A 54-year-old woman was diagnosed with COVID positive and recovered in a week. Due to mild symptoms, the lady was referred to home quarantine and not hospitalized. However, even after she recovered and detected negative, families residing in the building (where her apartment is there) shut their doors on her face and hurried scoot when they see her. A disgusting scene indeed! It is COVID Stigma!
However, this is not the only case related to COVID Stigma. Yes, the term is COVID Stigma and is one of the most prevalent evils apart from the virus itself at present! Many people and even medical professionals face this behavior from the people when they go back home after a rigorous duty in a COVID-19 ward. I believe you have heard about incidents where doctors treating COVID-19 patients were thrown out of their homes in the initial phase of the pandemic by the owners. That was in the initial days of the pandemic when people hardly were aware of the virus and its implications. But, even now! It is a sorrowful sight to see. After a year of the world facing the pandemic and enough information about the virus, people behave like this.
What is Social Stigma?
Social Stigma refers to discrimination that people do against a specific group of people, mainly in a negative attitude. In a pandemic scenario like COVID-19, the stigma is the people get labeled, massively stereotyped, and discriminated against due to a supposed link with the viral disease. The negative attitude through stigma affects the people affected by the disease and caregivers, their family, friends, and communities associated with the person. The stigma associated with COVID-19 primarily arises due to a lack of knowledge about the virus, leading to social stigma. The stigma basis on the following factors:
- COVID-19 is a new disease, and many people aren’t aware of the implication
- People fear the unknown.
- The difficult pandemic situation across the world creates anxiety, confusion, and fear, which lead to a defeatist attitude among the people.
The present COVID-19 pandemic has given birth to social stigma and discriminatory conduct against people belonging to specific backgrounds and anyone who has contracted the viral disease.
Impact of Social Stigma in terms of COVID-19
Social stigma can varyingly interfere with the social reasoning of people and lead to situations that might aggregate the spread of the disease. The discrimination can adversely affect people affected with the disease in addition to their families. Additionally, people who aren’t affected by COVID-19 but share identical characteristics with the affected group may also face the stigma.
As such, the social stigma associated with COVID-19 can:
- Prevent patients from seeking health care, which in turn may lead to the spread of the disease
- Bring feelings of shame in people and drive them to hide the disease to avoid any discrimination
- Discourage the patients to from adopting healthy habits and precautions
- Demotivate frontline workforce from conducting their responsibilities
- Hurt people more through anger and fear
- People infected from COVID-19 may experience discrimination in the form of:
- People avoiding or rejecting their presence
- A problem in acquiring healthcare, housing, or employment facilities
- Verbal abuse, harassment, and physical violence.
Shame and COVID Stigma
A crucial impact of the COVID Stigma is the shame that comes along with it. If the people develop feelings of shame, fear discrimination, and become hesitant to seek healthcare or medical attention, the virus will keep on spreading. The shame and blame elements will also contribute to depression, anxiety, and other mental health issues observed during the pandemic.
Ways of addressing Social Stigma associated with COVID-19
Studies portray that the stigma, lack of knowledge, and fear associated with infectious diseases make the stigma worse and hamper the response. The method that works best in the COVID-19 scenario is trusting in the available medical services, assist and help the frontline workers in whatever way possible, and showing empathy with the people affected. Additionally, it is also essential for people to gain knowledge about the pandemic, understand it, and adopt efficient measures to help another be safe and healthy. The thing that matters most at this hour is how people communicate about the pandemic and with one another, support one another, and take effective action to combat the pandemic scenario and erase the stigma from the society.
Everyone must be there for one another with empathy and care. If a person discloses a close contact that they might have inadvertently exposed to the virus, it is essential to ask them to quarantine and seek medical help. And most importantly, let them know that you appreciate their honesty and brave step to look out for others. As the close contact, develop symptoms or test positive, follow the guidelines directed by the health department.
It is perfectly normal for a person to develop emotions when they learn they or a close contact have tested positive or expose to the virus. These feelings may be anger, frustration, and you may want to yell or shame someone. Take long, deep breaths and clear the mind. Jot down the emotions, be true to yourself when you express yourself. It is okay to be angry or fearful- these are normal human responses.
Help from the Leaders
The leaders of the world have a huge responsibility to carry. To eradicate the COVID stigma, the leaders should encourage mitigation behavior among the public. They should advocate practices like regular mandatory mask-wearing and social distancing rules and condemn any harassment and violence occurring in the society. It is the leaders who should advocate a strict follower of the public health guidelines. A simple ‘thank you for wearing a mask or following the COVID-19 guidelines goes a long way to motivate people to work together as a collective society.
Messaging as an Educating Tool
Proper messaging to disseminate correct and relevant information is necessary at this hour. There should be clear and direct communication about what the people should do and not in times of the pandemic. It is essential to avoid rumors and fake information and focus on correct and relevant information related to COVID-19, dos and don’ts, and what a person should do if they test positive. Research on communication highlights that the messages that focus on providing solutions and positivity can overcome feelings of anxiety, helplessness, and frustration, leading to stigma.
