What healthcare-related terms got the most attention in 2020? We're betting you can name several off the top of your head. If you guessed "COVID-19" or "pandemic," you're right. But you may be surprised at some of the others, many of which stemmed from the virus, that became part of the cultural and medical lexicon during this wild, unprecedented year.
Here are some of the more popular terms, arranged alphabetically by category, along with their definitions and healthcare application. We contrast definitions in some cases to clarify the difference.
A carrier of an illness who shows no symptoms. The CDC says that people who do not have symptoms and do not know that they are infected can spread COVID-19, so it is wise to follow the recommended guidelines.
An investigational monoclonal antibody therapy, which received emergency use authorization in November 2020 for the treatment of mild-to-moderate COVID-19 in adult and pediatric patients. Bamlanivimab is not authorized for patients who are hospitalized due to COVID-19 or who require oxygen therapy due to COVID-19.
Sometimes referred to as community transmission, the term means the circulation of a disease among people in a specific area with no clear explanation of how they were infected. In late February, a woman in California became the first COVID-19 patient in the U.S. who could not confirm how she got the disease.
A method used to control coronavirus or any infectious disease. "Contact tracers" track down people who have been in close contact with someone who has coronavirus.
A family of viruses gets its name from the crown-like spikes that appear on the viruses under a microscope as a corona. Human coronaviruses were first identified in the 1960s.
While they vary in severity, all can cause respiratory illnesses. Coronaviruses span the spectrum from the common cold to the severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS).
SARS CoV-2 (severe acute respiratory syndrome coronavirus 2), the coronavirus first discovered in December 2019, causes the disease known as COVID-19.
We are used to the drive-thru windows at fast-food restaurants. Now, we have "drive-thru" COVID-19 testing where the medical staff takes a "swab test" (usually through the nose) to collect cells to test for the presence of the virus. Those being tested remain in their car, which reduces the chances of disease spread.
Droplet Transmission versus Airborne Transmission
Droplet transmission is a form of direct spread that occurs when a spray containing relatively large, short-range droplets are produced by sneezing, coughing, or talking. Droplet precautions include physical distancing, such as the recommendation to space six feet apart, and wearing masks.
Airborne transmission takes place when smaller particles contain the virus. They can travel farther and linger longer in the air. Droplets are created in the breath, and more are generated by very active breathing, so certain activities, like exercising and singing, pose greater exposure risks. Both types of exposures increase in an enclosed space.
Epidemic versus Pandemic
An epidemic is a transitory prevalence or rapid disease spread at the community or regional level. A pandemic is an epidemic that has spread over a large area and has become prevalent throughout an entire country, continent, or, in the case of COVID-19, the whole world.
Pandemics typically happen when a new virus spreads easily among people who have little or no pre-existing immunity because the virus is new to them. COVID-19 is the first pandemic known to be caused by the emergence of a new coronavirus.
Flattening the Curve
Slowing the spread of the virus. The expectation is that the disease spread will peak at some point as we reach herd immunity, and the upward trending curve flattens out as the incidence rate begins to decline. Precautions like mask-wearing are taken to slow the disease's natural progression in the meantime.
Herd immunity occurs when a high percentage of the community is immune to a disease, either through vaccination or prior illness, dramatically slowing or halting its spread.
An oral drug used to treat malaria, rheumatoid arthritis, and lupus. Its effectiveness in treating patients diagnosed with COVID-19 is controversial/no longer recommended.
Although it looks like a surgical mask, the N95 is a respirator that filters out 95 percent or more air particles. The CDC does not recommend N95 respirators for public use.
Personal Protective Equipment (PPE)
The Occupational Safety and Health Administration defines PPE as "specialized clothing or equipment, worn by an employee for protection against infectious materials.” In healthcare settings, PPE consists of gloves, gowns, aprons, masks, respirators, goggles, and face shields.
Quarantine versus Isolation
Quarantine and isolation are practices designed to prevent exposure to people who may have a contagious disease. While isolation separates sick people from those who are not, quarantine separates and restricts people's movement to see if they become ill.
An investigational antiviral drug administered intravenously that inhibits viral replication. It was first developed to treat Ebola and is being used for the treatment of COVID-19.
Respirator versus Ventilator
A respirator is a face mask that seals around the mouth and filters out particles from the air before being breathed in. A ventilator is a machine that moves air in and out of the lungs if a patient has trouble breathing independently.
One of the recommended methods—along with mask-wearing and hand washing—to help stop the spread of coronavirus. It mandates that people maintain a distance of at least six feet apart.
A person who, for unknown reasons, can infect an unusually large number of people. Super-spreaders align with the 80/20 rule in that 20 percent of infected patients may drive 80 percent of transmissions.
Thanks to COVID-19, telehealth has become a staple in American healthcare. More than 76 percent of U.S. hospitals now utilize technology in one form or another. According to health care leaders, the virus has pushed the telemedicine revolution forward by a decade, if not more.
"The adoption and acceptance of telehealth have expanded more in the past three months than in the past ten years," said Dick Flanigan, senior vice president at Cerner, a healthcare IT company. "Within days, health systems and providers scrambled to offer new telehealth services. While some drop-off is inevitable with the reopening of clinics and offices, this newer way of delivering care is here to stay."
With that in mind, here are some of the terms that have become more prominent.
Artificial Intelligence (AI)
Artificial intelligence is an arm of computer science devoted to building smart machines capable of performing tasks typically requiring human intelligence. Its use in medicine has become wide-ranging and includes rapid diagnosis and risk prediction of COVID-19. AI can also potentially help in the management of critically ill patients who have the coronavirus.
Telehealth versus Telemedicine
The American Telemedicine Association treats "telemedicine" and "telehealth" as interchangeable. There are differences between the two, however.
