Major health crises and the OED: language evolution and challenges in health communication

Covid-19 and language

During the coronavirus pandemic, the world’s languages have had to adapt to a sudden influx of neologisms and scientific terminology as scientists and policymakers strive to convey essential advice to the public in a timely and effective manner. As the coronavirus continues to spread to ever more densely populated and linguistically diverse countries, it has become even more urgent to provide crucial information in various languages so that affected communities are able to fully and easily understand everything they need to know about this global health crisis.

The Oxford English Dictionary responded to this unprecedented lexical change by quickly adding this new vocabulary in various special updates, and, instead of choosing a single Word of the Year, releasing an expansive report on the words that defined 2020, with an entire section dedicated to the language of Covid-19.

The importance of establishing a standard vocabulary around Covid-19 also became the impetus for Oxford Languages’ Multilingual Covid-19 project, which brings together the expertise of Oxford University Press’ lexicographers and translators in Oxford and in its international offices in China, India, East Africa, and South Africa, to offer translations of key Covid-19 terminology from English into 19 different languages[1], which together are spoken natively by over 40% of the world’s population.

Covid-19 and lexical change

Oxford Languages’ lexical monitoring has shown that most of the key terms related to Covid-19 are not new inventions. Some words, such as immune, infection, symptom, vaccine, and virus, form part of the basic vocabulary of many languages; others like droplet, swab, and testing are common words with medical senses that gained special significance during the pandemic; and still others are highly technical scientific terms such as basic reproduction number, case fatality rate, community transmission, herd immunity, morbidity rate, and mortality rate, which refer to complex epidemiological concepts that are now being mentioned in news broadcasts and political speeches, as they are the basis of many government decisions with untold impact on millions of lives and livelihoods.

The discourse on Covid-19 is also characterized by words and phrases referring to government and individual actions aimed at containing the spread of the virus and mitigating its social and economic effects. As personal hygiene and the prevention of infection became the main preoccupation of society, words such as disinfectant, face mask, and hand sanitizer have dominated the conversation in most languages. As the avoidance of possibly dangerous physical contact became the order of the day, phrases such as flattening the curve and social distancing, previously unknown to people other than statisticians and epidemiologists, have become part of the daily vocabulary of many languages. The English word lockdown, referring to the set of measures that many countries have taken to contain the spread of the virus by severely limiting the movement of people outside the home, has been borrowed by languages like Dutch, Filipino, German, Italian, and Telugu, while  languages such as Catalan, French, Portuguese, and Spanish prefer their equivalent forms for confinement. Languages like Arabic, Chinese, and Zulu use corresponding expressions conveying closure.

Another much-used word, quarantine, of Italian origin, has also given rise to self-quarantine, highlighting the self-imposed, voluntary nature of this means of avoiding the spread of infection. French speakers have modified quarantaine to quatorzaine, replacing the quarant- referring to the forty days that quarantine periods usually lasted, with quatorz-, referring to the 14 days of isolation required of everyone travelling to and from France, the typical length of confinement advised for people who have or are suspected to have Covid-19.

Predominance of Anglicisms

A few centuries ago, English had to borrow words from other languages as a response to devastating outbreaks of disease—the words epidemic, plague, and pestilence are all loanwords from French. Today, however, English is the principal language of global scientific communication, and as such, it has become the source of many of the words widely used during the pandemic. Many consider this prevalence of Anglicisms troubling, and citizens of countries like Italy and Japan have criticized their leaders for their over-reliance on English loanwords that they feel obscures rather than strengthens their public messages.

The influence of English on Covid-19 vocabulary can be seen in some interesting lexical innovations. In Italian, the word droplet has come to refer not only to the very small airborne drops of secretions from the nose, throat, or lungs by which the coronavirus can be transmitted, but also to the distance one person must maintain from another to prevent such a transmission from happening. The recurring metaphor of essential healthcare and service workers being on the frontline in the fight against Covid-19 has led to this group of people being called frontliners in Filipino and other Southeast Asian languages such as Malay and Bahasa Indonesia.

