| Drivers and facilitators |
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Focus on addressing country specific drivers and facilitators, interruption of the stigmatization process, shifting of stigmatizing norms and policies.
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Use of appropriate terms or words in public messaging (e.g. physical distancing instead of social distancing or physical distancing with enhanced social integration).
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Extend the infodemic mitigation efforts to include stigma alleviation.
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Anticipate COS in different settings (e.g. quarantine), population (e.g. HCWs) and stages.
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The new intervention or approaches should be innovative, creative, and preferably digital or virtual based.
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COS is a moving target with changing social dynamics (e.g. in initial phases, people with Asian descent and rich people with travel history were stigmatized, but now, immigrant, HCWs and people who recovered from COVID-19 are experiencing stigma and discrimination). Intervention should address the dynamic and changing dimension of COS.
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Public health measures must include stigma measures to build empathy and social justice, and to address the drivers of poor health outcomes and the risk for developing mental disorders.
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Develop global strategies and their cross-cultural adaptations through evidence-based findings and research.
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Encourage the strategies that may have the potential to reduce stigma (e.g. employment sick leave benefits, access to COVID-19 testing and treatment).
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More information about the drivers and facilitators of stigma is needed to inform appropriate interventions at primary or ground level.
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Artificial intelligence based platform to monitor infodemic (Ransing et al., 2020).
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| Intersecting stigma |
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Tackle the intersecting factors (e.g. social inequities) as a short term and long term strategy.
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Engage people affected with COS (e.g. caregivers, pregnant women, and HCWs) in stigma intervention strategies.
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Avoid stigmatizing language (e.g 'foreign virus' or country specific virus, 'coronized people') in public health messaging, media, and social media.
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Involve the religious, community leaders and celebrities to address the COS (e.g. "break the chain -campaign in India").
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Crucial evidence about social and health disparities, barriers for participation, intersecting stigmas, and contextually specific public health approaches is lacking.
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| Manifestations |
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Intervention should consider enacted, felt-normative, internalized, and anticipated stigma.
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Consider legal, policy approach to reducing some discrimination (e.g. providing houses to HCWs).
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Reduce the participation barriers (e.g., addressing access barriers posed by COVID-19 caregivers and/or healthcare provider).
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Data on manifestations of stigma is required for researchers, training personnel, policymakers, and implementers to assess the impact of interventions to reduce stigma or mitigate the related harmful consequences.
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| Potential outcomes |
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Share positive stories of those who have recovered from COVID-19, HCWs experiences and people living in quarantine to foster empathy and to enhance solidarity.
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Share audios or videos on social media (e.g. quarantined people are singing songs or dancing together in India and Italy) to reduce fear.
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| Health and Social Impacts |
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Celebrate the persons (particularly from marginalized populations) who have recovered from COVID-19 as ‘champions’ (e.g.,India) to foster resilience.
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Promote the patient advocacy group efforts to improve access to health care.
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Include participatory activities (discussions, role-play, and virtual games) and virtual contact approach with people who have experienced the stigma.
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