Pandemics are often fought with ancient methods, but this can mean society’s most vulnerable face ancient problems, argue Dr Christina Ergler, Associate Professor Robert Huish and Associate Professor Nichole Georgeou
Descriptors like ‘self-isolation’, ‘social distancing’ and ‘lockdown’ may be very nouveau, but societies have used these public health methods for more than 2000 years to combat health emergencies.
With ancient practices come ancient problems, and in the context of the Covid-19 pandemic, stigmatisation of ‘vulnerable’ social groups has again reared its head.
During the pandemic, this has extended not only to groups ‘vulnerable’ to contracting Covid-19 because of pre-existing health-conditions, but those close to the disease and social groups that experienced high levels of socio-economic disadvantage, marginalisation, discrimination and exclusion prior to the pandemic.
As New Zealand moves from eliminating Covid-19 to living with the virus we need to engage in a conversation about whether support for managing the virus needs to be accompanied by measures to address associated stigma, and whether it is possible to build a 'post-Covid future' that heals communities rather than divides them.
Covid-19, stigma and ‘rules’ analogies
New Zealand’s ‘go hard, go early’ approach resulted in very low infection rates until August 2021. Until then, public health messaging viewed the team of five million as being at the same end of the rugby pitch, and any evidence of Covid-19 meant that someone was ‘offside’. Messaging around this created fear and encouraged stigma against some groups in society.
Stigma is socially constructed; it underpins all social interactions to shape people’s experiences, values, beliefs and norms. With disease, stigmatisation takes on new dimensions: inequalities based on perceived differences appear, leading to social and geographical exclusion, silencing, and feelings of shame and guilt. Stigmatisation during the pandemic involves physical, social and emotional forms of violence which, although not viral, still threaten wellbeing.
The penalties for being onside vs offside
During 2020 and 2021, the composition of stigmatised groups in New Zealand changed as the pandemic developed. Initially, people who appeared to be of Asian descent were blamed for “bringing the virus in”. Since then, essential workers (such as supermarket workers and postal workers), health care workers, managed isolation workers (‘MIQ’), Pasifika communities, people on a low-income, as well as gang members and sex workers, have all been singled out when there has been a rise in Covid-19 numbers. More recently, those who choose to remain unvaccinated are being stigmatised.
Stigma, in its various forms, has very real consequences for these groups. Media reports and preliminary findings from an ongoing study of stigma in New Zealand the authors are involved in show that MIQ workers and their families lost their rental contracts, were cut from their social networks, while partners of frontline workers were asked to quit their jobs or to work from home as colleagues, friends and family members feared transmission.
Nursing and managed isolation uniforms marked people as potentially infectious, unclean or contaminated and they were abused or got treated differently in public spaces. Another group who feel stigmatised are those who were, or are, critical of the Government’s elimination strategy, or who question the processes and consequences of the border closures, such as families being apart.
In response, diverse coping strategies have arisen. Our research shows that the consequences of stigmatisation are that people have hidden their occupation, lied when filling in forms or kept quiet in conversations, avoiding critical engagement with the consequences of the alert levels to avoided stigmatisation.
Building a future that heals
How we build a kinder and more cohesive society as we learn to live with Covid-19 is crucial to social cohesion. Our research suggests three premises as prerequisites for post-pandemic healing processes within the many groups that make up the ‘team of five million’.
First, making space for telling and listening with kindness to diverse stories and experiences. Second, not band-aiding stigmatisation with empty phrases, but putting dignity at the heart of healing intentions that include respect, freedom, autonomy, and simple participation in public and private life in a dignified manner. Third, pairing an acknowledgment of the fears, anger and scars caused by the pandemic and prior social harms with concrete efforts to create a more just, kind and cohesive society.
By highlighting stigma as one of the many consequences of public health measures in a pandemic, as a society we must not only recognise the impacts of invisible wounds on stigmatised groups, but also question whether these wounds are necessary. We must ask ourselves the question of how we heal.
So far, these discussions have not been possible. The silence around stigma, its causes, and entrenchment can be deafening. If anything, the pandemic presents an opportunity to explore the ways stigmatised groups are silenced institutionally and in everyday life.
*Dr Christina Ergler is a senior lecturer, from the School of Geography, at the University of Otago.
*Associate Professor Robert Huish is a researcher, from the Department of International Development Studies, at Dalhousie University, Canada.
*Associate Professor Nichole Georgeou is director of the Humanitarian and Development Research Initiative (HADRI), at Western Sydney University, Australia.
