Coronavirus outbreak: Stigma making it worse

A person who later turned out to be coronavirus-positive had gone to Dhaka Medical College Hospital on April 8 after having visited a few other hospitals.

The patient was complaining of abdominal pain. Doctors performed an X-ray and suspected that the patient is probably infected with Covid-19.

When doctors suggested that samples be collected to be tested for the virus, the patient's relatives told the doctors that his sample had been collected earlier.

Later, the patient died and his namaz-e-janaza was held without following the WHO's burial guidelines as the family had kept his infection a secret.

Doctors learned later that his sample was collected and sent for testing when he had been at a private hospital prior to coming to DMCH, and the test results came out positive for Covid-19 the following day.

"Some of our doctors wore PPE during the treatment but there were other patients in the ward so they might have been infected," said a doctor wishing not to be named.

On April 9, nine doctors, six nurses and a ward boy of the hospital went into quarantine as they came to know that they had unwittingly treated a patient with coronavirus.

This is not an isolated incident. There are a number of reports that people suspected of coronavirus infection are avoiding quarantine facilities owing to fears of isolation and social stigma.

Experts said this is leading to panic and further spread of the deadly disease. Such patients are even infecting doctors, who are on the front line of the battle against Covid-19.

"People are hiding their disease due to [fear of] stigma. Our approach to coronavirus patients is supposed to be informed by empathy, but instead we stigmatise them. It is very dangerous as a single person is putting the whole community and subsequently the country at risk," Benazir Ahmed, former director (disease control) of the DGHS, told The Daily Star.

He said from sample collection to burial the whole communication strategy should be reviewed as the existing system is faulty.

"If people are confident that they would not be stigmatised, the situation will improve and risk will lessen," the public health expert suggested.

Till yesterday, the number of coronavirus positive cases in the country rose to 4,689 with 131 deaths.

The magnitude of the problem can be measured from an statement of Prime Minister Sheikh Hasina.

The PM on April 7 said, "Please don't conceal the disease as you may infect others if you hide it. It's not a matter of shame… we've made all kinds of arrangements for the treatment and we've also taken steps to protect those who will provide treatment to the Covid-19 patients."

When contacted, Director General of Directorate General of Health Services Prof Abul Kalam Azad said, "We are reviewing the communication strategy and changing it constantly. We are requesting people not to hide their infections."

According to a news report last month by a Sri Lankan media outlet, anyone found hiding symptoms of the novel coronavirus in the island nation would be handed a six-month jail term, as there were individuals who had avoided going into quarantine centres after arriving from virus-affected countries.

Mekhala Sarkar, associate professor of psychiatry at National Institute of Mental Health, said right information and proper knowledge can defeat fear.

"If the thought of isolation or quarantine is scaring them, we surely need to spread awareness and clarity regarding isolation and quarantine, which will remove the fear," she said.

It is unfortunate, she said, to come across news reports about people escaping quarantine facilities.

Take another example of how a suspected corona patient was socially stigmatised.

A woman said she, along with her husband, had been suffering from severe flu-like symptoms from March 18 and they went into self-isolation and had gone into home quarantine.

"We contacted the IEDCR for testing and when they came to test, the building's committee secretary called us up and was very rude to us, accusing us of hiding our situation," she said.

"We told him that we had nothing to let them know until the IEDCR would give us our test results."

"When the results came, we sent a message saying that we are negative, but he sent the caretaker to our house to let us know that he would not believe it until he saw the reports himself. He demanded the reports. As residents of this building we were happy to oblige and share the medical report."