We’re seeing for the first time in many decades a pandemic of this kind,
and that’s bringing out also the fact that stigmatization
can be a huge problem in disease.
You've seen it in Nepal,
you've seen it in a couple of European countries.
You've seen it in Korea and Japan.
Countries like Italy and America, you see a different kind of stigmatization,
which is a lot of it is directed towards the Chinese community.
There are a few things that are particular to perhaps South Asian countries.
Slum areas, for example, are considered a hotbed of disease.
You know, right in the beginning of the pandemic
in Bombay, you had Dharavi,
which is one of Asia's largest slums.
The government frontline health workers,
when they went back to their homes in different neighborhoods,
they were asked to leave because they knew they were working in Dharavi.
We saw that healthcare workers were attacked in Haiti.
It happened in Nepal, in Iraq.
A 60 year old man who was sort of put in quarantine because he had some symptoms, he tested positive.
He went into sort of institutional care nearby.
He came back to, essentially, what I was told
was an empty house, and a kind of deserted neighborhood.
I was told that he actually committed suicide.
When you look at past diseases like leprosy and HIV,
I think those are much more stigmatized diseases.
Leprosy, you know, sort of the archetypal stigmatized disease,
where the associations are so ancient
Even though you don't have much leprosy today
it still has that lingering association.
HIV is more recent and it’s slightly different.
because HIV is associated originally with homosexuals,
sex workers, those who are considered the vulnerable groups.
There's a certain amount of sort of moral judgment attached to that.
Stigmatization was such a problem,
the epidemic wasn’t being dealt with.
Perhaps most relevant from a public health perspective,
we've seen in past outbreaks that if they fear or they anticipate
that they're going to be ostracized or stigmatized
in some way, a lot of people hide their disease.
You're not getting the health outcomes because
people aren't adhering to treatment perhaps.
Or delaying care so that, you know, more serious
symptoms develop and then they can't be treated
or it's much harder to treat them.
The best data we have on this is from HIV.
One analysis they did, from 2011 to 2016,
They found that one in five people living with HIV
avoided going to medical facilities
because they feared or anticipated being mistreated.
Marginalized groups, who are already experiencing stigmatization in society,
it sort of adds to that condition.
If you’re for example, a sex worker and you have HIV
then you're less likely to afford health care.
You're economically perhaps not as well off,
and then you get the disease.
So, there's what you call a compounding effect.
All the public health experts and doctors say that
you need to communicate the science very well.
How transmission actually occurs, what is a virus actually,
and sort of quash rumors, misinformation, sensationalism.
Some people point to New Zealand as an example of good public health messaging.
"People are not the problem here.
The virus is the problem. People are the solution.
There should be no shame and no blame in contracting COVID-19.
A lot of experts suggest that having the media also cover cases of recovery
can be really helpful to reduce fear.
Because now we're at least six months into the pandemic,
I think that we see that there has been some improvement, even in Bombay.
There is a little less fear
as you become familiar with the disease and how it spreads.
Not as much as we need, but certainly there's been some improvement.
And that's certainly helped in being more perhaps
rational about, you know, who to avoid when and how.
It is going to go on for a long time.
So we're gonna have to see how this plays out.