Fear, history, stigma, and bias in the COVID-19 pandemic
Keywords:COVID-19, pandemic, fear, stigma, discrimination, isolation
Introduction: The greatest enemy of a global pandemic is not the virus itself, but the fear, rumor, and stigma that envelopes people. This article explores the context and history of fear and stigma relating to pandemic, summarizing key actions to mitigate the harms during an active pandemic.
Method: Our article draws from accounts in literature and journalist accounts documenting the relationship between infectious diseases and major disease outbreaks that have garnered fear and stigmatization.
Results: Fear, stigma, and discrimination are not new concepts for pandemics. These social effects run the risk of diverting attention from the presenting disease and government responses. Reactions to fear, stigma, and discrimination risk sabotaging effective efforts to contain, manage, and eradicate the disease.Conclusion: Emergency managers have an important role in dispelling myths, disseminating appropriate and evidence-based information without exacerbating fears. Knowledge about the roots of fear and bias along with a good understanding of historical plagues and pandemics is vital to ensure those in the field of emergency management can effectively manage irrational fears.
Bagcchi S: Stigma during the COVID-19 pandemic. Lancet Infect Dis. 2020; 20(7): 782.
WHO: WHO Director-General’s opening remarks at the media briefing on COVID-19. 2020. Available at https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-themedia-briefing-on-covid-19---28-february-2020. Accessed August 21, 2020.
Asmundson GJ, Taylor S: Coronaphobia: Fear and the 2019-nCoV outbreak. J Anxiety Dis. 2020; 70: 102196.
Ransing R, Ramalho R, de Filippis R, et al.: Infectious disease outbreak related stigma and discrimination during the COVID-19 pandemic: Drivers, facilitators, manifestations, and outcomes across the world. Brain Behav Immun. 2020. DOI: 10.1016/j.bbi.2020.07.033.
Sotgiu G, Dobler CC: Social stigma in the time of coronavirus. Eur Respir J. 2020; 56: 2002461. DOI: 10.1183/13993003.02461-2020.
Vogel L: World must prepare for inevitable flu pandemic, says WHO. CMAJ. 2019; 8(191): E405. DOI: 10.1503/cmaj.109-5735
Sandman PM: A severe pandemic is not overdue—It’s not when but if. Center for Infectious Disease Research and Policy. 2007. Available at https://www.cidrap.umn.edu/news-perspective/2007/02/severe-pandemic-not-overdue-its-not-when-if. Accessed September 9, 2020.
Sermrittitog S, Van Brakel W: Stigma in leprosy: Concepts, causes and determinants. Lepr Rev. 2014; 85; 1-12.
Gibson N, Cave A, Doering D, et al.: Socio-cultural factors influencing prevention and treatment of tuberculosis in immigrant and aboriginal communities in Canada. Soc Sci Med. 2005; 61(5): 931-942. DOI: 10.1016/j.socscimed.2004.10.026.
Pappas G: Ebola in your living room. Lancet Infect Dis. 2019; 19(8): 820. DOI: 10.1016/S1473-3099(19)30343-3.
Daftary A: HIV and tuberculosis: The construction and management of double stigma. Soc Sci Med. 2012; 74: 1512-1519.
Person B, Sy F, Holton K, et al.: Fear and stigma: The epidemic within the SARS outbreak. Emerg Infect Dis. 2004; 10(2): 358-364. Available at http://www.cdc.gov/ncidod/EID/vol10no2/03-0750.htm. Accessed August 1, 2020.
Mark J: Effects of the black plague death on Europe. Ancient History Encyclopedia. 2020. Available at https://www.ancient.eu/article/1543/effects-of-the-black-death-on-europe/. Accessed August 1, 2020.
Shultz JM, Cooper JL, Baingana F, et al.: The role of fear-related behaviors in the 2013–2016 West Africa Ebola virus disease outbreak. Curr Psychiatry Rep. 2016; 18(11): 104.
