By Dr. Arati Kumari Panda
The COVID-19 pandemic has dramatically changed the lives of people around the globe which appeared in Wuhan, China in Dec ember 2019. The disease and its death toll have had a great impact on the healthcare, economic and financial systems of low, middle, high income countries. People’s lives have been disrupted and negatively impacted by covid-19 related suffering and lockdowns at community and house hold level.
The rigidity of lockdown measures has radically changed social interactions .Social distancing maintaining a physical distance] besides frequent hand washing , using of face masks in public and increasing ventilation in indoor spaces are some important health behaviors to reduce virus transmission from one infectious patient to other. It is also evidence that SARS-COV-2 is transmitted by the inhalation of airborne particles.
Insufficient knowledge and contradictory information about the transmission of SARS-COV-2 and protective measures such as wearing face masks in public is associated with anxiety among the people. People’s uncertainty and anxiety has led them to believe biased and vague information provided by traditional media, social media and self- proclaimed expert. Misinformation about COVID-19 has rapidly spread worldwide. During the early days of the pandemic, the identification of infectious clusters, super spreaders or community outbreaks caused widespread fear among the people. Anxiety caused by Lockdowns, many unknowns around COVID-19 and the fear of being infected have given rise to stigma in local communities.
Stigma is discrimination against an identifiable group of people, a place, or a nation. Stigma is associated with a lack of knowledge about how COVID-19spreads, a need to blame someone, fears about disease and death and gossip that spreads rumors and myths. Social stigma in the context of health is the negative association between a person or group of people who share certain characteristics and a specific disease. In an outbreak, this may mean people are labelled, stereotyped, discriminated against, treated separately, and/or experience loss of status because of a perceived link with a disease.
Such treatment can negatively affect those with the disease, as well as their caregivers, family, friends and communities. People who don’t have the disease but share other characteristics with this group may also suffer from stigma .The current COVID-19 outbreak has provoked social stigma and discriminatory behaviors against people of certain ethnic backgrounds as well as anyone perceived to have been in contact with the virus.
When an infectious disease outbreak becomes a pandemic as with corona virus disease 2019, people are understandably frightened and concerned. When the outbreak is caused by a new virus, rumors and misinformation run rampant . Stereotypes quickly arise about people who have or may have the disease. In US and Europe people of Asian descent have been treated with suspicion and blamed for COVID-19, even though they are more likely to spread the virus than the general population.
In some cases it is believed that who have recently completed quarantine have COVID-19 and are contagious, but there is no correct evidence to suggest that’s the case. Blaming and shaming groups in this way is dangerous. It can create anger and hostility.
Some group of people who experienced stigma during the COVID-19 pandemic include
1- Certain racial and ethnic minority groups including Asian, Americans, black or African Americans.
2- People who tested positive for COVID-19 have recovered from this or were released from COVID-19 quarantine.
3- Health workers who are the frontline warriors have been assaulted, spit on, hit with rock, sprayed with bleach, denied rides to work and made homeless because of fears that they would transmit SARC- COV-2 to the people around them.
4- Chinese people have fallen victim to racist attacks during the pandemic and that Chinese restaurants around the world at risk of shutting down completely due to decrease in customers and because of discrimination against Chinese restaurants and lockdown.
5- People returning from travel.
6- Frontline warriors like Policeman, Sanitary workers.
Stigma can make people feel isolated and even abandoned. They may feel depressed, hurt and angry when friends and others in their community avoid them for fear of getting Covid-19. Stigmatized groups may often be deprived of the resources they need to care for themselves and their families during a pandemic.
Social stigma was defined by Goffman in 1963 as “an attribute which is deeply discrediting” that reduces a person “from a whole and usual person to a tainted, discounted one”. It creates a dichotomy between being normal and acceptable to tainted and undesirable. Social stigma is commonly related to race, culture, gender, intelligence, and health.
The conceptualization of stigma identifies four elements that interact with each other, anticipated, perceived, experienced and internalized stigma. COVID-19 has been associated with all of these elements of social stigma. People have modified their actions because of fear of being discriminated against, for example, by avoiding testing of Covid that is anticipated stigma. Patients and their families felt judged by other is perceived stigma, infected or exposed person were excluded, isolated and discriminated against by their household or community members is experienced stigma. Some patients might have felt shame and self-rejection is internalized stigma.
