, region, or country infected by a disease to stop the spread of the disease.
Epidemiology – Epidemiology is the method used to find the causes of health outcomes and diseases in populations. Experts in this field are known as epidemiologists. According to the CDC, in epidemiology, the patient is the community, and individuals are viewed collectively. By definition, epidemiology is the study (scientific, systematic, and data-driven) of the distribution (frequency, pattern) and determinants (causes, risk factors) of health-related states and events (not just diseases) in specified populations (neighborhood, school, city, state, country, global). The term also refers to the application of this study to the control of health problems.
PPE — An acronym for “personal protective equipment.” According to the FDA, PPE refers to protective clothing, helmets, gloves, face shields, goggles, facemasks, and/or respirators or other equipment designed to protect the wearer from injury or the spread of infection or illness. PPE can serve as a barrier between infectious materials such as viral and bacterial contaminants and a person’s skin, mouth, nose, or eyes (mucous membranes). The barrier provided by PPE has the potential to block transmission of contaminants from blood, body fluids, or respiratory secretions.
R0 — Pronounced “R naught,” a mathematical term that describes the number of cases, on average, an infected person will cause during their infectious period. R0 for measles ranges from 12 to 18, depending on factors like population density and life expectancy, while the influenza virus is less infectious, with its R0 ranging from 2 to 3. The Imperial College group has estimated R0 for SARS-CoV-2 to be somewhere between 1.5 and 3.5.
N95 respirator — An N95 respirator is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles. The “N95” designation means that when subjected to careful testing, the respirator blocks at least 95 percent of very small (0.3 micron) test particles. If properly fitted, the FDA says, the filtration capabilities of N95 respirators exceed those of face masks. However, even a properly fitted N95 respirator does not completely eliminate the risk of illness or death. Most N95 respirators are manufactured for use in construction and other industrial-type jobs that expose workers to dust and small particles, though some types are intended for single-use in a health-care setting. (The Centers for Disease Control and Prevention does not recommend that the general public wear N95 respirators to protect themselves from respiratory diseases, including coronavirus.)
Surgical masks (face masks) — A surgical mask is a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment. (Although they are often referred to as face masks, surgical masks are regulated while other face masks may not be.) As the FDA notes, a surgical mask is meant to help block large-particle droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria), keeping it from reaching your mouth and nose. Surgical masks may also help reduce exposure of your saliva and respiratory secretions to others.
Ventilator — The use of the term in the context of COVID-19 almost always refers to mechanical ventilators. A mechanical ventilator is a machine that helps patients breathe (ventilate) when they are having surgery or cannot breathe on their own due to a critical illness. The patient is connected to the ventilator with a hollow tube (artificial airway) that goes in their mouth and down into their main airway or trachea. The pressure on a mechanical ventilator needs to be precisely calibrated to the patient, Sarah Constantin notes. If too much pressure is applied, the lung can tear. If too little pressure is applied, the patient’s blood will fill with CO2 and not get enough oxygen. This is one reason why patients need to be placed on ventilators by trained experts (typically ICU nurses, doctors, and respiratory therapists). Patients remain on the ventilator until they improve enough to breathe on their own.
Herd immunity — Herd or community immunity occurs when a high enough percentage of a community becomes immune to a disease because of vaccination and/or prior illness. This makes the spread of this disease from person to person less likely, which provides some protection for individuals not vaccinated (such as newborns and the immunocompromised). The point at which herd immunity is obtained is related to the rate of transmission. The more infectious a disease is, the more people need to be immune before herd immunity can be achieved.
Case fatality rate (CFR) — The reported case fatality rate is a measure of the severity of a disease and is defined as the proportion of reported cases of a specified disease or condition that are fatal within a specified time. The CFR varies by country and age group, and the final figure will depend on figuring out the true number of cases. In the case of COVID-19, the CFR is hard to estimate because of a lack of widespread testing.
Shelter in place — An order issued by local or state governments that mandates citizens stay home and only leave for essential activities. What constitutes “essential” varies by locale, but it generally includes such as activities as going to doctor appointments, getting food from the grocery store, or walking the dog. Essential businesses include health-care facilities, grocery stores and other food markets, banks, media services, hardware stores, and laundromats and delivery services, among others. Some locales prefer to use the phrase “stay at home” order.
Terms related to geographic spread —An endemic condition currently has a stable and predictable rate of occurrence among a specific geographical location and can always be found in the population that lives there. An outbreak is when there is a sudden increase in the number of people with a condition greater than is expected. An epidemic is an outbreak that spreads over a larger geographical area. An epidemic that spreads globally is a pandemic. The use of the terms endemic, outbreak, epidemic, and pandemic do not denote the severity, or how serious the condition has become.