Public Health Legacies: Tuberculosis, HIV/AIDS, and SARS in Singapore

Tuberculosis, HIV/AIDS, and Severe Acute Respiratory Syndrome (SARS) are historically significant cases of infectious disease outbreaks that have posed economic, social, reputational, and moral challenges to Singapore and its much-vaunted model. Until only in recent years, Singapore's neoliberal public health system—focused on efficiency and optimal allocation—had neglected HIV/AIDS and thus the segments of society often associated with it. This neglect had been heightened by prevailing social stigmas and stereotypes. This may shed some light on the COVID-19 pandemic, which elicited rapid, responsive, robust, and inclusive government action where mainstream Singaporean community was concerned, but at the same time failed to recognize and deal with the marginalized and possibly stigmatized segments of society, such as migrant workers, whose badly infected dormitories became an international spectacle of crisis and social injustice. COVID-19 resembled tuberculosis and HIV/AIDS in terms of social stigmatization and even moral panic over the unhealthy elements in society. This resulted in the othering of—and disproportionate concern and hostility towards— teenage "spitters” who threatened to spread tuberculosis through their "defiant” behaviour, homosexuals who threatened to spread HIV/AIDS through their "immoral” behaviour and migrant workers in dormitories who were the foreign bringers of disease. The SARS crisis in 2003 was a "wake-up call” for a less-than-prepared Singapore. A subsequently more proactive government learnt key lessons from the crisis, which were systematically institutionalized in readiness for the next infectious disease outbreak. © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.

Migrant Worker Dormitories: Virus in a Neoliberal Politics of Space

In neoliberal Singapore, capitalism thrives on the exploitation of low-waged migrant workers who are attracted to Singapore to earn a living building and cleaning the city and serving its residents. Their presence in this already crowded city provokes a dualistic public response that originates from a grudging acceptance of their indispensability: on the one hand, a refusal to allow them to fully integrate with Singapore society and be treated as equal human beings;and, on the other hand, a compassionate desire to help them when they are in need. The former tendency has had the effect of making migrant workers as invisible as possible, hence the profitable solution to house large numbers of them in dormitories located in the peripheral spaces of the island. Capitalism, profit maximization, and space optimization have created conditions and practices of exploitation that are, in normal times, cloaked in invisibility. The 2020 outbreak of COVID-19 in these dormitory spaces should not be surprising, unless they had been so well-hidden in the blind spots of public conscience and policy consciousness. The outbreaks also produced dualistic public reactions: moral panic and the stigmatization of infectious foreigners as dirty and dangerous folk devils, which demands further spatial segregation;and civic activism that steps up to the service of helping the vulnerable in their time of need. The solutions going forward will likely be technical rather than normative in nature, well within the segregating and exploitative logic of neoliberal globalization, with evermore-ingenious ways to extract value from migrant-worker labour, while making them and the heterotopia in which they exist as invisible and distant as possible. © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.

Exploring the Social Dynamics of Public Stigmatization in China of Wuhanese During the Initial Outbreak of COVID-19: A Moral Panic Analysis

During the initial outbreak of COVID-19 in China in 2019 and 2020, the Wuhanese suffered tremendous public stigmatization. Why and how did the general public in China develop such strong feelings against the Wuhanese? To address these questions and understand the social forces underlying this phenomenon, a moral panic analysis was conducted. Using a mixed-method design, this research examined the scale and mechanisms of the public stigmatization of the Wuhanese as ‘the folk devil' of a moral panic and identified the social factors (social media, the collective memory of SARS, and the influence of close relations) which produced and facilitated the initial panic and subsequent public stigmatization. Through its presentation and analysis of quantitative and qualitative data, this article explains how public stigmatization has served as an effective social control instrument in China during the COVID-19 outbreak, used to contain the disease, garner strong public support for the government authorities, legitimize extreme methods used to implement containment policies, and monitor and restrict the population. [ FROM AUTHOR] Copyright of Journal of Contemporary China is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Exploring Racial Microaggressions Toward Chinese Immigrant Women in Greater Boston During Covid

