Stigma during the COVID-19 pandemic.

Healthcare workers and patients who have survived COVID-19 are facing stigma and discrimination all over the world. Sanjeet Bagcchi reports.

Stigma associated with COVID-19 poses a serious threat to the lives of healthcare workers, patients, and survivors of the disease. In May 2020, a community of advocates comprising of 13 medical and humanitarian organisations including, among others, the International Committee of the Red Cross, the International Federation of the Red Cross and Red Crescent Societies, the the International Hospital Federation, and World Medical Association issued a declaration that condemned more than 200 incidents of COVID-19 related attacks on healthcare workers and health facilities during the ongoing pandemic.

According to the declaration, “The recent displays of public support for COVID-19 responders are heartwarming, but many responders are nevertheless experiencing harassment, stigmatization and physical violence.” In a Mar 18, 2020 statement, WHO also unveiled that “some healthcare workers may unfortunately experience avoidance by their family or community owing to stigma or fear. This can make an already challenging situation far more difficult.”

Several incidents of stigmatization of healthcare workers, COVID-19 patients, and survivors have come up during this pandemic across the world. For instance, in Mexico, doctors and nurses were found to use bicycles, as they were reportedly denied access to public transport and were subjected to physical assaults. Similarly, in Malawi, healthcare workers were reportedly disallowed from using public transport, insulted in the street, and evicted from rented apartments. In India, media reports revealed that doctors and medical staff dealing with COVID-19 patients faced substantial social ostracism; they were asked to vacate the rented homes, and were even attacked while carrying out their duties. With respect to social stigma of COVID-19 patients, there was an incident where a pregnant woman was reportedly abandoned by her family in India, after she gave birth to a child at a hospital in Maharashtra state, and was found positive for SARS-CoV-2. In some cases, COVID-19 survivors in India were stalked in social media. A COVID-19 survivor in Harare, Zimbabwe, got surprised, according to a media report, when the road in front of his house was named as “corona road” and some people even preferred to avoid the road fearing the possibilities of infection.

“COVID-19 pandemic has created an unprecedented panic in the minds of people in India and several other countries”, says Diptendra Kumar Sarkar, a professor of surgery and Covid-19 strategist affiliated to the Institute of Post Graduate Medical Education Research (Kolkata, India). According to him, healthcare workers in India have become a natural target in the society, which is why they are suffering mental stress. Many of them faced social isolation, because of their job, and some had even faced near lynching situations, he points out. “Such a situation of social isolation may be linked to the high infectivity of the virus”, he suggests. Rahuldeb Sarkar, a respiratory medicine consultant at the Medway Maritime Hospital (Kent, UK) adds that, in countries such as India and Mexico, healthcare workers have to face substantial stigma during the pandemic as a result of the fear (about the infection) of the general public. “People do not have clear idea about modes of transmission of the virus”, he says. “Social stigma in COVID-19 pandemic is attributable to unscientific belief and improper understanding of common masses”, says Asis Manna, a professor of microbiology at the Infectious Diseases and Beliaghata General Hospital (Kolkata, India). According to him, some people believe that healthcare staff working in a hospital are a potential source of infection. This baseless belief extends to drivers of ambulances, family members of COVID-19 patients, and also patients discharged from the hospital after cure, he notes.

However, in USA and UK, the doctors' experience of COVID-19 related stigma is different. “In the USA, we have had several instances where healthcare workers have faced harassment at public places because they have been perceived as at higher risk of transmission”, says Anish Ray, a consultant pediatrician at the Cook Children's Medical Center (TX, USA). However, according to Sarkar put, “In the UK, we were fortunate not to have stigma around healthcare workers' possibility of catching COVID. Instead of turning on against us, our neighbors truly appreciated the work we have been doing”.

To tackle social stigma derived from COVID-19, WHO speaks of creating an environment where open discussion among people and healthcare workers is possible. “How we communicate about COVID-19 is critical in supporting people to take effective action to help combat the disease and to avoid fuelling fear and stigma”, WHO says, in a statement. “All efforts must be taken to scientifically destigmatise COVID-19 instead of statutory sermons by law makers”, urges Sarkar. “Proper health education targeting the public appears to be the most effective method to prevent social harassments of both healthcare workers and COVID-19 survivors”, says Ray. “It would also help create a proper environment to work as a team to contain this pandemic”, he stresses.