July 2020 update: scientific terminology of Covid-19

In April the OED published an update to include language relating to Covid-19, in recognition of the disease’s impact on the English language and the appearance of an emerging pandemic vocabulary. Three months on, the pandemic continues and so too does the related linguistic development. As we increase our understanding of the virus and its effects and potential treatments, specialist scientific and medical language is increasingly prominent in everyday discourse. As the saying (recently) goes, “we’ve all become armchair epidemiologists”. The OED decided to publish another update to cover these developments, this time focusing more on scientific and medical terminology.

It’s not uncommon for the name of a disease to be applied to the pathogen causing it (and vice versa), and this case is no different: Covid-19 is now being used for both the disease and the virus. And a multiplicity of abbreviations of Covid-19 have also appeared. While the official name for the disease caused by the coronavirus Sars-CoV-2 is Covid-19, the terms Covid, C-19, CV-19, CV, and corona are also used to refer to the virus and the disease. CV and corona both appear well before the current pandemic, 1985 and 1974 respectively, because they have been used in reference to other coronaviruses. Thus although World Health Organization (WHO) documentation has 11 February 2020 as the date on which the name Covid-19 was officially bestowed, evidence shows that CV-19 was used as early as 22 January 2020, because CV is an earlier abbreviation for coronavirus. As time goes on, we’re sure to come up with other abbreviations; for example ‘rona’ is currently trending in Australia and the U.S.

We’ve updated the original definition of Covid-19, no longer defined as ‘an acute respiratory illness’ but ‘a disease…characterized mainly by fever and cough’, ‘capable of progressing to pneumonia, respiratory and renal failure, blood coagulation abnormalities, and death’.  This reflects new information about the effects of the virus on multiple organ systems. OED first published an entry for coronavirus in 2008. We’ve now added a second sense that refers specifically to those coronaviruses that cause life-threatening diseases in humans, including SARS, MERS, and Covid-19.

Many of the more serious and lingering effects of Covid-19 appear to be the result of a cytokine storm. First described in the context of Graft Versus Host Disease, this is an overactive immune response involving the excessive production of cytokines which results in inflammation and can lead to organ failure and death. This is why many people continue to be affected by a variety of symptoms, even after their immune system has cleared the virus from the body. At the start of the pandemic it was observed that young people were less likely to be negatively affected. But a small proportion of children infected with the Covid-19 virus have had an illness resembling Kawasaki disease, an acute illness which primarily affects infants and young children and is thought to result from an abnormal immune response to an infectious agent. The potential link between Kawasaki disease and Covid-19 means this illness, first described in the 1970’s, is in the spotlight.

The search for effective treatments, as well as a vaccine, is ongoing and worldwide. The names of drugs which appear to mediate symptoms or provide protection against the effects of the virus are splashed across the headlines. In the early stages of the pandemic, hydroxychloroquine, developed in the 1940’s-1950’s to treat malaria, was thought to be a possible candidate. However, World Health Organization trials concluded that the drug provides little or no benefit to patients suffering from Covid-19. Recent evidence suggests that dexamethasone, a cheap and widely-available corticosteroid used to treat autoimmune and inflammatory conditions, may have a beneficial effect on patients suffering from severe cases of Covid-19.

Most of the vaccines for Covid-19 currently under development target the viral spike protein. These glycoproteins project from the envelope of a virus, binding to receptors on a host cell and allowing the virus to insert its genome into the host. It is hoped that a vaccine which stimulates the immune system to produce antibodies to coronavirus spike proteins will help prevent the virus from infecting host cells. The current extraordinary circumstances mean that some vaccine trials may involve participants being challenged, or purposefully exposed to the coronavirus to measure the efficacy of a vaccine.

A Covid-19 patient whose breathing is being regulated by a ventilator has become one of the enduring images of the pandemic, given their widespread use in treating those severely affected by the disease and so we’ve updated our definition. Some patients are treated through the use of CPAP, continuous positive airway pressure, which is less invasive than treatment involving a ventilator.

Many of our most urgent questions about the Covid-19 are related to the epidemiology of the disease, how quickly it spreads and how fatal it is. Early in the pandemic, it was established that there was widespread community transmission or community spread of Covid-19, meaning that the disease was being transmitted between members of a community through casual contact. One of the features of this type of transmission is the difficulty in establishing sources of infection for individual cases, making it harder to contain outbreaks of a disease.

The spread of a disease, and the likelihood that it will either subside, remain at a stable level within a population, or result in a pandemic are all related to R (also R number, reproduction number, and reproductive number), the average number of cases of an infectious disease arising by transmission from a single infected individual. R varies according to a number of factors; one of which is the degree of immunity already existing in a population. R₀ – for which an entry appeared in the first Covid update – is used with reference to populations which have no prior exposure to a disease.  If  R/R₀ is greater than one, the number of people infected will increase and the disease will continue to spread. If R/R₀ remains at or below 1, the number infected will remain steady or decrease, and the disease may disappear from a population. The severity of a disease can be measured by its CFR, or case fatality rate, which is the proportion of cases of a disease that are fatal, especially within a specified period of time.

The potential for some hospitals to run out of room for patients at the height of the Covid-19 pandemic led to the widespread creation of field hospitals. These were first used in military contexts as early as 1690 in close proximity to battlefields to treat wounded soldiers. The meaning of the term has expanded now to cover such temporary hospitals used to treat victims of natural disasters, famines, and outbreaks of infectious diseases, and which may be located anywhere they’re needed, including central London and New York in the current pandemic.

Triage, from the French “trier” meaning to pick or sort, was first used as an English term in the 18^th and 19^th centuries to describe the sorting of wool or other commodities according to quality. It was only during the First World War that the verb and noun came to be applied in English to the process of assessing and assigning treatment to the injured, and is now most commonly used in hospitals and other medical situations. The harsh realities associated with triaging patients became apparent in the Covid-19 outbreak, when shortages of medical supplies meant that doctors were forced to consider the possibility of assigning treatment based on the likelihood of survival. The term triage has now moved beyond medical contexts, and into more general use. So a large company might ‘triage’ customer complaints, for example.

As scientists and medical professionals continue to expand our knowledge of the effects of Covid-19 on the body, develop methods of treatment and better understand how the virus spreads, new terms will emerge and specialist language will continue to be adapted to communicate this knowledge to the public. The need for accurate communication of complex ideas and topics has never been greater, and the OED will continue to update its coverage of these specialist terms, charting their passing from scientific journals to newspapers and social media.

Header image: CDC on Unsplash

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