This study was an initial qualitative exploration to (a) capture varied experiences of racial microaggressions directed at Chinese immigrant women before and during Covid and (b) investigate different forms and levels of microaggressions based on socioeconomic status, age, and other characteristics. Racial microaggressions were examined by interviewing 12 foreign‐born, Chinese immigrant women aged 23 to 80 years old, with most of the participants identified as middle class or above. Building upon previous scholarship on racial and gendered microaggressions, an analytical framework was developed using 12 major themes to identify and interpret discriminatory behaviors. Our main findings suggest that the research sample encountered more blatant hate incidents and expressed heightened concern over their physical safety in the post‐Covid period. Young women, compared to their older counterparts, were more inclined to report microaggres-sion episodes and distinguish more subtle forms of discrimination. These findings could serve as preliminary evidence for future research. © 2023 by the author(s).

Stigmatization, panic disorder, and death anxiety among patients of Covid-19: Fourth wave of pandemic in Pakistan.

BACKGROUND: In Pakistan, the fourth wave of COVID-19 is causing an increasing number of positive cases. This fourth wave may be a risky aspect of mental health issues for COVID-19 patients. This quantitative study is designed to understand the stigmatization, and panic disorder and to explore the mediating role of death anxiety among patients of COVID-19 during the fourth wave of novel coronavirus. METHODS: The study was conducted using a correlational research design. The survey was carried out by utilizing a questionnaire with a convenient sample technique. The sample of the study was comprised of 139 patients with COVID-19. Data were collected through Stigma Scale for Chronic Illnesses (SSCI), The Panic Disorder Severity Scale (PDSS), and Death Anxiety Inventory. RESULTS: Results show that stigma is significantly positively related to panic disorder and death anxiety. Furthermore, panic disorder is also significantly positively related to death anxiety. Results also indicate that stigmatization is a significant positive predictor for death anxiety and panic disorder. Moreover, results indicate that death anxiety has a mediating role in the relationship between stigmatization and panic disorder with age and gender as covariates. CONCLUSION: This study would be helpful for people around the world to understand this threatening contagious virus so they wouldn't stigmatize infected ones. Additional research is required for the sustainable improvement of anxiety over time.

Recovered but Constrained: Narratives of Ghanaian COVID-19 Survivors Experiences and Coping Pathways of Stigma, Discrimination, Social Exclusion and Their Sequels.

BACKGROUND: Research about the coronavirus disease 2019 (COVID-19), its epidemiology and socio-economic impact on populations worldwide has gained attention. However, there is dearth of empirical knowledge in low- and middle-income settings about the pandemic's impact on survivors, particularly the tension of their everyday life arising from the experiences and consequences of stigma, discrimination and social exclusion, and how they cope with these behavioral adversities. METHODS: Realist qualitative approach drawing data from people clinically diagnosed positive of COVID-19, admitted into therapy in a designated treatment facility, and subsequently recovered and discharged for or without follow-up domiciliary care. In-depth interviews were conducted by maintaining a code book for identifying and documenting thematic categories in a progression leading to thematic saturation with 45 participants. Data were transcribed and coded deductively for broad themes at the start before systematically nesting emerging themes into the broad ones with the aid of NVivo 12 software. RESULTS: Everyday lived experiences of the participants were disrupted with acts of indirect stigmatization (against relatives and family members), direct stigmatization (labeling, prejudices and stereotyping), barriers to realizing full social life and discriminatory behaviors across socio-ecological structures (workplace, community, family, and social institutions). These behavioral adversities were associated with self-reported poor health, anxiety and psychological disorders, and frustrations among others. Consequently, supplicatory prayers, societal and organizational withdrawal, aggressive behaviors, supportive counseling, and self-assertive behaviors were adopted to cope and modify the adverse behaviors driven by misinformation and fearful perceptions of the COVID-19 and its contagious proportions. CONCLUSION: In the face of the analysis, social campaigns and dissemination of toolkits that can trigger behavior change and responsible behaviors toward COVID-19 survivors are proposed to be implemented by health stakeholders, policy and decision makers in partnership with social influencers, the media, and telecoms.

