Discourses around Stigma and Denial in the COVID-19 Pandemic

A widespread but underexplored aspect of the Covid-19 pandemic in India has been the prevalence of stigma and denial at different levels in the community mediated by state policy and actions. Based on a field study in three districts of Tamil Nadu between the two waves of the pandemic, this article explores the nature of stigma and denial and their consequence for health-seeking behaviour and access to healthcare. This is important not just to prevent further suffering of the affected people but also for formulation of more effective and equitable public health interventions in management of the pandemic.

According to official statistics, on 30 April 2021, over 4 lakh COVID-19 infections were recorded in India. In Tamil Nadu (TN) alone, since the onset of the pandemic, more than 11 lakh cases and 13,933 deaths were reported as of 30 April 2021. Yet, in December 2020, when undertaking a COVID-19-related field study in rural TN, one could be asked, ‘‘Is there really a disease called COVID-19? And even if it exists somewhere in the world, has it really affected us or is it all an exaggeration, a fabrication, or even a conspiracy?’’ While an outright denial of the pandemic may not have been so apparent in Chennai, conspiracy discussions were not uncommon among the urban sections either. This article discusses the widespread COVID-19 denial uncovered in a field study in TN and explores its relationship to an equally pervasive social phenomenon, namely stigma.

The ugly underbelly of stigma has long been associated with infectious diseases, most notably leprosy, HIV/AIDS, and tuberculosis, and such stigma was associated with increasing vulnerability of those infected as well as rendering ineffective disease control and public health initiatives (Chandrashekhar 2020; Gilbert 2016). Theories of health-related stigma define it as a social process in which illness is constructed as preventable or controllable, certain ‘‘immoral’’ behaviours causing the illness are identified and existing social constructions of the “other” are usually displaced onto the ‘‘carriers’’ of disease (Deacon 2006). An important part of this process is that people are blamed for their own infection, with some categories of people singled out for such blame. A classic case in point is the blaming, shaming, and othering of population groups that are perceived as being at greater risk of contracting HIV/AIDS, such as gay men, “promiscuous” people, and commercial sex workers in diverse regional contexts (Deacon 2006). In the early months of the pandemic, news reports highlighted the stigmatising and discriminatory treatment meted out to doctors, nurses, flight attendants, police, and a range of other frontline workers across the country (Ganapathy 2020; Mantri 2020). Healthcare workers and even patients recovering from COVID-19 in India and elsewhere were asked to vacate rented homes, denied access to public transport and other essential services, subjected to physical assault, and stalked and abused on social media (Bagcchi 2020).