New COVID-19 Stigma: Widespread Shunning of Healthcare Workers

Megan Brooks

September 01, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Many members of the public, who show support for healthcare professionals battling COVID-19 by nightly cheering and clapping, also go out of their way to avoid them for fear of catching the virus.

In what is believed to be the first survey of its kind, one third of respondents reported they avoid HCWs and one quarter believe that healthcare workers' freedoms should be restricted to protect others.  

"We thought there would be some fear and avoidance of healthcare workers but we were a little surprised that it was at such a high level," Steven Taylor, PhD, professor of psychiatry, University of British Columbia, Vancouver, Canada, told Medscape Medical News.

"Being around healthcare workers is quite safe. In fact, when healthcare workers get COVID-19, they usually get it from the community, not from the hospitals," said Taylor.

The results were published online August 19 in the Journal of Anxiety Disorders.

Misinformation Rampant

Between May 6 and May 19, a random sample of 3551 adults in Canada and the US completed the online survey. The cohort has a mean age of 54 years, 42% were women, 69% were White, and 92% had full- or part-time jobs. None of the respondents were HCWs.

Results showed 33% of respondents would not want to be around HCWs and 32% believed that HCWs who work in hospitals were likely to have COVID-19. 

This stands in sharp contrast to COVID-19 research, which shows that the typical HCW is highly unlikely to be infected with SARS-CoV-2, the investigators note.

They point to data collected by the US Centers for Disease Control and Prevention (CDC) from February to April, showing that 89% of COVID-19 cases were not in HCWs.

Likewise, research from Canada shows that HCWs as a group — regardless of whether they specifically care for COVID-19 patients — have a risk of only 0.14% of developing COVID-19 vs 0.10 % in the general population.

One in four (25%) survey respondents believe that in order to ensure public safety, HCWs should not go out in public and 31% believe HCWs who treat COVID-19 patients should be separated from their families.

HCW stigmatization was unrelated to whether respondents knew anyone who was, or had been, infected with SARS-CoV-2. However, most respondents (84%) did not personally know anyone with the virus.  

Participating in nightly public shows of support for HCWs didn't make individuals any less likely to stigmatize HCWs.

"Behind the facade of altruistic cheering and clapping for HCWs, there are important, under-recognized, and widespread stigmatizing attitudes toward healthcare providers," the researchers write.

The survey also suggests that fear and avoidance of HCWs is part of a broader pattern of stigmatization, in that those who tend to stigmatize HCWs also tend to do the same to foreigners, fearing they too may be a source of infection, Taylor noted. Such individuals also tend to avoid drugstores and pharmacies and, by extension, retail workers in those stores.

To combat the problem, Taylor said it's important to make sure people have accurate information about infection risk factors and that they understand that the risk of contracting the virus from a healthcare worker is "very low."

A Harmful Repercussion

Reached for comment, Brittany LeMonda, PhD, neuropsychologist at Lenox Hill Hospital in New York City, said shunning of healthcare workers is a "concerning and unfortunate" repercussion of COVID-19.

"Actions such as nightly clapping for frontline workers are positive gestures that support their efforts. However, stigmatizing and isolating these same individuals is harmful," said LeMonda, who wasn't involved in the research.

"Additionally, individuals with COVID stress syndrome are more likely to avoid and stigmatize healthcare workers, which can worsen anxiety. These same individuals may avoid important doctor's appointments and may not receive the appropriate healthcare they need, which can have negative consequences," said LeMonda.

She agreed that educating patients and the public that healthcare workers do not have a high risk for COVID-19 infection is critical.

LeMonda also said communicating the measures that hospitals are taking to prevent the spread of COVID-19 will help allay public fear.

"Finally, if an individual is suffering from severe COVID stress syndrome that is causing distress or interfering with their daily lives, certain types of cognitive behavioral therapy and exposure therapy may be useful," said LeMonda.

This research was funded by the Canadian Institutes of Health Research and the University of Regina. Taylor receives financial support through royalties from various book publishers and from editorial duties as associate editor of the Journal of Obsessive-Compulsive and Related Disorders. LeMonda has disclosed no relevant financial relationships.

J Anxiety Disord. Published online August 19, 2020. Full text

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