Stigmatization in the context of the COVID-19 pandemic: a survey experiment using attribution theory and the familiarity hypothesis.

BACKGROUND: The COVID-19 pandemic has created a global health crisis, leading to stigmatization and discriminatory behaviors against people who have contracted or are suspected of having contracted the virus. Yet the causes of stigmatization in the context of COVID-19 remain only partially understood. Using attribution theory, we examine to what extent attributes of a fictitious person affect the formation of stigmatizing attitudes towards this person, and whether suspected COVID-19 infection (vs. flu) intensifies such attitudes. We also use the familiarity hypothesis to explore whether familiarity with COVID-19 reduces stigma and whether it moderates the effect of a COVID-19 infection on stigmatization. METHODS: We conducted a multifactorial vignette survey experiment (28-design, i.e., NVignettes = 256) in Germany (NRespondents = 4,059) in which we experimentally varied signals and signaling events (i.e., information that may trigger stigma) concerning a fictitious person in the context of COVID-19. We assessed respondents' cognitive (e.g., blameworthiness) and affective (e.g., anger) responses as well as their discriminatory inclinations (e.g., avoidance) towards the character. Furthermore, we measured different indicators of respondents' familiarity with COVID-19. RESULTS: Results revealed higher levels of stigma towards people who were diagnosed with COVID-19 versus a regular flu. In addition, stigma was higher towards those who were considered responsible for their infection due to irresponsible behavior. Knowing someone who died from a COVID infection increased stigma. While higher self-reported knowledge about COVID-19 was associated with more stigma, higher factual knowledge was associated with less. CONCLUSION: Attribution theory and to a lesser extent the familiarity hypothesis can help better understand stigma in the context of COVID-19. This study provides insights about who is at risk of stigmatization and stigmatizing others in this context. It thereby allows identifying the groups that require more support in accessing healthcare services and suggests that basic, factually oriented public health interventions would be promising for reducing stigma.

Psychosocial Impact of the Implementation of COVID-19 Protocols.

BACKGROUND: The COVID-19 pandemic has spread globally since the first case was diagnosed in Wuhan, China in December 2019 and we are now experiencing the fourth wave. Several measures are being taken to care for the infected and to curtail the spread of this novel infectious virus. The psychosocial impact of these measures on patients, relatives, caregivers, and medical personnel also needs to be assessed and catered for. METHODS: This is a review article on the psychosocial impact of the implementation of COVID-19 protocols. The literature search was done using Google Scholar, PubMed, and Medline. DISCUSSION: Modalities of transportation of the patient to isolation and quarantine centres have led to stigma and negative attitudes towards such individuals. When diagnosed with the infection, fear of dying from COVID-19, fear of infecting family members and close associates, fear of stigmatization, and loneliness are common among COVID-19 patients. Isolation and quarantine procedures also cause loneliness and depression, and the person is at risk of post-traumatic stress disorder. Caregivers are continually stressed out and have the constant fear of contracting SARS-CoV-2. Despite clear guidelines to help with closure for family members of people dying from COVID-19, inadequate resources make this unrealistic. CONCLUSION: Mental and emotional distress resulting from fear of SARS-Cov-2 infection, the mode of transmission, and consequences have a tremendous negative impact on the psychosocial well-being of those affected, their caregivers, and relatives. There is a need for the government, health institutions, and NGOs to establish platforms to cater to these concerns.

