In the popular media, including otherwise-intelligent talking heads and world leaders have invented new pretentious, uses for words that have little actual meaning. Chief among these are: “surge,” “spike”, “epicenter” and “biblical proportions.”
For example: the head of large United Nations agency has been prolific about how this pandemic might lead to famines and food shortages “of biblical proportions.“ The biblical proportion part has subsequently been repeated by many journalists and in headlines. In fact, this pandemic has certainly led to dramatic increases in malnutrition across the world, associated with the collapse of livelihoods and jobs of income-earners. But what about this is of proportions that are “biblical?” The Bible refers to famines and food shortages on a number of occasions, but never defines how many people were malnourished or died. In other words, there are no proportions described or implied. The populations in Biblical times numbered in the tens of thousands or hundreds of thousands, much smaller than those affected today (hundreds of millions). So, if anything, “biblical proportions” under-plays the extent of death and excess malnutrition occuring today.
Many journalists liked to spruce up their reporting by referring to pockets of Covid-19 cases as “epicenters.” One anchorwoman referred multiple times to parts of New York as the “epicenter of the epicenter.” Actually, epicenter is not a term defined to say anything about diseases; it is defined for earthquakes where it refers specifically to the source of the release of the quake waves, i.e. the origin. So it is untrue, misleading and surely unintended for our media to suggest that the current pandemic began and spread outward from Brooklyn or the Bronx. Nor from most of the other places called epicenters in this pandemic. It would be more useful and accurate to say simply “areas of high caseload.”
The most abused terms have been “spike” (an abrupt rise followed by a fall) and “surge.” Spike was used early in the outbreak to refer to any spread of the disease, or increase in cases. Mostly, it was misleading as the increase in cases was not followed soon after by a decline, but instead by continued, gradual increases. Because the word “spike” may have sounded mathematical, it allowed those reporting to sound dramatic while avoiding saying anything specific about the extent of increase, or the rate of spread. Better to just say “increase.”
“Surge“ has been used the most consistently, at times interchangeably with spike but, now, much more often. “Surge” has grown in use in 2020 to serve as the all-purpose noun, verb and adjective for Covid-19. In almost all instances it is undefined, without meaning and another way to avoid reporting anything specific. Based on the context, surge has displaced terms with clearer meanings such as “increase”, “wave”, introduction into a new area, “outbreak”, “plateau,” and “cumulative caseload.” Some people think it means acceleration, others simply “spread.” In most cases it means nothing more than “the disease continues to spread from person to person”, which, after all, is what communicable diseases do. When the first few cases hit Washington, DC, in the same short speech, the Mayor used the word “surge” several times but each in a different way to mean: “any new cases”, the overall curve, the cumulative caseload, an eventual “plateau” and a growing epidemic. As another example: on August 2, the New York Times ran a headline that “Britain had Europe’s Worst Surge in Deaths.” The article used surge to mean several things at once: the cumulative deaths over many months, the extent of geographic spread, and the duration of the outbreak. Where “surge” sometimes means nothing more than “increase”, it is also now referring to everything else that happens including to the sum total of the disease’s effects.
The word surge has historic usage connoting a “wave.” But consistently talking about Covid-19 spread as a wave distracts from the reality that it moves from a single person to another single person at a time. It does not drop from the sky in one big wave onto a lot of people at once.
We do have simple yet specific terms that journalists have become too lazy to use, such as “spread,” “increase”, “caseload”, “outbreak”, and others which public health scientists have used for decades and continue to use. What epidemiologists care about is the rate of person-to-person spread, one measure of which is R nought (R0), also known as the Reproduction Number, which can vary from town to town and from week to week but which tells us how quickly a disease is spreading. When R0 is much higher than 1, the spread is geometric (predicted by an exponential equation). When it is below 1 for an area, the outbreak is declining.
Early in the outbreak, pundits liked to talk about “flattening the curve”, with accompanying pictures of a simple curve. The valid point they wanted to make was the importance of slowing the spread of the disease as much as possible so health systems could catch up. But it was misleading to the public to imply that there was a simple up-and-down curve to the whole epidemic. In early 2020 we were unsure the extent to which the pattern of the Covid-19 pandemic would have seasonal ebbs or increases, orwhether it could be readily contained, or other patterns. We misled at that time in pretending that it would be a simple curve. We know now that the curve can be very complicated, with distinct waves and peaks.
The global health crisis underway can be a good teaching moment for us all to learn more about humanitarian crises and the science associated with them. Journalists should up their game in learning to use more precise language.
Steve Hansch is an editor and board member of WHES.