Medichealthy Stigma During Outbreaks COVID-19 and How to Reduce It - Medichealthy Stigma During Outbreaks COVID-19 and How to Reduce It

Stigma During Outbreaks COVID-19 and How to Reduce It

Coronavirus disease pandemic 2019 (COVID-19) has formed a person's stigma against others, society, the environment, or himself, so that requires proper treatment. Some news, especially regarding the increasing number of infections, deaths, unavailability of drugs, inadequate facilities, and personal protective equipment, also influenced the stigma.

Stigma During Outbreaks COVID-19 and How to Reduce It

Stigma and Outbreaks of Infectious Diseases

During an outbreak, people who live at the location of the outbreak need to follow a few instructions:
  • Know the status of self-infection,
  • Undergo treatment,
  • Prevent the spread of disease,
  • Maintain personal health to prevent infection.

The stigma that arises in the community reduces compliance to do and follow these instructions.

Adverse Effects of Stigma on Disease

This is similar to a review conducted by Fischer et al., who saw the impact of stigma on HIV / AIDS infection. The emergence of stigma harms the form of non-compliance with the instructions above. Non-compliance can be marked by refusing to examine infectious diseases and not complying with treatment. Also, other impacts arise, such as depression, anxiety, excessive anxiety, defense mechanisms, and suicide ideas.

The same condition also occurs in Tuberculosis infections. Stigma causes the low of tuberculosis examination, treatment-seeking behavior, medication compliance, and difficulty in investigating people who have contact with sufferers.

Effects of Stigma on Disease Outbreaks

Labeling stigma can occur in infected patients, caregivers, family and relatives of patients, patient communities, as well as the personnel who are directly exposed to patients.

The stigma effects cause the individual to be labeled as the owner of the infection, disease characteristics, or other devaluation attributes. One example is the stigma that Coronavirus disease 2019 (COVID-19) is a disease originating from the Chinese people.
Stigma can also originate from the person experiencing or surviving an infection. People who are stigmatized believe themselves as inferior, worthless, and hate themselves because of the status of their illness.

Management of Stigma in Disease Outbreaks

A meta-analysis of 42 studies on the effectiveness of an insight-raising program in a group of people to reduce negative responses to patients with HIV, shows the results of the improvement tends to be lower.

The results of that analysis indicate the requirement for a multidimensional stigma reduction program to achieve better outcomes, especially in overcoming pandemic cases. The stigma reduction program covers the important role of various parties, especially the government, health service providers, the community, and the media.

The strategy consists of:

1. Anticipating the Stigma
During an infectious disease outbreak, stigma is associated with individuals who are potentially exposed to the infection. These populations are individuals from infected countries, medical personnel and co-workers in health facilities, infected families, and the environment (occupation, residence, or environmental activity) are infected.

2. Checking public understanding of disease
Stigma can arise as a result of an incorrect understanding of information about the disease. Therefore, when a pandemic occurs, people need to recognize and understand the disease.
Checking public understanding of the disease can be performed by community leaders and clinicians. Meanwhile, to assess the increase in stigma in society by conducting surveys by the media, community meetings, focus groups to get direct information about obstacles, opportunities, and the possibility of conflict.

Official media information from the government or official health institutions helps provide reliable information and help understand the disease. Prompts for individuals to screen social media content and confirm that official health sites can also serve to reduce misconceptions.

3. Collaboration with leaders and communities
Leaders and Communities can provide insights to reduce the stigma of certain groups, increase public health promotion, or the means of disseminating information that can affect a community. It is related to their ability to determine the method and message which are appropriate with the community's needs.

4. Campaign and Community Values ​​Message
Dissemination of information quickly and continuously can increase changes in beliefs and behavior following the contents of the information. It can be used to develop an informative community message and directly fight stigmatization in certain circles.
Dissemination of messages can be through public campaigns and campaigns of community leaders or experts. Matching the contents of messages and interventions with specific populations (health workers, children, ordinary people, the elderly, or other groups) is needed because stigma can occur in diverse groups.

5. Educational Program
Information campaigns that only come from trusted sources or by community leaders are not enough, so there is a need for more intensive education programs to fight stigma. This intervention needs to be given briefly and can be integrated with counseling services, related to the limited time facing a pandemic that occurs. For example, the intervention of a stigma reduction program for people with HIV briefly varies between 1 day (50 minutes session) or 2 days (90 minutes session). While a more in-depth intervention consisting of 4 days of training is needed for community mobilizers, holding workshops, or supporting group leaders. Some cases may require more extensive training.

Educational programs can also increase opportunities for infected groups to be able to interact with healthy groups accompanied by useful information-based interventions to reduce stigma. This intervention includes individual interviews and testimonials by sufferers. Skills development interventions can include overcoming negative behavior, improving coping strategies, or engaging in support groups for people who are stigmatized. 

5. Evaluation 
The response of various stigma reduction interventions during the outbreak needs to be assessed to increase effectiveness. The evaluation includes program objectives and objective assessments related to stigma reduction interventions. Both the group giving and receiving the intervention provided feedback. The assessment covers the effectiveness of the intervention, providing information to the right group, obstacles encountered, evidence of success, as well as assessing additions (information and resources) needed.

The stigma of an outbreak of COVID-19 disease increases non-compliance with treatment measures, seeking treatment, strategies to reduce transmission and increase the risk of failure to control infection.

The stigma management step is a multidimensional step taken by all parties ranging from the government, health service providers, the media, to the community.

The coping strategy consists of anticipating stigma, assessing community understanding related to disease, working with leaders or policymakers, increasing information dissemination to fight stigma, conducting stigma reduction education programs, and evaluating stigma reduction steps that have been carried out.


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  1. Terima kasih dok untuk sharingnya.
    Memang benar, pertama kali saya mendengar case ini di berita saat sedang viral di Wuhan, berita begitu simpang siur, sempat saya melihat ada video "yang terinfeksi" kemudian ambruk di jalanan, yang membuat saya berpikir bahwa virus ini amat berbahaya.
    Bahkan saat Covid ini mulai menjalar di Indonesia, saya menjadi makin takut, karena kebetulan sehari sebelumnya saya banyak melakukan aktivitas di luar dan menggunakan transportasi umum. Dada saya tiba" sesak, sempat demam, dan berpikir muncul gejala.
    Alhamdulillaah, waktu itu saya mengisi sebuah kuesioner yang dibuat semacam komunitas kesehatan masyarakat dari UNPAD, 3 minggu setelahnya saya dihubungi kemudian diberi semacam konseling tentang apa itu Covid, apa saja gejalanya, bagaimana pencegahannya, sehingga saya jadi makin tahu tentang Covid ini. Semenjak itu saya sudah jarang untuk membaca berita negatif tentang Covid, secara tidak langsung jadi berpengaruh pada mental saya.