CONTEXTE: La pandémie de SRAS-CoV-2 causée par le COVID-19 s'est propagée à l'échelle mondiale depuis que le premier cas a été diagnostiqué à Wuhan, en Chine, en décembre 2019, et nous vivons maintenant la quatrième vague. Plusieurs mesures sont prises pour prendre en charge les personnes infectées et freiner la propagation de ce nouveau virus infectieux. L'impact psychosocial de ces mesures sur les patients, les proches, les soignants et le personnel médical doit également être évalué et pris en compte. MÉTHODES: Il s'agit d'un article de synthèse sur l'impact psychosocial de la mise en œuvre des protocoles COVID-19. La recherche documentaire a été effectuée à l'aide de Google Scholar, PubMed et Medline. DISCUSSION: Les modalités de transport du patient vers les centres d'isolement et de quarantaine ont conduit à une stigmatisation et à des attitudes négatives envers ces personnes. Lorsque l'infection est diagnostiquée, la peur de mourir du COVID-19, la peur d'infecter les membres de la famille et les proches, la peur de la stigmatisation et la solitude sont courantes chez les patients atteints du COVID-19. Les procédures d'isolement et de quarantaine provoquent également la solitude et la dépression, et la personne risque de souffrir du syndrome de stress post-traumatique. Les soignants sont continuellement stressés et ont la crainte constante de contracter le SRAS-CoV-2. Malgré des directives claires visant à aider les membres de la famille des personnes décédées du COVID-19 à tourner la page, le manque de ressources rend cette démarche irréaliste. CONCLUSION: La détresse mentale et émotionnelle résultant de la peur de l'infection par le SRAS-Cov-2, de son mode de transmission et de ses conséquences a un impact négatif considérable sur le bien-être psychosocial des personnes touchées, de leurs soignants et de leurs proches. Il est nécessaire que le gouvernement, les institutions de santé et les ONG mettent en place des plateformes pour répondre à ces préoccupations. Mots clés: SRAS-CoV-2, COVID-19, impact psychologique, détresse mentale, stigmatisation.

Understanding of Stigmatization and Death Amid COVID-19 in India: A Sociological Exploration.

The unanticipated outbreak of Coronavirus had proven detrimental to human existence. It had created waves of panic, anxiety, and fear among people hence facilitating stigmatization toward an infected person. This stigmatization further influences patients health-seeking behaviour due to the trust deficit in the public health system. The virus had placed the world in an impotent situation as people helplessly watched their loved ones pass away in the absence of effective treatment. Dead bodies are denied a dignified death due to mandatory guidelines prescribed by countries to control the pandemic. This article attempts to understand the process of stigmatization of Coronavirus and its mechanism of influencing the health-seeking behaviour of people. Moreover, the way this stigmatization, accompanied by fear and anxiety, led to the denial of having a dignified death in India.

Covid-19 stigmatization: A systematic literature review.

Covid-19 has severe implications for the emergence of negative stigmatization of specific individuals and community groups. Due to labeling and discrimination, mental attacks cause psychological distress so seriously that it requires proper handling. Therefore, this study aims to conduct a systematic literature review on articles on COVID-19 stigmatization. This paper used descriptive analysis that 248 articles are from the Scopus database obtained by keyword Covid-19 stigmatization in the 2020-2021 time span were then processed and visualized using the Vosviewer software. The results reveal the three most dominant concepts studied: anxiety, isolation, and knowledge. The Covid-19 stigma arises due to low public knowledge, widespread Covid-19 disinformation, and lack of trust in the government. This research contributes to a description of the root causes and adverse effects of stigmatization during Covid-19 to help formulate recommendations for preventive and treatment actions that can be taken. Meanwhile, the limitation of this research is that the articles reviewed are only sourced from Scopus, so they do not have comparative data. Therefore, future studies require using a comparative analysis approach that uses a Web of Science (WoS) database.

Learner Experience of an Online Co-Learning Model to Support Mental Health during the COVID-19 Pandemic: A Qualitative Study.