Social stigma negatively affects social justice as stigmatized people feel that they cannot actively participate in society. The anxiety and concern of being discriminated against can lead to two hazardous clinical and public health consequence: delayed presentation of symptomatic patients to healthcare services and under detection of infectious individuals. Delayed diagnosis has been associated with more severe disease, mainly in the elderly and vulnerable groups, while delayed notification after infectious patients can facilitate the rapid spread of the SARS-COV 2 in the community.
Health workers including doctors, nurses allied and healthcare professionals are rendering their services tirelessly to provide care and medical support in this situation .Sanitary workers and police are also doing selfless service. They all deserve our support, praise and appreciation.
All those directly involved in the management of COVID-19 are equipped with appropriate protective equipment to keep them safe from the infection.
To reduce the COVID-19 stigma education is one-way to fight stigma. It helps harmful stereotypes11.Stigma can be reduce by many ways like
a- Getting the facts about the COVID-19 from reputable sources such as ministry of health and family, welfare, Govt of India, centers for disease control and prevent on and World health organization & share them with your family and friends.
b- Cross check any information related to COVID-19 from reliable sources before forwarding any messages on social media. Reaching out to people who may feel stigmatized ask for help. Listen to them and show that you understand and support them. We have to support for healthcare workers and others who are caring for people with covid-19. Thank them for their work and share positive message on social media.
c- Thank and support to be given the community helper like police officers , grocery store, clerks, bus driver, food bank workers and delivery people. By sharing positive stories of those who recovered from COVID-19 we can eliminate stigma in the society .In some other way we can reduce COVID-19 stigma , like never spread names or identity of those affected or under quarantine or their locality on social media, avoid spreading fear and panic, not to panic, not to target health care and sanitary workers, by stopping the use terms such as infected and carrier and switch to affected or acquired. Avoid addressing those under treatment as covid victims. Address them as people recovering from Covid. The COVID-19 pandemic wil be over sooner if fears and rumors are replaced by facts, proper action and a show of support for one another.
d- Stigma can be heightened by insufficient knowledge about how the new coronavirus disease (COVID-19) is transmitted and treated, and how to prevent infection. In response, priorities the collection, consolidation and dissemination of accurate country- and community-specific information about affected areas, individual and group vulnerability to COVID- 19, treatment options and where to access health care and information. Use simple language and avoid clinical terms. Social media is useful for reaching a large number of people with health information at relatively low cost.
e- Engaging social influencers such as religious leaders on prompting reflection about people who are stigmatized and how to support them, or respected celebrities to amplify messages that reduce stigma. The information should be well targeted and the celebrities who are asked to communicate this information must be personally engaged, and geographically and culturally appropriate to the audiences they seek to influence. An example would be a mayor (or another key influencer) going live on social media and shaking hands with the leader of the Chinese community.
f- Amplify the voices, stories and images of local people who have experienced the new coronavirus (COVID-19) and have recovered or who have supported a loved one through recovery to emphasize that most people do recover from COVID-19. Also, implementing a “hero” campaign honoring caretakers and healthcare workers who may be stigmatized. Community volunteers also play a great role in reducing stigma in communities.
g- Make sure you portray different ethnic groups. All materials should show diverse communities being impacted and working together to prevent the spread of COVID-19. Ensure that typeface, symbols and formats are neutral and don’t suggest any particular group.
h- Journalistic reporting which overly focuses on individual behavior and patients responsibility for having and “spreading COVID-19” can increase stigma of people who may have the disease. Some media outlets have, for example, focused on speculating on the source of COVID-19, trying to identify “patient zero” in each country. Emphasizing efforts to find a vaccine and treatment can increase fear and give the impression that we are powerless to halt infections now. Instead, promote content around basic infection prevention practices, symptoms of COVID-19 and when to seek health care.
i- There are a number of initiatives to address stigma and stereotyping. It is key to link up to these activities to create a movement and a positive environment that shows care and empathy for all.
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Dr. Arati Kumari Panda is a Lecturer in History, Govt. Science College, Chatrapur, Ganjam.
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