Telehealth refers to the entire spectrum of remote healthcare services delivered via telecommunications and virtual technologies. Telemedicine, on the other hand, pertains to a subset of telehealth that provides clinical and medical services to patients through technology, such as video conferencing, text messaging, and audio.
Telehealth covers a wide range of healthcare-related disciplines, including dentistry, counseling, physical and occupational therapy, home health, and more.
Another term, mHealth (shorthand for mobile health), has also come into greater use. It is a form of telemedicine that involves providing clinical and medical services through cell phones and other wireless mobile devices.
A telehospitalist is a hospitalist who provides remote services to patients and providers that range from initial and follow-up encounters to post-acute care visits, and from home visits to consultations and emergency care.
Traditionally, telehospitalists have been thought of as a nighttime service to supplement in-person clinical care and coverage gaps, but that is changing. A new 24/7 telehospitalist model has evolved and is proving to be an innovative means of support.
Healthcare and Society
This year, 2020, has seen a drastic increase in attention on racism, diversity, equity, and justice. Medically, the pandemic has emphasized social determinants of health and its effect on racial and ethnic minority populations. It's helpful to clarify what these terms mean, particularly regarding their healthcare implications.
Diversity is not as easily defined as you may imagine. Traditionally, it has been based on demographic representations that include race, ethnicity, religion, gender, and sexual orientation.
However, the millennial generation has advanced a newer, more inclusive definition that views diversity within the context of experiences, opinions, and thoughts, a report by Deloitte University and Billie Jean King Leadership Initiative stated.
Further, millennials believe that "programs aimed at diversity and inclusion should focus on improved business opportunities and outcomes due to the acceptance of cognitive diversity, specifically individualism, collaboration, teamwork, and innovation," the report said.
That is not unlike the definition offered by Ross Ott, chief human resource officer for SCP Health.
"Diversity is an ethereal concept that's less about skin color or gender and more about recognizing the differences that exist in all of us and how we show up with those to affect a better outcome," he said. "We can define diversity in terms of the outcome we're trying to get to—better patient care, or better operational or financial results.”
Equality versus Equity
According to the Milken Institute School of Public Health, equality means each individual or group is given the same resources or opportunities. Equity recognizes that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome.
The World Health Organization (WHO) defines equity as "the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically." The CDC refers to health equity as everyone having "the opportunity to be as healthy as possible."
Understanding the difference between health equality and health equity is vital to public health to ensure that resources are directed appropriately.
Gender identity is a term we are now seeing used more and more.
It has to do with the assignment of sex as male, female, or intersex at birth. It can also refer to self-identified gender, transgender, gender self-expression, or nonbinary that includes preferred pronouns, such as she/her, he/him, and they/them.
Its healthcare implication has to do with electronic medical records (EMR) and laboratory information systems (LIS), commonly using patient identifiers, such as legal name, sex, medical record number, and birth date. There have been recommendations from some EMR working groups to include preferred name, pronoun preference, assigned sex at birth, and gender identity in the EMR.
Institutional racism, also known as systemic racism, is a form of discrimination embedded as a normal practice within society or an organization. It manifests in healthcare through individuals who report experiencing racism having higher illness rates.
In the U.S., compared with white individuals, black men and women face higher risks of chronic illness, infection, and injuries. Taken together, the average lifespan for African Americans is six years less compared with Caucasians.
Not only has the pandemic dramatically affected people's physical health, but the toll it has taken mentally and emotionally has also had grave consequences. The result has been increases in mental health distress, substance abuse, and suicidal ideation due to economic stress, increased isolation, and limited community support access.
Here are some of the mental health terms that have increased in prevalence in 2020.
People with anxiety disorders respond to particular objects or situations with fear and dread. Anxiety disorders can include obsessive-compulsive disorder, panic disorders, and phobias.
Behavioral Health versus Mental Health
The terms "behavioral health" and "mental health" are often used interchangeably, not unlike telehealth and telemedicine, previously mentioned. The term "behavioral health" is less stigmatized than "mental health," however, and is a kinder, gentler, more hopeful name that opens doors to acceptance, which may remain closed otherwise.
Burnout is a state of exhaustion caused by prolonged stress. It may manifest as excessive detachment, cynicism, and feeling overwhelmed.
Trauma and Stress-related Disorders
Post-traumatic stress disorder (PTSD) can occur after living through or seeing a traumatic event, including the trauma brought on by COVID-19 and the subsequent consequences of the economy and society.
Post-traumatic growth describes situations where someone or some organization develops positively after going through a major trauma. Post-traumatic growth includes 5 domains: developing deeper relationships, openness to new possibilities, a greater sense of personal strength, a stronger sense of spirituality, and a greater appreciation of life.
Other Popular Terms
Person-centered care is caring for patients and their families in meaningful and valuable ways that reduce disparity. That includes showing respect for patients' values, preferences, and expressed needs. Person-centered care aims to improve patients' lives and health outcomes and unite communities around health and wellness.
Unfortunately, COVID-19 has affected the clinical staff’s ability to offer person-centered care by reducing access to in-person care and restricting family visitation to hospitalized patients.
The term healthcare consumerism has been around a while, but COVID-19 has given it new impetus. The pandemic has significantly changed consumer behaviors and attitudes and their anxiety and comfort levels about healthcare. The result is that consumers are taking charge of their health more than ever before.
Although we don't know what terms 2021 will popularize, let's hope the list includes "post-pandemic" and "coronavirus vaccine."
For now, as we approach the year's end, we celebrate the advances in medical technology and express appreciation for the frontline heroes who put themselves at risk to fight this disease every day. Let's also spend time with our loved ones, albeit virtually, and strive to have a more positive outlook on the future.