The COVID-19 pandemic has had a negative impact on the mental health of the population such as increased levels of anxiety, psychological distress, isolation, etc. Access to mental health services has been limited due to the "overflow" of demands. The Recovery College (RC) model, an education-based approach, has addressed this challenge and provided online well-being and mental health courses to at-risk populations. The RC model proposes a co-learning space in an adult education program where learners from diverse backgrounds collectively learn and empower themselves to better address psychological well-being and mental health issues. The aim of this study was to document the experience of learners who participated in online RC courses during the COVID-19 pandemic and the perceived impact of these courses on their mental health. A qualitative interpretative descriptive study design was employed, and Miles and Huberman's stepwise content analysis method was used to mine the data for themes. Fourteen structured online interviews were conducted with a sample representative of the diversity of learners. Five categories of themes emerged: (1) updating and validating your mental health knowledge, (2) taking care of yourself and your mental health, (3) improving and modifying your behaviors and practices, (4) changing how you look at yourself and others, and (5) interacting and connecting with others. Results suggest that online RC courses can be an effective strategy for supporting individual self-regulation and empowerment, breaking social isolation, and reducing the effects of stress in times of social confinement measures and limited access to care.

The emotional well-being of Long COVID patients in relation to their symptoms, social support and stigmatization in social and health services: a qualitative study.

BACKGROUND: Long COVID patients have experienced a decline in their quality of life due to, in part but not wholly, its negative emotional impact. Some of the most prevalent mental health symptoms presented by long COVID patients are anxiety, depression, and sleep disorders. As such, the need has arisen to analyze the personal experiences of these patients to understand how they are managing their daily lives while dealing with the condition. The objective of this study is to increase understanding about the emotional well-being of people diagnosed with long COVID. METHODS: A qualitative design was created and carried out using 35 patients, with 17 participants being interviewed individually and 18 of them taking part in two focus groups. The participating patients were recruited in November and December 2021 from Primary Health Care (PHC) centers in the city of Zaragoza (Northern Spain) and from the Association of Long COVID Patients in Aragon. The study topics were emotional well-being, social support networks, and experience of discrimination. All an inductive thematic content analyses were performed iteratively using NVivo software. RESULTS: The Long COVID patients identified low levels of self-perceived well-being due to their persistent symptoms, as well as limitations in their daily lives that had been persistent for many months. Suicidal thoughts were also mentioned by several patients. They referred to anguish and anxiety about the future as well as a fear of reinfection or relapse and returning to work. Many of the participants reported that they have sought the help of a mental health professional. Most participants identified discriminatory situations in health care. CONCLUSIONS: It is necessary to continue researching the impact that Long COVID has had on mental health, as well as to provide Primary Health Care professionals with evidence that can guide the emotional treatment of these patients.

Reliability and validity of the post COVID-19 condition stigma questionnaire: A prospective cohort study

Summary Background Many of the 10–20% percent of COVID-19 survivors who develop Post COVID-19 Condition (PCC, or Long COVID) describe experiences suggestive of stigmatization, a known social determinant of health. Our objective was to develop an instrument, the Post COVID-19 Condition Stigma Questionnaire (PCCSQ), with which to quantify and characterise PCC-related stigma. Methods We conducted a prospective cohort study to assess the reliability and validity of the PCCSQ. Patients referred to our Post COVID-19 Clinic in the Canadian City of Edmonton, Alberta between May 29, 2021 and May 24, 2022 who met inclusion criteria (attending an academic post COVID-19 clinic;age ≥18 years;persistent symptoms and impairment at ≥ 12 weeks since PCR positive acute COVID-19 infection;English-speaking;internet access;consenting) were invited to complete online questionnaires, including the PCCSQ. Analyses were conducted to estimate the instrument's reliability, construct validity, and association with relevant instruments and defined health outcomes. Findings Of the 198 patients invited, 145 (73%) met inclusion criteria and completed usable questionnaires. Total Stigma Score (TSS) on the PCCSQ ranged from 40 to 174/200. The mean (SD) was 103.9 (31.3). Cronbach's alpha was 0.97. Test-retest reliability was 0.92. Factor analysis supported a 6-factor latent construct. Subtest reliabilities were >0.75. Individuals reporting increased TSS occurred across all demographic groups. Increased risk categories included women, white ethnicity, and limited educational opportunities. TSS was positively correlated with symptoms, depression, anxiety, loneliness, reduced self-esteem, thoughts of self-harm, post-COVID functional status, frailty, EQ5D5L score, and number of ED visits. It was negatively correlated with perceived social support, 6-min walk distance, and EQ5D5L global rating. Stigma scores were significantly increased among participants reporting employment status as disabled. Interpretation Our findings suggested that the PCCSQ is a valid, reliable tool with which to estimate PCC-related stigma. It allows for the identification of patients reporting increased stigma and offers insights into their experiences. Funding The Edmonton Post COVID-19 Clinic is supported by the University of Alberta and Alberta Health Services. No additional sources of funding were involved in the execution of this research study.

