COVID-19 stigma high among certain groups in Asia-Pacific, survey reveals

MANILA — Almost half of the respondents in a new Asia-Pacific survey perceive certain groups of people are responsible for spreading COVID-19. Some of them point to Chinese people and migrants, while others say its rule breakers and the government's insufficient response, according to the survey. An initiative of the Asia-Pacific Risk Com­munication and Community Engagement Working Group, comprised of various United Nations and humanitarian agencies, the survey involved 4,993 respondents in Indonesia, Malaysia, Myanmar, and Pakistan. It found that one in three respondents across the four countries believe certain groups of people are responsible for spreading the disease. The highest response was in Malaysia, where 69% responded positively to the survey question: “Do you think a specific group if responsible for spreading COVID-19?” Among the most frequently cited groups are Chinese people, returning migrants, foreign tourists, migrant workers, and “illegal foreigners.” The survey provides insights into how communities in the region perceive COVID-19 and the depth of knowledge on the disease. It highlights areas where humanitarian organizations involved in risk communication need to improve, such as addressing stigma, but also what information they need to clarify and reinforce in communities, including about COVID-19 transmission. Who are communities blaming for COVID-19? Over 30% of respondents in Myanmar also think Chinese people and returning migrants are responsible for the spread of COVID-19 there. In Indonesia, however, the majority apportion blame to those who don’t diligently follow government safety protocols such as wearing masks and avoidance of unnecessarily travel. Some also believe less-than-robust government action early on contributed to the spread of the disease in the country. In Pakistan, a few believe that Chinese people, returning nationals such as pilgrims from Iran and Syria, and foreigners are responsible for the spread of COVID-19. But this is only secondary to what most respondents perceive as “insufficient control measures related to travel, isolation, and quarantine facilities established by the government at the Iranian border.” Some of the results are not entirely surprising, such as sentiments toward Chinese people. This is likely mostly due to COVID-19 having been first reported in Wuhan, China, before it spread across the globe. Some also have “quite reasonable thoughts” for who they think is responsible for the spread of COVID-19, said Viviane Fluck, community engagement and accountability coordinator for the International Federation of Red Cross and Red Crescent in the Asia-Pacific. “There are people who are saying it is others that don't abide by health measurements, for instance. And there's, of course, some truth in that … If we don't take up preventative measures, we're much more likely to spread the disease. And also saying, people who are ill with COVID-19 are the ones who are spreading it, which is basically common sense, right? If you're ill, and you go outside, then you will most likely infect other people,” Fluck told Devex. “How can we reassure people? How can we make things more transparent and more clear that it is not a specific group that is spreading [the virus]?” --— Viviane Fluck, community engagement and accountability coordinator, International Federation of Red Cross and Red Crescent Asia-Pacific What do communities want? And what do they need to know? Fluck said IFRC and other humanitarian agencies need to better understand why people blame certain groups, such as migrants, to help IFRC and other humanitarian agencies involved adapt their messaging. “I think we need to understand even more why that is the case. So that we can identify what are the questions and the worries behind the stigma and how can we address that. How can we reassure people? How can we make things more transparent and more clear that it is not a specific group that is spreading [the virus]?” she said, while acknowledging the challenges that come with addressing stigma and in measuring how an action could change people’s perceptions. “I have no illusion about the impact of humanitarian organizations. This is our remit, and we work on that. But in a whole community, we are just one actor,” she said. “I think we need to definitely work more on stigma as well. But of course, we're not the only ones who hold the key to the solution there.” IFRC and other humanitarian partners plan to roll out a second survey in the next few weeks and months to gather more insights into why certain groups are seen as causing the spread of the virus in the region. In the meantime, IFRC and partners are looking at different ways to address findings in the survey, including stigma, and how to fill in information gaps and make use of people’s most trusted medium or source for information. More than 60% of respondents identify television as a trusted source of information across all countries, followed by radio and print newspapers in Malaysia and Myanmar. But in Pakistan, the Internet has become a notable source of information after TV. In Indonesia, respondents said they trust community health workers, the ministry of health, and humanitarian groups over television. Fluck also said IFRC and partners are looking at changing the content of their messages. “One of the changes that I'm suggesting is that we move a bit away from just kind of basic communication on how you [can] prevent the disease. Of course that's still important to keep up … but in quite a number of the countries, people actually knew that quite well. So I think it can become a bit patronizing if we continue communicating that same thing,” she said. One issue Fluck said that IFRC and partners could provide more messaging and clarity on is about COVID-19 transmission. While the majority of the respondents were knowledgeable about COVID-19 transmission from droplets through direct or close contact with infected people and animals, and through contaminated objects or surfaces, a significant number of respondents also answered: “through the air.” There remains an ongoing debate over the virus’s airborne transmission. A group of scientists has appealed to the World Health Organization in July to update its recommendations to include the risk of airborne transmission of COVID-19. WHO has maintained this may occur during the performance of certain medical procedures that generate aerosols. While some outbreaks have been reported in indoor crowded settings such as in restaurants, suggesting the possibility of aerosol transmission, the aid agency said this “requires further study.” Last week, the U.S. Centers for Disease Control and Prevention released an update on its website acknowledging the virus airborne transmission, only to remove it on Monday saying the update “was posted in error.” “That is something that I think we need to work on, because there has been content that apparently wasn't clear enough on that because it's a bit more difficult as well to explain ... than some of the other transmission modes, I think. And so we're changing the content as well to suit more what people are asking for,” Fluck said. In the survey, Fluck also found an increased interest in COVID-19 vaccine information. “That's not surprising, of course, because I think a lot of ... community members see that as a possible solution to kind of end the pandemic,” she said.