Words can paint a softened impression of Covid-19’s onslaught

Language gives us many resources for softening the blow of bad news, but in the time of Covid-19, there is a strong case to be made for doing away with these words, or at least being more cautious of the ways they are used. The coverage of Zindzi Mandela-Hlongwane’s passing offers some important lessons in how words can be deceptive in the reporting of Covid-19 deaths, and about the sensitivities associated with them.

In my database of top online news articles in July, my interest was caught by two words which show a strong association with “Covid-19”: “complications” and “related”. Both of these words, when used in phrases such as “Covid-19-related complications”, are examples of words that soften the boundaries of meanings, introducing grey areas and slippage into them.

If I say: “He died of Covid-19,” that statement is either true or false, with no room for manoeuvre between those two alternatives. If, however, I say: “He died of complications related to Covid-19,” then what killed this poor person was something indeterminate, one step removed from the virus itself, and many more questions can be asked, such as: “How are the complications related to Covid-19? Could something else have caused them?”

With the stigma that has unfortunately grown around the disease, grieving families are reluctant even to acknowledge that their loved ones have died from complications related to Covid-19, as was shown by the death of Mandela-Hlongwane. On July 17, an Independent Online article quoted her son Zondwa as saying: “There were other tests that were conducted and my mother did, in fact, test positive for Covid-19 on the day of her passing. Although this doesn’t therefore mean that she died of Covid-related complications, but simply that she tested positive for it.” On the same day, a TimesLive article said bluntly: “She died of complications related to Covid-19.” It seems likely that the TimesLive reporters were trying to give the brief version rather than the more nuanced view reflected in the IOL article (I have not been able to find any more recent information shedding light on Mandela-Hlongwane’s cause of death).

The Mandela family has rightly been lauded for revealing that she tested positive for Covid-19. That on its own goes a significant distance towards diminishing the stigma surrounding the virus. But the incident highlights the difficulties of reporting on Covid-19 deaths more broadly.

President Cyril Ramaphosa has boasted of our official case fatality rate, currently at about 1,6%, but recent statistics about “excess deaths” in South Africa this year have shown that there may be drastic underreporting of the effects of Covid-19 in the country. The South African Medical Research Council (SAMRC) has revealed that there were 22 279 of these excess deaths from May 6 to July 21. In the week before July 21, there were 6 256 such deaths, although only 915 deaths from Covid-19 were included in the official statistics. Yet, when the possible reasons for these excess deaths and their geographical locations are examined, the influence of Covid-19 looms large.

Some SAMRC members claim that anomalies in the issuing of death certificates are causing Covid-19 deaths to be underreported. As one article explains: “For example, if someone with diabetes dies of Covid-19 as a result of their comorbidity placing them at much higher risk of death in the first place, some officials would register the death as being due to diabetes and others as a Covid-19 death.” In other words, often Covid-19 doesn’t kill people; comorbidities do, but those people probably would not have died if they had not had the virus, even though these deaths are then not counted as Covid-19 deaths.

This all helps us to understand why softeners such as “related” and “complications” are often used in Covid-19 reporting, but also why we might be better off without them. If every death directly or indirectly caused by the disease was called a Covid-19 death, we would have a better picture of how dangerous the virus is, and more motivation to stick to preventative measures. This is especially important as fatigue with these measures is setting in and more people may let their guards down after reports that we have passed a peak of infections in some areas such as the Western Cape. Although I believe that alarmism and exaggerated reporting of risks is counterproductive, it is important to keep a clear, realistic view at all times. It may seem cruel to dispense with euphemisms and softeners at a time like this, but doing so may save lives.