American Consequences - April 2021

ONE YEAR AFTER COVID-19

pandemic, and it has to do with the well- established use of language. Any apolitical review of the most well- known medical journals prior to the Wuhan outbreak, or any discussion with a medical practitioner unafraid to buck the new tread, would see the word “case” used in a universally agreed upon and very specific way. Although a “medical case” in its simplest epidemiological usage can refer to anyone infected with a given disease, a cursory review of our very own JAMA , or the U.K.’s Lancet , or even global publications such as Nature , prior to the COVID outbreak, sees the term used very differently. Prior to the global lockdown, in practice, a “case” was only meaningfully used to apply to an individual whose contraction of said disease so affected them that they were hospitalized or otherwise seriously impacted. If a person contracted the disease, never felt ill, or didn’t even know they were infected, that was not dealt with as a medically relevant case, and it most definitely not used as an input into health policy data given the way such instances that required no response would distort national reactions and triage. And we now know with COVID that millions have caught the virus with little, if any, effect on them at all, and the total number of these “pseudo cases” may be as large as a quarter of the reported positives. Why this crucial word, “case,” was redefined to include all who may have tested positive but who have zero impact in terms of the need to provide them with emergency or remedial care is not yet known. However, it has added to the distortion of our

are 23,345,948 active COVID cases in the world, using the post-2019, far-looser definition of “case,” which I will explain in a moment. Of that number, only 92,494, or 0.4% , are serious infections (which is what we would have called actual “cases” in the past). The other 23-plus million people are suffering from mild infections, as was my experience last year when I contracted COVID and simply had to endure the mildest flu symptoms. Add to that the additional significant factor that those who are in real danger from COVID-19 are the elderly and those with preexisting conditions such as diabetes, pulmonary disease, or the immunosuppressed, not to mention numerous other comorbidities. If we are to be honest about the global response, in addition to the actual numbers, we will start to reveal a subtle but crucial linguistic sleight of hand when reporting COVID-19 that has distorted almost all data in a way that’s emphasized the grimmest of projections. If we are to be honest about the global response, in addition to the actual numbers, we will start to reveal a subtle but crucial linguistic sleight of hand when reporting COVID-19 that has distorted almost all data in a way that’s emphasized the grimmest of projections. Something strange happened as the world began to grapple with the new

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April 2021

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