Perceived risk of COVID-19 diagnosis and stigma among Nigerians.

The World Health Organization (WHO) classified Nigeria as one of the 13 African countries with a higher risk of spreading COVID-19. Although the Nigerian government and its health agencies set directives in place to help curb the spread of COVID-19, there are instances of unconcerned attitudes and adherence to false and superstitious beliefs surrounding COVID-19 among Nigerians. The current study examined the general perception of COVID-19 risk among Nigerians. Additionally, it examined the fear of possible stigmatization if an individual is diagnosed with COVID-19. A cross-section of 332 Nigerian men and women responded to measures on perceived vulnerability to diseases, perception of risk of being infected with COVID-19, COVID-19 stigma, and social and demographic characteristics. The findings show that respondents with a higher perception of vulnerability to diseases reported higher COVID-19 risk and perception of COVID-19-related stigma. Further, we found that gender, age, and education impacted COVID-19 risk and perception of COVID-19-related stigma. Our findings suggest that risk perceptions and attitudes towards COVID-19 can impact the level of preparedness against a pandemic. Also, the findings could inform strategies for the proper implementation of health protective measures at national, state, and local government levels during a viral outbreak.

Managing Contagion: COVID-19, public health, and reflexive behavior

This paper characterizes a pandemic as a kind of contagion, and describes a contagion as a two-level, two-direction, reflexive feedback loop system. In such a system, expert opinions for managing a pandemic can act as self-fulfilling prophecies due to how they influence collective belief formation. However, when multiple experts produce multiple expert opinions that act as self-fulfilling prophecies, this can fragment a society’s response to a pandemic, worsening rather than ameliorating it. This paper models this possible outcome by distinguishing two competing expert opinions, appealing respectively to people in club good and common pool types of employment/health insurance situations, and argues that to combat fragmentation of opinion about how to address a pandemic, public health policy needs to attend to the nature of public reasoning. It argues this entails asking how just and legitimate deliberative institutions can function in an ‘inclusive and noncoercive’ way that allows society to reconcile competing visions regarding how to combat system-wide crises such as pandemics. © 2022, UNIV SAOPAULO. All rights reserved.

Between Minimum Living Income and Basic Income: disputes over the government of poverty in Spain during the Great Interruption

In this article, the discourses around wealth redistribution policies in Spain based on the case of disputes around the Minimum Living Income during the Great Interruption ???the period of health and economic crisis from March to September 2020??? are analyzed. To do this, the most meaningful moments in the evolution of the public debate on the policy are synthesized and analyzed: the outbreak of the pandemic in March, the approval of the Minimum Living Income in June, and the first phase of implementation of the policy until September of 2020. The analysis of political, media and activist discourses shows the disputes in the ways of tackling poverty, on the one hand, with the initial openings of the political imagination to innovative policies ???such as the Universal Basic Income or the Quarantine Income??? or the normalization of an approach to the expansion of social and economic rights, and on the other hand, the transversal affirmation of the work ethic, the narratives of stigmatization of people without income, the modes of control, bureaucratization and government of the poverty, and the technocratic justification of the policy as an improvement of the minimum income system of the regions. Despite the continuities and discontinuities in the discursive frameworks, it is concluded that the disputes analyzed around the Minimum Vital Income express some of the social tensions derived from the trends of growing inequality since the 2008 which have not been reversed to date.

