Institute for Population Health, Weill Cornell Medicine, Doha, Qatar.
Scand J Public Health. 2022 Aug;50(6):819-826. doi: 10.1177/14034948211057736. Epub 2021 Dec 13.
In this paper, we explore the contextual use of 10 epidemiological terminologies, their significance, and interpretation/misinterpretation in explaining various aspects of the 2019 novel coronavirus disease (COVID-19) pandemic.
We first establish the different purposes of the terms 'pandemic' and 'Public Health Emergency of International Concern.' We then discuss the confusion caused by using the 'case fatality rate' as opposed to 'infection fatality rate' during the pandemic and the uncertainty surrounding the limited usefulness of identifying someone as 'pre-symptomatic.' We highlight the ambiguity in the 'positivity rate' and the need to be able to generate data on 'excess mortality' during public health emergencies. We discuss the relevance of 'association and causation' in the context of the facemask controversy that existed at the start of the pandemic. We point out how the accepted epidemiological practice of discussing 'herd immunity' in the context of vaccines has been twisted to suit the political motive of a public health approach. Given that a high proportion of COVID-19 cases are asymptomatic, we go on to show how COVID-19 has blurred the lines between 'screening/diagnosis' and 'quarantine/isolation,' while giving birth to the new terminology of 'community quarantine.'
本文探讨了 10 种流行病学术语的语境用法，以及它们在解释 2019 年新型冠状病毒病（COVID-19）大流行的各个方面时的意义和解释/误解。
我们首先确定了术语“大流行”和“国际关注的突发公共卫生事件”的不同目的。然后，我们讨论了在大流行期间使用“病死率”而不是“感染病死率”所带来的混淆，以及确定某人“无症状前”的有限作用的不确定性。我们强调了“阳性率”的模糊性，以及在公共卫生紧急情况下生成“超额死亡率”数据的必要性。我们讨论了在大流行开始时口罩争议背景下“关联和因果关系”的相关性。我们指出，在疫苗背景下讨论“群体免疫”的被接受的流行病学实践是如何被扭曲以适应公共卫生方法的政治动机的。鉴于 COVID-19 病例中有很大一部分是无症状的，我们接着展示了 COVID-19 如何模糊了“筛查/诊断”和“检疫/隔离”之间的界限，同时产生了“社区检疫”的新术语。
