Dermatologists as recipients of COVID‐19 stigma

We read with interest the recent article by Ibrahim et al. in Clinical and Experimental Dermatology, entitled ‘The impact of COVID‐19 on dermatology outpatient services in England in 2020’.¹ As excellently presented by the authors, the ongoing novel coronavirus (COVID‐19) pandemic is presenting many pressing challenges to the dermatological community, including the reduction of outpatient appointment attendance as well as the safety considerations of the use of biologic, immunosuppressive and targeted therapies. The aforementioned challenges are superimposed upon the need for acquisition of high‐quality teledermatology equipment, limitation of daily activities to priority cases and postponement of elective aesthetic dermatology procedures, which directly impact the financial aspect of dermatologists.² In our opinion, the imposed stigma and social discrimination that dermatologists may face at their workplace and surroundings should also be added to this list.

At the beginning of the outbreak, several groups of people reported experiencing stigmatization because of COVID‐19, including people of Italian or East Asian descent as well as people who had travelled in COVID‐19‐affected areas.³ Stigma has also been reported to occur even after a person has been released from quarantine, even though they are not considered a risk for spreading the virus to others.⁴ Stigmatized groups can be subjected to social avoidance and rejection, denial of healthcare, education, housing or employment, and even physical violence.⁴ The emerging fear and anxiety since the declaration of the outbreak of COVID‐19 as a public health emergency can also lead to social stigma towards healthcare professionals (HCPs), as the Centers for Disease Control have addressed.³

In an effort to counter stigma, the World Health Organization (WHO) has worked with the International Federation of Red Cross and Red Crescent Societies, and the United Nations International Children's Emergency Fund on a guide to preventing and addressing the social stigma associated with the disease.⁵ Additionally, the WHO Director‐General has repeatedly called for ‘solidarity, not stigma’ to address COVID‐19.⁶ As public health emergencies, such as the outbreak of COVID‐19, are stressful times for people and communities, fighting stigma is of vital importance.

HCPs themselves are not immune to such shame; being labelled, stereotyped and discriminated against because of a potential negative affiliation with COVID‐19, may significantly affect their emotional or mental health during these difficult times, and allow myth and rumour to gain traction. Dermatologists are now considered first‐line healthcare workers, because of the evolving knowledge about the cutaneous manifestations of COVID‐19 and the increasing involvement of dermatology professionals in the management of this crisis as the pandemic unfolds.

Reports of various incidences of HCPs experiencing harassment, stigmatization or even physical violence have made headline news.⁷ To thwart the stigma associated with COVID‐19, WHO has suggested creating an environment where open discussion between HCPs and the general public can take place. In the meantime, it is imperative to disseminate accurate information and put emphasis on providing comprehensive support to the frontline HCPs to protect their mental wellbeing and allow them to continue practising their services effectively.