Social stigma is the concept given when a person’s social, physical, or mental state influences other people’s views of them or their behaviour towards them. Stigma involves negative perceptions and attitudes or discrimination against someone based on a distinguishing characteristic, e.g., a mental illness, health condition, or disability. Social stigmas can also be related to other features, including gender, sexuality, race, religion, and culture. Members of the general public may be uneasy with someone with an infectious disease. This may be overcome by informing them exactly what the seizures entail, but because of fears of rejection, many people with infectious disease try to hide their condition.
Nowadays, there is a significant social stigma associated with COVID-19. Erving Goffman, a Canadian sociologist, defined social stigma 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” versus “being tainted and undesirable”. It is already noted that social stigma is commonly related to race, culture, gender, intelligence, and health. The conceptualisation of stigma identifies four elements, which interact with each other: anticipated, perceived, experienced, and internalised stigma. COVID-19 has been associated with all these elements of social stigma. According to the World Health Organization (WHO), the level of stigma associated with COVID-19 is based on three main factors: (a). it is a disease that’s new and for which there are still many unknowns; (b). we are often afraid of the unknown; and, (c). it is easy to associate that fear with ‘others’. Understandably, there is confusion, anxiety, and fear among the public. Unfortunately, these factors are also fuelling harmful stereotypes.It has been observed that discrimination evolved in many places in parallel to the pandemic. Stigma makes people feel more 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. Perhaps more concerning, stigma harms people’s health and well-being in many ways. Stigmatised groups may often be deprived of the resources they need to care for themselves and their families during a pandemic. Research from past epidemics has shown that stigma undermines efforts to test for and treat disease. People who are worried about being shunned or worse may be less likely to get tested or seek medical care, which increases infection risks for them and others. However, social stigma towards the segregated appears to be normal behaviour to the common mass. Moreover, it gains social acceptance amidst the chaos of the unknown. Institutional segregation of those who are affected by a disease, at present COVID-19, further strengthens the stigma.
Governments, citizens, media, key influencers, and communities have an essential role to play in preventing and stopping the stigma. We all need to be intentional and thoughtful when communicating on social media and other communication platforms, showing supportive behaviours around the new coronavirus disease (COVID-19). The WHO provides some examples of possible actions to counter stigmatising attitudes.
Spreading the facts - stigma can be heightened by insufficient knowledge about how the COVID-19 is transmitted and treated, and how to prevent infection. In response, prioritise 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 healthcare and information. Use simple language and avoid clinical terms. Social media is useful for reaching a large number of people with health information at a relatively low cost. Engaging social influencers like religious leaders on prompting reflection about people who are stigmatised 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. Amplify the voices, stories, and images of local people who have experienced the COVID-19 and have recovered or who have supported a loved one through recovery to emphasise that most people do recover from COVID-19. Community volunteers also play a significant role in reducing stigma in communities.
Furthermore, there are several 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. For example, the World Health Organization has initiated some steps to fight against misinformation in the Rohingya camps in Cox’s Bazar by providing technical guidance to respond to rumours and promote community feedback quickly. Cox’s Bazar in Bangladesh is home to the world’s largest refugee settlement, a location where a disease like COVID-19 has the potential to spread rapidly with devastating consequences due to vulnerable populations in cramped quarters. The spread of rumours and misinformation have created fears among the Rohingya about quarantine and isolation for COVID-19 cases and their contacts. Therefore, many are avoiding health services and not reporting instances of possible cases.
Misinformation spreads quicker than the virus itself and is creating additional difficulties in their attempts to contain COVID-19. The organisation is also collaborating with partners to disseminate information that helps the population prepare and protect themselves from COVID-19, including the safe use of facial masks. In the overall fight against the disease in Cox’s Bazar, the WHO is using all of its available tools to detect, isolate, test, and manage suspected cases. It has appointed additional medical staff to strengthen COVID-19 surveillance at the camp level. The staffs have recently initiated a field investigation to identify gaps in reporting cases and collecting information. In response, the WHO is strengthening community surveillance with enhanced community engagement to address the existing fear and stigma around COVID-19.
COVID-19 has been declared a global health emergency. But social stigma reduces the effectiveness of the COVID-19 response. In an outbreak, people who have a perceived link with the disease might experience discrimination. They may be treated separately and/or experience a loss of status. Trusted, clear, and effective communication and engagement approaches are critical to ensure that fear, panic, and rumours do not undermine response efforts and lead to COVID-19 to spread even more quickly. The COVID-19 pandemic will be over sooner if fears and rumours are replaced by facts, proper action, and a show of support for one another.(The author acknowledges with gratitude the different sources of information.)
The writer is the Assistant Professor, Department of Public Administration, Jagannath University, Dhaka.