What’s in a name

A close look at the words that dominate the global pandemic conversation can also reveal the intersections of language, communication, and medicine, and how identity categories and other language repertoires impact the provision of care during a health crisis.

Early in the pandemic, former American president Donald Trump drew ire for referring to the coronavirus as the ‘Wuhan virus’ or the ‘Chinese virus’, amid mounting fears that such phrases were intensifying anti-Chinese and anti-Asian racism in the United States and other countries. The power of words to create or reinforce social and political divisions was made clear during the first years of the only other current global pandemic, HIV/AIDS. The disease was first named ‘Gay-Related Immune Deficiency’ (GRID) in 1982, and was also commonly called the ‘gay cancer’ in the press. These terms, apart from being exceedingly inaccurate, led to a public backlash against homosexuality in the 1980s and early 1990s following the gay liberation movement of the 1970s, and severely hindered the public-health response to the HIV/AIDS outbreak.

In the case of Covid-19, its very name seems to be an indication that we have learned from the mistakes of the past. The name of the disease caused by the coronavirus may seem just a simple acronym for the English phrase coronavirus disease 2019, but this choice very carefully follows the World Health Organization’s best practices for naming new human infectious diseases. While past practices tended to link diseases with certain populations, as reflected by terms like Spanish flu and gay cancer, the term Covid-19 was meant to provide an accessible term for people around the world to use while avoiding the stigmatizing association of the disease with any particular group of people.

Physical distancing, not social isolation

The importance of using the right words to call public-health measures is also underlined by the term social distancing. The OED entry for social distancing includes an older definition based on examples from as early as 1957: ‘The action or practice of maintaining a degree of remoteness or emotional separation from another person or social group.’ The definition that is in more popular use right now in public health is much younger, dating only to 2009. The thin line that separates the two definitions points to the main problem with the term social distancing, which is that it is a misnomer. WHO even launched a campaign with the message, ‘Keeping each other safe and connected is everyone’s responsibility; physical distancing is not social isolation.’ The most important lesson we have learned from HIV/AIDS is that public-health measures should not undermine the importance of social relationships in resolving health crises. Communities emerge from networks of social relationships, and they play an indispensable role in determining health outcomes. One important question that scholars interested in language as social action should be asking right now is how, if at all, might digital communication technologies such as Zoom help people create or build relationships with each other that might serve as the building blocks of larger communities and their joint projects.

Local knowledge

Borrowing scientific terms alone does not suffice. Linguists across the world agree that there is an urgent need to include local and indigenous knowledges and grassroots practices in health communication in meaningful ways. During a pandemic, it is vital not only to tell people what they need to do to avoid or deal with contagion, but also to explain to them how the spreading disease affects the body and how treatments and containment measures work, using words and concepts they are familiar with. This enables them to make informed decisions and makes them more likely to trust and follow official health advice.

In the 1980s, community organizers and members worked with medical professionals, policymakers, and other stakeholders in public health in the fight against HIV/AIDS. Their collaboration was partly based on the recognition of biomedical practitioners that health information may not necessarily be best conveyed in print or textual format. One of the major aspects of community health work for HIV/AIDS has been its focus on in-person, face-to-face interactions with key populations. Recent works in linguistic and medical anthropology have similarly explored the role of community activities such as fiddle stories in Mongolia in the delivery of information about Covid-19.

The challenge is to provide essential information on Covid-19 in as many languages as possible, in a way that is accurate, accessible, and culturally appropriate, and to adopt health communication approaches that remain grounded in the lived experiences and specific needs of key demographics, such as people who are poor, old, or belong to racial and ethnic minority groups. To meet this challenge, language and translation have to remain a key component of our response to the Covid-19 pandemic.

[1] Afrikaans, Arabic, Catalan, Chinese, Dutch, Filipino (Tagalog), French, German, Hindi, Italian, Northern Sotho, Portuguese, Setswana, Spanish, Swahili, Tamil, Telugu, Xhosa, and Zulu.

The opinions and other information contained in the OED blog posts and comments do not necessarily reflect the opinions or positions of Oxford University Press.