Shame and stigma have been prominent features of the COVID-19 pandemic. Stigma, in particular, has been identified as an urgent issue related to COVID-19 by health organizations worldwide, including Public Health England, the CDC and the WHO. Stigma negatively impacts on health seeking behaviours, causes personal and social harm, and exacerbates existing social and health inequalities. In the UK, the first months of the COVID-19 crisis have demonstrated that instances of shame, shaming, stigma and discrimination are related to, and often arise from, public health interventions (e.g., consider the “Lepers of Leicester” resulting from the UK’s first local lockdown or the on-going shaming of individuals for the use/non-use of face masks). This is of particular concern when considering the uneven distribution of social power, resources and health for BAME communities in the UK who are disproportionately impacted by COVID-19, and how these inequalities are, in turn, intimately related to experiences of stigma and shame.
Understanding the concrete harms caused by the negative phenomena associated with social stigma (e.g., discrimination, vilification, ostracization, and stereotyping) and the behaviours associated with experiencing stigma (e.g., avoidance, withdrawal) is paramount in order to understand the overall harms caused not only by the COVID-19 virus, but also by the public health interventions that are put in place to mitigate its negative effects.
As we have seen, shaming has become a powerful social and political force during COVID-19, driven by the widespread use of social media. For example, consider instances of doctor shaming (e.g., for being ‘disease spreaders’ or for refusing to work without adequate PPE) and pandemic shaming (e.g., the widespread phenomena of identifying people who ignore public health warnings as ‘COVIDIOTS’ or ‘#selfishpricks’).
Shame has become a common affective experience for individuals struggling with various COVID-19 related hardships, especially during lockdown (e.g., due to factors as diverse as poverty, job loss, illness, isolation, and domestic abuse). In care contexts, providers have spoken about the shame associated with losing patients, unknowingly spreading the virus, and being unwilling to return to work to ‘fight on the frontline’ after having left the profession.
Shame dynamics are also circulating in political contexts, where the charge of attempting to ‘save face’ during COVID-19 is frequently levelled at politicians and governments, and the persistent use of the term “China virus” has been a political strategy to deflect blame and responsibility. In fact, the stigma generated by racially-loaded terminology has been directly related to racism and abuse experienced by ethnic minorities and foreigners in Britain.
As we enter a new phase of ‘living with the virus’, emerging public health interventions need to be continuously assessed for their potential to produce shame, shaming, stigma and discrimination. For example, interventions such as local lockdowns, international and national quarantines, the use/non-use of face masks and other PPE, the proposed introduction of so-called ‘immunity passports’, or the use anti-body tests need to be managed carefully to avoid the stigma and shame that easily arises when populations are divided or stratified, especially in climates of fear and uncertainty.
As part of the Shame and Medicine project, we have been considering the role that shame and stigma are playing in the current global health crisis. We have done some preliminary writing exploring the public shaming of frontline doctors during Covid, the positive and negative stigma attached to health workers and the idea the ‘saving face’ is motivating political public health decisions.