Perspectives: The vocabulary of COVID-19
For weeks, the American public has endured a crash course in how words can inspire and denigrate, instill hope and incite fear, divide and unite, and clarify and confuse. We have learned that words have variable meanings that drive certain behaviors, and we’ve learned to recognize good, failed, timely, and delayed risk communication.
We’ve expanded our vocabularies, too. Epidemiological terms such as, “flattening the curve,” “routes of disease transmission,” “zoonosis,” “pandemic,” and “mortality rates” are now household words that the general public understands with relative accuracy. This, alone, is a powerful outcome of the COVID-19 pandemic, not to mention the integration of public health measures like handwashing and personal protective equipment into our daily conversations and behaviors.
Americans have learned that words, their framing, and their context can be confusing, political, misleading, and triggering.
Lauren Bernstein, MVB, MPH
Americans have also learned that words, their framing, and their context can be confusing, political, misleading, and triggering. “Stay at home” may inspire civic duty in some and stoke fears of imprisonment in unsafe spaces for others, just as “shelter in place” may elicit feelings of protection in some and serve as reminders of sheltering from past traumas for others. Some acknowledge that “essential” services and workers keep us fed and healthy, while others feel devalued by the unintended implication that they are expendable.
Previously, I have written about Surgeon General Jerome Adams’ careful word choice to blame COVID-19 racial disparities on a “social predisposition” instead of “structural inequities.” Days later, I watched people react to calls for “liberation" from an unjust lockdown as others championed the “liberty” to exert choice in adhering to their state’s guidelines.
Over the past few months, I have heard impassioned debates among leaders over naming the virus, including confusion about what qualifies as “racism” versus “geography.” I’ve watched the framing of state and federal guidelines change each week with motivational calls to do “it” for your health, for your grandmother’s health, for the economy, and for freedom — “it” referring to staying at home, protesting orders to stay at home, or even overhauling immigration policies.
Often, the use of these pandemic-era words becomes skewed, even if the general idea remains much the same. Once a term reserved for sci-fi movies and history books, “quarantine” is now 2020’s slogan despite its frequent misuse. The word itself isn’t entirely benign and it, too, drives varied reactions of fearful stockpiling, movements of hope and solidarity, and resurfaced trauma from generations of being called “diseased” or “unclean.” Because of this, precise language matters.
Precise language matters.
Lauren Bernstein, MVB, MPH
“Quarantine” refers to separating yourself from well people if you have been exposed to a sick person and you are not ill. With COVID-19, quarantining in its true meaning is particularly challenging because the virus can be everywhere or nowhere, and exposure to infected people who are asymptomatic is possible, if not very likely.
Regardless of these discrepant definitions, the purpose of quarantine remains unchanged: reduce disease spread to others. “Isolation” is also intended to reduce disease spread to others. Whereas quarantine involves separating a potentially exposed healthy person from others, isolation refers to separating a sick person from healthy people until that person is no longer infectious.
Both methods are among the most ancient and most successful disease-control strategies, but their historical association with crime, detainment, and government mandates creates challenges for their modern use. We see these challenges unfolding in real time.
Quarantine and isolation are voluntary in the U.S. during this pandemic, but they have historically been mandatory and enforceable, resulting in social consequences like marginalization and threatened civil liberties.
Lauren Bernstein, MVB, MPH
Despite the fact that quarantine and isolation are voluntary in the United States during this pandemic, they have historically been mandatory and enforceable, resulting in social consequences like marginalization and threatened civil liberties. Negative connotations associated with these words have led to uncertainty in current events.
There is confusion about what the public should or should not do and where we can or cannot go. These words have been used interchangeably not just with each other, but also with “stay at home” orders and “social distancing,” leading to further confusion about who is actually in control and what kind of repercussions there could be if the public does not “comply.”
Despite widespread confusion and misleading and divisive political discourse among those in power, people still choose their shared humanity first. The public’s cooperation with social/physical distancing demonstrates a deeper human desire to protect each other, even in the absence of an enforceable law that tells them they have to.
[Humans] cooperate in ways that no other animals do, especially with none kin. [...] We've evolved to deal with crises by coming together and relying on each other.
Chris Shaffer, PhD
Christopher Shaffer, PhD, a biological anthropologist at Grand Valley State University in Allendale, Mich., and collaborator on epidemiological research teams at the University of Minnesota, describes this phenomenon: “I think of humans as an almost uniquely cooperative and altruistic species. We cooperate in ways that no other animals do, especially with none kin. It's been the most important characteristic in our evolutionary success as a species. I see a plethora of evidence that humans respond to disasters by becoming more cooperative, rather than the doomsday idea of everyone killing each other for limited food. Instead, people come together to deal with the crisis, especially with other members of their cultural group. In a sense, we've evolved to deal with crises by coming together and relying on each other.”
When you look at humans cross-culturally and throughout time, you immediately see that this idea that you need [...] a state-operated police/military force to ensure people fall in line is simply not true.
Chris Shaffer, PhD
Shaffer explains that we are seeing this on a global scale and in ways that align with 21st-century forms of connection, like virtual gathering. He agrees with the observation about unclear leadership and minimally or non-coercive public cooperation. “[It] doesn't surprise me at all,” he says, “When you look at humans cross-culturally and throughout time, you immediately see that this idea that you need a strong authority telling people what to do, or a state-operated police/military force to ensure people fall in line, is simply not true. Many societies operate without these. Much more coercive are the social norms of the cultural group to which people belong.”
Those with influence have failed to use language that unites us in this time of crisis. Let the public’s response be a comfort, though. Despite words that divide—intentionally or not—our communal spirit has mobilized a global effort to serve the common good. Let this also serve as a thoughtful reminder that words have variable interpretations and generate variable reactions that arise from deeply embedded cultural context or personal experience. As individuals that make up larger communities, let us use this as a framework to foster cross-cultural dialogue and understanding among others within our communities.
Lauren Bernstein, MVB, MPH, is a veterinary public health resident in the University of Minnesota College of Veterinary Medicine's Center for Animal Health and Food Safety. She received her BS in animal science from the University of Tennessee in Knoxville and completed her veterinary education at the University College Dublin School of Veterinary Medicine in Ireland. Lauren is interested in preventive medicine, One Health and policy initiatives, community outreach, and public education surrounding One Health topics. Prior to moving to Minneapolis, she practiced in a private small animal and exotics practice in Dallas, Texas, for nearly five years.
Editor’s note: The views expressed here are those of the authors and not necessarily of the University of Minnesota College of Veterinary Medicine. We present them here to further discussion around topics related to veterinary medicine that our faculty, staff, and students find important and worthy of deeper contemplation. We encourage you to send responses to firstname.lastname@example.org.