Udbodh Bhandari

The COVID-19 pandemic has sparked unparalleled panic in Nepal and several other countries. In this regard, social stigma in the pandemic is due to unscientific beliefs and a lack of understanding among the general public. Erving Goffman, a Canadian sociologist, stated that social stigma is a behaviour that socially discredits an individual as the "undesirable other" by society. Pandemics are thus more than just a medical phenomenon, they have an impact on an individual's quality of life. This creates a “we versus they” dichotomy, which aids in the formation of a socioeconomic hierarchy. With the COVID-19 outbreak, people are now labeled, stereotyped, discriminated against, separated, and encounter loss of status as a result of a perceived link with the disease.

Impact at home
Health care workers and COVID-19 patients or those who have returned home from abroad, including India, are being stigmatised. The situation is even worse within the community of health workers. Some landlords in Kathmandu and across the country have been reported to evict nurses, doctors, and other medical professionals from their rental apartments, fearing the spread of the virus. For instance, when a virus was discovered in a six-year-old Tribhuvan University Teaching Hospital (TUTH) inpatient in Kathmandu on May 15, last year, chaos reigned in and around the hospital. As a result, healthcare workers were asked to vacate their rented apartments, along with a case of misbehaviour to them living at a house in Baneshwor, Kathmandu.
The media has also reported on physical violence and abuse directed at healthcare workers by their neighbours, community, and patients' visitors as a whole. In other cases, stories in the media about people with fever being denied health care in private hospitals across the country are common. At the same time, many people with disabilities have underlying medical conditions that make a disease like COVID-19 more dangerous for them. Persons with disabilities from minority communities have been impacted by limited access to culturally respected information, personal assistance, and medical care. In this regard, the World Health Organisation (WHO) issued guidance on COVID-19 psychosocial considerations as well as a guide on preventing and downplaying social stigma.
The extensive media exposure of the infection, as well as the occurrence of an 'infodemic' of incorrect information, has exacerbated the disease's misunderstanding and increased stigmatisation of people infected with COVID-19. Furthermore, mass quarantine, which has been used effectively in many countries to control disease transmission, has inadvertently amplified the stigma. As COVID-19 enters its second and third waves of transmission, unchecked stigma can result in severe psychosocial syndromes, an increased risk of psychiatric disorders, and suicidality. One of the most obvious consequences of pandemic stigma is that if people are reluctant to tell others that they may have unwittingly exposed them, the virus will continue to spread unchecked.
A coworker, for example, may not disclose a potential exposure for fear of upsetting others or being fired. The fear of stigmatisation may deter at-risk individuals from seeking appropriate medical help promptly. In a case, hundreds of nurses (more than 350 as of May 17, 2020) quit their jobs at multiple private hospitals in West Bengal in two days, in an unfortunate turn of events.   The majority of these nurses were from other states, and they began to return to their home states. Rahuldeb Sarkar, a respiratory medicine consultant at Medway Maritime Hospital (Kent, UK), adds that in countries such as India and Mexico, healthcare workers face significant stigma as a result of the pandemic
The WHO warns that stigmatising language "may contribute to a situation in which the virus is more likely to spread, rather than less likely to spread." Using dehumanising language (e.g. ‘suspects,' 'cases,' 'victims,' 'the elderly,' 'the sick') gives the impression that those who acquire COVID-19 have done something wrong or are less deserving of help than other members of society. In the past, the stigma associated with influenza during the 1918 Spanish flu pandemic and the 1994 Indian plague epidemic hampered effective public health responses in a variety of ways. Furthermore, in 18th century England, Mary Malon became known as "Typhoid Mary," accused of spreading the infection among wealthy families despite being unaffected.
Similarly, the "pestilences" of bubonic plague, Asiatic flu, and cholera, Middle East respiratory syndrome, and the Ebola outbreak in Africa have all been linked to polarisation, racism, blame directed at specific ethnicities, and resulting psychological distress. The practice of naming illnesses after their country of origin has been dubbed "epidemic orientalism," and it is regarded as a form of social labeling. Fear and uncertainty about unknown infections have been shown in studies to have a significant impact on human behaviour. According to the research, more than half of those affected by the COVID-19 pandemic experienced fear, and sixty-four per cent experienced stigma.

Authentic information
WHO and other health-related organisations strongly advise sharing only authentic information available on the Ministry of Health and Population or the World Health Organisation's websites, and to double-check any information related to COVID-19 from credible sources before forwarding any messages on social media. It is necessary to train populations that have been “left behind,” such as ethnic and gender minorities, incredibly important workers, people living in high-density areas, older people, and even community health workers and key health-related stakeholders, to help them understand how COVID-19 is and is not transmitted, what constitutes discrimination, how to defend their rights, and how to connect justice if discrimination occurs. Community awareness can improve knowledge, attitudes, and practice (KAP). Besides, messages about the disease's facts, figures, and realities should be delivered through virtual or other secure platforms and forums.

(Bhandari is a social development specialist. aruudbodh@gmail.com)