Investigating Stigma During the Early Stages of a Pandemic Through the Lens of COVID-19

Background: Individuals face stigma associated with numerous health conditions. Stigma can arise rapidly during the early spread of a new disease, adding to the burden felt by those affected. COVID-19 can be used as an example to study stigma during the early phases of a pandemic. This narrative review is a descriptive analysis that tracks the ways in which COVID-19 stigma was discussed in the scholarly literature during the first year of the pandemic to understand how stigma was viewed in the context of a rapidly spreading pandemic. Methods: PubMed was used as a non-exhaustive sample of the literature. Searches for stigma and COVID-19 or SARS-CoV-2 were carried out in January 2021. To be included for review, articles had to be accessible in English, published on PubMed in 2019 or later, and focused on COVID-19/SARS-CoV-2, with at least a mention of stigma related to COVID-19. The included articles were then reviewed for chronological time, depth of emphasis on stigma, definition and interpretation of stigma, type of publication, and recommendations. Demographic features of the authors and studied populations were also tracked. Results: This review identified 321 articles on PubMed discussing stigma and COVID-19. Of these, 180 articles met inclusion criteria and were reviewed. The earliest publication included in the review was from April 2020. Authors from India, the USA, and China published the most articles related to COVID-19 and stigma. The most frequent forms of publication were cross-sectional studies, commentaries, and letters to the editor. In nearly half of the publications, stigma was one of several factors studied. All of the included publications described the negative impact stigma has on the community. Five major types of recommendations were noted: need for further research, dissemination of accurate health information, expansion of resources, policy and protocol changes, and community engagement. Conclusions: Stigma can have a profound impact on individuals affected by a disease, causing barriers to both treatment and attempts to stop disease spread. The stigma seen during the early days of COVID-19 provides useful information on pandemic-related stigma. The recommendations gleaned from this review can be helpful in the mitigation of disease-related stigma and used to slow the spread of stigma during the early stages of future pandemics