Combatting the Stigma Experienced by COVID-19 Patients

While we still are determining all the ways that COVID-19 is transmitted, people who have been diagnosed with the virus may be the victims of multiple forms of stigma. After recovery, they may still be viewed as pariahs among friends and family. They may be made to feel that they are to blame for intentionally falling ill or that they still pose risks to others, even after multiple tests showing otherwise, and should not be out and about among others.

Stigmatization of COVID-19 Takes a Significant Emotional Toll on Its Victims

Throughout history, people have stigmatized certain illnesses and disabilities and ostracized or ridiculed the people who suffer from these challenges. While most of us are taught to care about those who are coping with illness, stigmas may limit our willingness to support people we care about.

What Generates Stigma?

The act of stigmatizing others has deep roots in human history. Evolution plays a role in this process. When humans lived together in small, collaborative groups, illnesses that might limit the capacity to contribute to the greater good could lead to shunning or abandoning an individual. When survival is at risk, people do what they must to take care of themselves and protect their kin. While survival of the species may not be at risk, vestiges of the survival instinct can motivate people to close ranks to keep out a member of the group who is now seen as a threat.

Types of Stigma

There are several types of stigma that have been identified and Griffith and Kohrt (2016) provide a clear summary of these stigma status states.

Moral stigma occurs towards people who are seen to be challenging our beliefs and values. For instance, we may view someone’s symptoms of depression as proof that they are too “lazy” to handle their responsibilities.

Disruption stigma is related to the resentment felt when someone’s illness results in disruption of our own lives. This is the frustration that can be felt in response to the extra time and care that a person needs due to their physical or mental health.

Empathy fatigue occurs as a response to our feelings of overwhelm from needing to care “too much” for others.

Courtesy stigma is generated by the desire to avoid being associated with someone due to the stigma that a person’s illness carries. People may fear being given a “courtesy membership” in the stigmatized group.

Peril stigma arises when the manifestation of someone’s illness motivates us to feel afraid. In thinking about the stigma associated with COVID-19, peril stigma seems to be quite high.

Prior Dx: COVID-19 – Current Dx: Stigmatization

People who have fully recovered from COVID-19 have shared that they continue to suffer from anxiety and stress when they are preparing to leave their homes as they try and cope with their feelings of being “marked” by COVID-19. Somehow, their prior diagnosis and recovery aren't appreciated as "triumphs" by others, as many experience being treated differently than before their illness and some have shared that family and friends are "different" around them, even via phone and video calls.

Anticipatory stress and anxiety can get in the way of normal activities and thoughts as feelings of shame bubble up beforehand. The stress can be pervasive and individuals feel devalued and avoid social situations where they may find the emotional support that might help them better handle their distress. This reflects internalized stigma which can be damaging to psychological and emotional well-being in covert ways.

Internalized stigma is the state of disliking ourselves based on the feelings of dislike that others have for our identity or qualities or diagnoses. It turns into a self-loathing that often leads us to stigmatize others who are similar to us. Internalized stigma is an insidious thing as it magnifies the level of fear or revulsion by turning our own negative feelings towards ourselves against others — it magnifies and spreads damaging feelings exponentially.

Combatting COVID-19 Stigma If You’ve Been Diagnosed

• When incidents of stigmatization occur, name the behavior that is being exhibited at that moment.
• Describe to the perpetrator how their words or actions make you feel.
• Describe the impact of what they are doing to help them grow their empathy.
• Talk about the assumptions that you feel others are making.
• Ask for what you would prefer that they say or do — this action provides them with education in case they don’t know “what” they should be doing instead.
• To help eradicate bad behavior, don’t just walk away from the conversation — show your courage and strength through persistence and commitment to the cause.

Combatting COVID-19 Stigma as an Advocate

• Be aware of how you speak to those who’ve been affected and how you speak about them with others.
• Share facts about COVID-19, as appropriate, and challenge stereotypes and disrespectful comments about those who have been diagnosed with COVID-19. Don’t passively allow others to promote stigmatizing behaviors or actions — advocate for those who are not present or unable to advocate for themselves.
• Model the hygiene practices that are recommended — mask-wearing, hand-washing, distancing from others. When these behaviors are seen as “typical practice,” they become more readily accepted and eradicate the stigma of mask-wearing.
• Advocate through volunteering — actions can speak louder than words, so get involved in activities such as helping at food banks, giving blood, making masks, writing letters of support, staffing helplines, making wellness calls, etc.

Stigmas can leave lasting psychological damage that feels like a virtual prison and denigrates the self-worth of people who are already dealing with challenging wellness concerns. Educate yourself and others to help minimize stigma throughout your community and further afield.