Harlan C: An epidemic of fear and anxiety hits Americans amid Ebola outbreak. Washington Post. Available at https://www.washingtonpost.com/business/economy/an-epidemic-of-fear-and-anxietyhits-americans-amid-ebola-outbreak/2014/10/15/0760fb96-54a8-11e4-ba4b-f6333e2c0453_story.html. Accessed November 23, 2020.
Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD): History of 1918 flu pandemic. 2018. Available at https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm. Accessed August 1, 2020.
Fischer LS, Mansergh G, Lynch J, et al.: Addressing disease-related stigma during infectious disease outbreaks. Disaster Med Public Health Prep. 2019; 13: 989-994. DOI: 10.1017/dmp.2018.157.
Taylor S: The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease. Newcastle upon Tyne: Cambridge Scholars Publishing, 2019.
Freckelton QI: COVID-19: Fear, quackery, false representations and the law. Int J Law Psychiatry. 2020; 72: 101611. DOI: 10.1016/j.ijlp.2020.101611.
Logie CH, Turan JM: How do we balance tensions between COVID-19 public health responses and stigma mitigation? Learning from HIV research. AIDS Behav. 2020; 24: 2003-2006. DOI: 10.1007/s10461-020-02856-8.
Outhoff K: This too shall pass: Coronaphobia and other fears. S Afr Gen Pract J. 2020; 1(3): 92-93.
Strong P: Epidemic psychology: A model. Soc Health Illn. 1990; 12(3): 249-259. DOI: 10.1111/1467-9566.ep11347150.
Aguilera J: Xenophobia “is a pre-existing condition.” How harmful stereotypes and racism are spreading around the coronavirus. Time. 2020. Available at https://time.com/5775716/xenophobiaracism-stereotypes-coronavirus/. Accessed August 1, 2020.
Evelyn K: Coronavirus: Royal Caribbean bans all Chinese nationals from its cruise ships. The Guardian. 2020. Available at https://www.theguardian.com/world/2020/feb/07/coronavirus-royalcaribbean-cruise-bans-chinese-nationals. Accessed August 5, 2020.
Lowen M: Coronavirus: Chinese targeted as Italians panic. BBC News. 2020. Available at https://www.bbc.com/news/worldeurope-51370822. Accessed August 1, 2020.
Ipsos: New Center for Public Integrity/Ipsos poll finds that most Americans coronavirus pandemic is a natural disaster. Ipsos. 2020. Available at https://www.ipsos.com/en-us/news-polls/centerfor-public-integrity-poll-2020. Accessed August 5, 2020.
Cranley E: Hong Kong protestors set planned quarantine building on fire amid coronavirus concerns. Business Insider. 2020. Available at https://www.businessinsider.com/hong-kong-protesters-burned-coronavirus-quarantine-site-2020-1. Accessed September 1, 2020.
Magdy S, Schmall E: Medics around the world face hostility over virus stigma. NBC News. 2020. Available at https://www.nbcconnecticut.com/news/coronavirus/medics-around-the-world-facehostility-over-virus-stigma/2272311/. Accessed August 25, 2020.
Cook H, Dow A: How COVID-19 stigma is turning Victorians away from testing. The Age. 2020. Available at https://www.theage.com.au/politics/victoria/how-covid-19-stigma-is-turning-victorians-awayfrom-testing-20200819-p55n84.html. Accessed September 9, 2020.
Pinho F, Davis H: Costa Mesa gets court order to keep Farview Development Center from use as coronavirus quarantine site. Daily Pilot. 2020. Available at https://www.latimes.com/socal/daily-pilot/news/story/2020-02-21/costa-mesa-seeks-order-to-keep-fairviewdevelopmental-center-from-being-used-as-coronavirus-quarantinesite. Accessed August 5, 2020.
NBC: OC supervisors join Costa Mesa law suit against housing Coronavirus patients. NBC News. 2020. Available at https://www.nbclosangeles.com/news/local/oc-supervisors-join-costa-mesa-lawsuitagainst-housing-coronavirus/2317809/. Accessed August 5, 2020.
