Stigma during public health emergencies
Public health emergencies are understandably very stressful periods, filled with uncertainties and concerns for many. Such periods of heightened pressures and anxieties can also, unfortunately, be a breeding ground for stigmatising attitudes and discriminatory behaviours. These are often fuelled by misinformation and a lack of knowledge.
The fear, mistrust, and subsequent stigmatising and discriminatory behaviours can be targeted at certain groups of people, nationalities, geographic areas, or professions that become associated with the health emergency and illness. This is the case particularly for infectious disease outbreaks, where fears of contagious and attributions of blame are common. And it is often the most vulnerable populations within our communities who face an increased risk of both illness and of becoming directly impacted by health emergencies. The negative impact of this can be compounded by damaging treatment from others, due to systemic inequalities in our society.
In the past we have seen stigma and discrimination in relation to previous influenza pandemics, infectious diseases like tuberculosis, Ebola, HIV/AIDS, and other non-communicable diseases, such as mental illness. For example, when the 2003 severe acute respiratory syndrome (SARS) surged in the United States, it was confirmed that successfully controlling transmission required addressing the stigma around the decease. If people were feared and stigmatised they did not seek treatment and remained in the community undetected, further exposing more lives to the illness (Person et al., 2004).
In Sierra Leone, Ebola virus disease (EVD)-related internalised and enacted stigma among the survivors hindered their recovery and re-integration in the community. EVD survivors are known to suffer from short and long-term physical symptoms and mental complications due to the traumatic experience of surviving the illness (James et al., 2020). Now, during the current COVID-19 pandemic, daily media reports remind us of the rise in hostility and xenophobia that many people who are affected by, or associated with, the illness are facing.