The effect of stigmatization education on the social distancing of nursing students toward patients with a diagnosis of schizophrenia.

PURPOSE: To assess the effect of a program designed to reduce nursing students' social distancing from individuals diagnosed with schizophrenia. METHOD: This experimental study was designed using a pretest, a posttest, and a control group. All participants were nursing students, of which 25 were included in the intervention group and 23 were placed in the control group. A 13-week program was offered to the intervention group. The measuring instruments consisted of a personal information form and the Social Distance Scale. Data were analyzed using the two-way repeated measures analysis of variance. FINDINGS: A significant difference was found between the two groups. CONCLUSION: The Education Program on Stigmatization in Schizophrenia is an effective intervention that reduces the social distance of nursing students from individuals diagnosed with schizophrenia.

Age Differences in Psychological Antecedents and Behavioral Consequences of Stigmatization Associated with COVID-19 among Koreans.

The first goal of this study is to develop a conceptual model of the causal relationship between psychological antecedents (internal attribution, anger, dangerousness, fear) of stigmatization, stigmatization (public stigma, anticipated stigma), and the behavioral consequences (compliance with COVID-19 prevention guidelines, COVID-19 testing intention) of stigmatization associated with COVID-19. The second goal of the study is to investigate the age differences in the conceptual model between younger and older adults unconfirmed with COVID-19 in Korea. After building the model based on previous studies, an online survey was conducted with Koreans in their 20s (n = 300, females: 50%) and 60s (n = 300, females: 50%) who had not been confirmed with COVID-19. The results revealed that for participants in their 20s and 60s, their internal attribution of COVID-19 infection to individuals confirmed with COVID-19 enhanced their anger at the individuals. Afterward, their anger increased their anticipated stigma of being confirmed with COVID-19 through enhancing the public stigma of the individuals confirmed with COVID-19. Unexpectedly, the fear of individuals confirmed with COVID-19 elicited by the dangerousness of the individuals had no effect on the public stigma of the individuals among participants in their 20s and 60s. The fear directly enhanced their compliance with the COVID-19 prevention guidelines. Next, for participants in their 20s, their anticipated stigma increased their compliance with COVID-19 prevention guidelines, but not their COVID-19 testing intention. However, the anticipated stigma did not affect both the compliance with the COVID-19 prevention guidelines and COVID-19 testing intention among participants in their 60s. The implications and limitations of these findings are discussed.

Global prevalence of stigmatization and violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis.

PURPOSE: During COVID-19, stigmatization and violence against and between professional healthcare workers worldwide are increasing. Understanding the prevalence of such stigmatization and violence is needed for gaining a complete picture of this issue. Therefore, the purpose of this review was to update estimates of the prevalence of stigmatization and violence against healthcare workers during the pandemic. DESIGN: A systematic review and meta-analysis was conducted. METHODS: This review followed PRISMA guidelines and encompassed these databases: PubMed, Academic Search Complete, CINAHL, Web of Science, MEDLINE Complete, OVID (UpToDate), and Embase (from databases inception to September 15, 2021). We included observational studies and evaluated the quality of the study using the Joanna Briggs Institute methodology. Further, a random effects model was used to synthesis the pooled prevalence of stigmatization and violence in this study. FINDINGS: We identified 14 studies involving 3452 doctors, 5738 nurses, and 2744 allied health workers that reported stigmatization and violence during the pandemic. The pooled prevalence was, for stigmatization, 43% (95% confidence interval [CI]: 21% to 65%) and, for violence, 42% (95% CI: 30% to 54%). CONCLUSIONS: Stigmatization and violence during the COVID-19 pandemic were found to have affected almost half the studied healthcare workers. Healthcare professionals are more prone to be stigmatized by the community and to face workplace violence. CLINICAL RELEVANCE: Health administrators and policymakers should anticipate and promptly address stigmatization and violence against and between healthcare workers, while controlling the spread of COVID-19. Health care systems should give serious attention to the mental health of all health providers.