What does a new “case” of covid-19 mean? (And is it okay to shout “fire” in a crowded theater?)

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One of William Shakespeare’s most well-known questions is: “What’s in a name?  That which we call a rose by any other name would smell as sweet.”  However, it is also well known that names, words, can and do make a great difference in how we perceive a thing.  The noun “case”, especially when relating to illness/disease is one of these words.  We have to be aware that sometimes a word means something in common usage, and also, within the specialization of one discipline or another, that word may have a particular meaning.  For example, we all know what the common usages of the word “head” are.  Either a body part or possibly the boss, or leader of something.  However, in the Navy, the word “head” can and often does refer to the toilet/WC.  Sometimes it all depends on the context the word is being used in.  The word “case” has some similar usage issues.

In common usage I venture to say we usually think of a “case” as being something that holds something else, like a cellphone case.  Or, when speaking about illness, a case is commonly thought of occurring when someone is actively ill with something.  We’ve all probably heard about someone coming down with a case of food poisoning, or, heaven forbid, a case of cancer.  The fact that someone ate some food which somehow, later, turned up as tainted, means that maybe the person might “come down with a case of food poisoning”, but not necessarily.   With cancer I have heard that at any given time most (all?) of us have some potentially cancerous cells in our body, however that doesn’t mean we’re suffering with a case of cancer. A “case” of something commonly means someone is actively suffering, ill, with whatever it is.   The CDC and other public health related people and agencies however, seem to have a different meaning for the word “case” within their technical jargon.  In that usage a “case” can evidently mean simply a positive test result which may, or may not, indicate the presence of detectable material from a COVID virus. Remember, at any given time most of us have some potentially cancerous cells in our body which does not indicate we have a case of cancer.

So when we hear about all the new cases of covid-19 turning up, what does that mean?  Does that mean all the people represented by that number are actively suffering from the severe ravages of covid-19, which we’ve heard so much about?  If we’re thinking in common usage terms, the word “case” tends to lead our minds down that path.  However, the reality is that in terms of the daily covid “scoreboard”, it doesn’t mean that at all.  It means more people have been tested and some of the test results are positive.  Kind of like someone eating some food with some unwanted bacteria growing on it.  It doesn’t mean that they are necessarily going to come down with a case of food poisoning.  As with exposure to just about every potentially harmful substance on Earth, there a few other variables involved such as the amount of the “dose” of bacteria and the person’s pre-existing state of health.  I think that the robustness of the human immune system is being largely ignored as the covid scenario progresses.  Which brings us back to: will someone who tests positive for covid become ill, develop symptoms?  Maybe. I’m not sure there are any reliable numbers on the relationship between testing positive and becoming symptomatic.  But even if odds are that an infected person will develop some symptoms, as the World Health Organization states:  “COVID-19 affects different people in different ways. Most infected people will develop mild to moderate illness and recover without hospitalization.”

At this point I find myself asking, would the daily news have the same quality of sensationalism if what is reported as “cases” are more accurately reported as “positive test results”?  At this time the sensationalized use of the the word “cases” is an instrument for the production of fear.  Imagine the headline:  “Today an additional 1,000 people tested positive for covid.”  After a few weeks, how many people are going to be on the edge of their seats waiting for the latest tally?  But if they say there are 1,000 new cases of covid, especially without any qualifying explanations, our minds, our imaginations, tend to take us down the path of common usage to a forest of doom and gloom, don’t they?  So, are we being misled?  I think so, I think the folks putting the words together know exactly what picture those words are likely to conjure up in the minds of the general public.  However, are they lying?  I think it can be easily argued in a court of law that, no, the health officials are merely reporting the facts as they define them.  And the media is just parroting what they’re being told. 

I think the reporting which is taking place around covid by the mainstream media in the U.S. begs the question: is it okay to shout “fire” in a crowded theater?

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