What is #covid19 stigma, why is it toxic to public health, and what can we do about it?

A short thread.

Without federal support, it feels like "personal responsibility" is what will save us—so of course people are trying to shame each other into healthier behavior. But shame and blame perpetuate stigma, which can have the *opposite* of the intended effect. https://www.theatlantic.com/ideas/archive/2020/05/quarantine-fatigue-real-and-shaming-people-wont-help/611482/

People are called "selfish" and "reckless," even criminalized, for not wearing masks, not distancing. They're told to just "do the right thing," be "responsible." So it's no surprise when those who get #covid19 are seen—& see themselves—as bad, careless, deserving of punishment.

Instead of deterring risk behavior, stigma deters disclosure. People become afraid to share their exposures, symptoms, and test results with each other, with contact tracers. They avoid getting tested at all. Stigma makes public health efforts break down. https://twitter.com/AbraarKaran/status/1327075959799902214?s=20

Empathy is an antidote to stigma. It's not always easy to muster, especially in the context of fear, anger, fatigue, and politicization. But trying to understand people's behavior, including risk taking, is the first step toward helping them change it. https://twitter.com/JuliaLMarcus/status/1284203364818079744?s=20

Few people are seeking infection, and even fewer want to get others sick. Risk taking often reflects people's unmet needs: for a paycheck, for social connection, for accurate information about risk. Acknowledging and meeting those needs supports risk reduction and reduces stigma.

Some may think people really *are* stupid and selfish if they're going to work sick or traveling to see loved ones, that they deserve to be shunned for putting others at risk. But compassion isn't coddling—it's a pragmatic and humane approach to maximizing public health.