In addition to the above, media coverage plays a crucial role in reducing stigma. The media should highlight COVID-19 recovery stories and stories of brave Corna warriors to create an environment of positivity for the people affected by the virus. It should also refrain from stigmatizing the people and aim at reducing fear and anxiety among the people through mindful coverage of the pandemic. One of the crucial things that the media should do is cross-check and install a solid fact check system to validate every news and information about COVID-19. The media should conduct regular content analysis and adopt a support toolkit to eradicate COVID stigma and discrimination in the society caused by any media reports.
Things to Follow
In addition to following the public health guidelines strictly, it is essential to:
- Wear a mask
- Stay at home as much as possible
- Socially distance
Only these steps can bring hope and the possibility of eradicating or not contracting the virus!
Although there is a roll-out of vaccines worldwide, the truth remains that the COVID-19 pandemic will not easily be over any time soon. Society needs collective efforts and robust systems to eradicate the virus! It should focus on
- Keeping one another safe and
- Avoid and stop the shame and stigma associated with COVID-19.
Reports of COVID Stigma
In the initial days of the COVID-19 pandemic, a lack of knowledge among the public and identifying the infection, super spreaders, and global community outbreaks caused widespread fear across the world. It led to complete lockdowns and a severe lack of relevant information about COVID-19, and its implications caused widespread stigma across local communities. There was almost hysteria among people that led to discrimination and attacks on vulnerable people. The hysteria soared to such a point that people infected with COVID-19 and their close contacts identified through the method of contact tracing were compared to heinous criminals. Global media reports showed how frontline medical workers were assaulted, hit, denied transportation facilities, and even rendered homeless due to fears among the people that they would transmit the virus to others. For example, in Mexico, the healthcare staff was forced to resort to bicycles as they were denied public transportation and saw physical assaults. Similarly, in Malawi, the frontline workers were denied public transport and repeatedly insulted the streets.
There have also been reports of Chinese people worldwide falling victim to brutal racist attacks during the pandemic as a result of discrimination. There have been reports of social stigma incidents towards people affected by the virus, with assaults on their family members. Also, people who succumbed to COVID-19 infections were denied last rites in many places. In several situations, the families of the people who died due to COVID-19 refused to accept the dead bodies. It led to the state governments performing the last rites instead. There have also been several incidents where their neighborhood isolated COVID survivors, and they took life far from the ordinary. They got labels like ‘super-spreaders which worsened their situation further.
COVID stigma prevails not only for the people who recovered from the viral infection but also for those undergoing medical treatment, who are presumed to be affected by the virus. Even society didn’t spare the people who succumbed to the virus! It is their families who have to face the wrath of COVID stigma! Additionally, the frontline medical workers- doctors, nurses, police personnel, ambulance personnel- all face the COVID stigma. The frontline workers couldn’t enter their homes, and their families received multiple threatenings. Also, the mental health practitioners who give positive counseling to the patients and work hard to create an aura of positivity amidst the chaos saw verbal abuses, labels, and harassment.
COVID stigma towards the marginalized groups, including the homeless, migrants, and laborers, also prevailed. Migrant laborers who returned home in harsh conditions amongst the lockdown couldn’t enter their villages, and the community banished their families from the village. These were the same people who were stranded for months amidst the lockdown and managed to return home in strenuous situations. The migrant laborer stigma situation predominantly existed in India, where there were rampant cases of COVID stigma in almost every region across the country. The Government of India, in its wake, then issued a regulatory advisory on April 8, 2020, asking the citizens to be more responsible at a crucial time of the pandemic and to refrain from any acts of stigmatizing individuals or any community.
In another incident in Delhi, around March 13–15, 2020, there was a religious meeting among the members of Tablighi Jamaat. It is an Islamic missionary and reformist organization where people worldwide met at the Nizamuddin Markaz (Center). Later on, it was that several members of the organization tested COVID positive. Before the people could be tested and quarantined, they returned to their respective homes across the country. The fear among the people of the spread of COVID-19 from these organization members was high at that time. As a result, the entire Muslim community bore the brunt of being stigmatized as ‘super spreaders’ of the COVID-19 virus.
At present, where cases are still prevalent and on a high in some parts of the world, there is a need for multilevel strategies to identify stigma drivers and reduce the stigmatization from society. Also, society needs collective empathy, solidarity, and effective cohesiveness to tackle the pandemic effectively. By reducing and eradicating the stigma associated with the pandemic, we can prevent, contain, and develop efficient long-term strategies to fight the pandemic and bring social justice in the future. As WHO puts it, to tackle COVID stigma, we should create an environment where there is an open discussion amongst all the common public and the healthcare professionals. “It is how we as a society communicate about COVID-19 is essential to support people to take practical steps to combat the viral disease and avoid igniting any fear and stigma in the society.