Rowe J, Abutaleb Y: US judge delays decision on moving coronavirus-exposed Americans to Costa Mesa Calif. Washington Post. 2020. Available at https://www.washingtonpost.com/health/california-judge-delays-decision-on-moving-coronavirus-exposedamericans-to-costa-mesa/2020/02/24/c6fdfcac-574e-11ea-9b35-def5a027d470_story.html. Accessed August 20, 2020.
Gallacher J: Healthcare workers likely to leave the profession after COVID 19 pandemic is over. HR. 2020. Available at https://www.hrmagazine.co.uk/article-details/one-in-five-healthcare-workers-likely-to-leave-the-profession-after-covid-19-pandemic-is-over. Accessed April 20, 2020.
Ali SS: Why some nurses have quite during coronavirus pandemic. NBC News. 2020. Available at https://www.nbcnews.com/news/us-news/why-some-nurses-have-quit-during-coronavirus-pandemic-n1201796. Accessed August 25, 2020.
Ginsberg C: NYS Nurses Association files three lawsuits to protect nurses health and safety. NY Nurses Association. 2020. Available at https://www.nysna.org/press/2020/nys-nursesassociation-files-three-lawsuits-protect-nurses-health-and-safety#.XzDQlDV7nIX. Accessed August 25, 2020.
Altstedter A, Shrivastava B, Pandya D: Doctors come under attack in India as Coronavirus Stigma Grows. Bloomberg. 2020. Available at https://www.bloomberg.com/news/articles/2020-04-13/doctors-come-under-attack-in-india-as-coronavirus-stigma-grows. Accessed September 8, 2020.
Litvinova D: ‘We’re expendable’: Russian doctors face hostility, mistrust. CTV News. 2020. Available at https://apnews.com/article/78d8e23fc2a819d1956e4d0a332f7618. Accessed February 19, 2021.
Mamuim A, Rozdilsky J, Lee C, et al.: Expanding the narrative on anti-Chinese stigma during COVID-19. 2020. Available at https://figshare.com/articles/preprint/EXPANDING_THE_NARRATIVE_ON_ANTI-CHINESE_STIGMA_DURING_COVID-19_-_Initial_Report_pdf/12759512. Accessed September 8, 2020.
Hendry-Tennent I: Health Minister Chris Hipkins shuts down myth Oranga Tamariki is taking children from people with COVID-19. News Hub. 2020. Available at https://www.newshub.co.nz/home/politics/2020/08/health-minister-chris-hipkins-shuts-down-mythoranga-tamariki-is-taking-children-from-people-with-covid-19.html. Accessed September 1, 2020.
Gray L, MacDonald C, Mackie B, et al.: Community responses to communication campaigns for influenza A (H1N1): A focus group. BMC Public Health. 2012; 12: 205. DOI: 10.1186/1471-2458-12-205.
APA: Combatting bias and stigma related to COVID-19. APA. org. 2020. https://www.apa.org/news/press/statements/combatingcovid-19-bias.pdf. Accessed September 1, 2020.
Taylor S: The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease. Newcastle upon Tyne: Cambridge Scholars Publishing, 2020.
McDonnell WM, Nelson DS, Schunk JE: Should we fear “flu fear” itself? Effects of H1N1 influenza fear on ED use. Am J Emerg Med. 2012; 30(2): 275-282. DOI: 10.1016/j.ajem.2010.11.027.
Alizamir S, De Vericourt F, Wang S: COVID-19: Why the WHO was afraid of crying ‘pandemic’. Medicalxpress. 2020. Available at https://medicalxpress.com/news/2020-03-covid-pandemic.html.Accessed August 20, 2020.
Ahorsu D, Lin C, Imani V, et al.: The fear of COVID-19 scale: Developmental and initial validation. Int J Ment Health Addict. 2020. DOI: 10.1007/s11469-020-00270-8.
Badrfam R, Zandifar A: Stigma over COVID-19: New conception beyond individual sense. Arch Med Res. 2020. DOI: 10.1016/j.arcmed.2020.05.006.
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