November 19, 2020

What is Stigma?

Stigma is a mark of disgrace associated with a particular quality, person or circumstance, such as COVID-19. Stigma occurs when people associate a risk with a specific people, place, or thing while there is no evidence the risk is greater in that group. Stigmatization is especially common in disease outbreaks. In an outbreak, this often means people are labelled, stereotyped, separated, and/or experience loss of status and discrimination because of an association with a disease.

People are understandably frightened and concerned when an infectious disease outbreak becomes a pandemic. When the outbreak is caused by a new virus, rumors and misinformation run rampant. Confusion is the breeding ground of stereotypes, prejudice, and discrimination leading to stigma. This stigma can negatively affect those with a disease themselves, as well as their caregivers, family, friends, and communities.

Stereotypes quickly arise about people who have or may have the disease. For example, people of Asian descent have been treated with suspicion and blamed for COVID-19, even though they’re no more likely to spread the virus than the general population. Also, some people worry that individuals who have recently completed quarantine have COVID-19 and are contagious, but there is no current evidence to suggest that is the case.

This kind of stigma harms people with COVID-19 in three ways. First is public stigma, harm that results when people endorse stereotypes about individuals with COVID-19, such as they’re tainted. Second is self-stigma: the disrespect that results when people associated with the virus internalize stereotypes and feel tainted or dirty. It is difficult enough dealing with the virus; in addition, people are supposed to be ashamed of themselves. Third is what has been called label avoidance, which is an obvious and observable mark that the public discriminates against. For example, the mark of most stigmatized health conditions is different because it is hidden; one cannot tell who in a room of one hundred people is positive for coronavirus. People will try to avoid the label by avoiding health-related experiences. Label avoidance causes people not to be tested or isolate should results be “positive.”

Blaming and shaming groups in this way can be hurtful and dangerous. It makes people targets for misplaced anger and hostility. It also creates hardships and divisions that hamper the response to the pandemic. Stigma arises when the virus and the person with the virus are conflated; when we change the question from what’s to blame to who’s to blame. Find out how to identify COVID-19 stigma and how to respond to it.

Who experiences stigma related to COVID-19?

  • People of Asian descent
  • People returning from travel
  • Health care workers and emergency responders
  • People with the disease and their family and friends
  • People released from quarantine

What happens to those that are stigmatized?

  • They may be excluded or shunned in social situations.
  • They may be denied job and educational opportunities.
  • They may be denied access to adequate housing and health care.
  • They may be targets of verbal, emotional and physical abuse.

How does stigma affect people that experience it?

Stigma can undermine social unity and prompt possible social isolation for those who are stigmatized. This might contribute to a situation where the virus is more likely to spread. In fact, stigma can drive people to hide the illness to avoid discrimination, refrain from seeking health care immediately, and prevent them from adopting healthy behaviours. 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.

Why does stigma hurt everyone?

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 for others.

What you can do to reduce COVID-19 stigma?

Education is one way to fight stigma. It helps dispel harmful stereotypes. Also, it is well evidenced that stigma and fear around communicable diseases hamper the response. What works is building trust in reliable health services and advice, empathy for those affected, understanding of the disease itself, and adopting effective practical safety measures. 

How we talk and communicate about COVID-19 is critical in supporting people to take effective action to combat the disease and avoid fuelling fear and stigma further. An environment needs to be created in which the disease and its impact can be discussed and addressed openly, honestly, and effectively. Here are some tips on how to address and avoid compounding social stigma:

You can help reduce stigma by:

  • Get and share the facts about COVID-19 from reputable sources such as the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO). 
  • Speak up if you hear/see incorrect statements about COVID-19 and certain people/groups.
  • Reaching out to people who may feel stigmatized. Ask how you can help. Listen to them and show you understand and support them.
  • Showing support for health care workers and others who are caring for people with COVID-19. Thank them for their work and share positive messages on social media.
  • Showing support for and thanking all who continue their essential jobs to help you and your community, such as police officers, bus drivers, grocery store clerks, food bank workers, security personnel, and delivery people.

COVID-19 Stigma Do’s and Don’t

DO – talk about the new coronavirus disease (COVID-19)

DON’T – attach locations or ethnicity to the disease, such as “Wuhan Virus”, “Chinese Virus” or “Asian Virus”. The official name for the disease was deliberately chosen to avoid stigmatization – the “co” stands for Corona, “vi” for virus and “d” for disease, 19 is because the disease emerged in 2019.

DO – talk about “people who have COVID-19”, “people who are being treated for COVID-19”, “people who are recovering from COVID-19” or “people who died after contracting COVID-19”

DON’T – refer to people with the disease as “COVID-19 cases” or “victims”

DO – talk about “those who may have COVID-19” or “those presumptive for COVID-19”

DON’T – talk about “COVID-19 suspects” or “suspected cases”.

DO – talk about people “acquiring” or “contracting” COVID-19

DON’T talk about people “transmitting COVID-19” “infecting others” or “spreading the virus” as it implies intentional transmission and assigns blame, which creates the impression those with the disease have somehow done something wrong. This feed stigma, undermining empathy, and potentially fuelling wider reluctance to seek treatment or attend screening, testing, and quarantine.

DO – speak accurately about the risk from COVID-19, based on scientific data and latest official health advice.

DON’T – repeat or share unconfirmed rumours, and avoid using hyperbolic language designed to generate fear like “plague”, “apocalypse” etc.

DO – talk positively and emphasise the effectiveness of prevention and treatment measures. For most people this is a disease they can overcome.

DON’T – emphasize or dwell on the negative, or messages of threat. We need to work together to help keep those who are most vulnerable safe.

DO – emphasize the effectiveness of adopting protective measures to prevent acquiring the new coronavirus, as well as early screening, testing and treatment.

DON’T – be rude, give the evil eye, say mean things, be racist, or be too hard on yourself.

If you or a person you care about is experiencing a mental health crisis or emergency, please encourage them to seek help immediately. You can reach our Mental Health Crisis Coordinator, Stephanie MacLaurin, at (807)630-6212 or email them at stephaniemaclaurin@fwfn.com. If you require immediate assistance after hours, please call the Health Centre On Call 24 hours at (807)472-7701.