Ebola and healthcare worker stigma

Exposure to infection is a risk for all healthcare workers. This risk acquires another dimension in an outbreak of highly contagious, lethal disease, such as the Ebola epidemic in West Africa in 2014. Healthcare workers are usually well and correctly informed about the risks from such diseases, but family, neighbours, friends, or colleagues may react strongly to the risk that staff might bring infection home from an epidemic overseas. Research around such stigmatization is scarce. We wanted to investigate how common it is, which expressions it assumes and how it is influenced by dissemination of information.

We interviewed a sample of Swedish healthcare workers who had worked in West Africa during the 2014 outbreak of Ebola, as well as one close contact for each of them, about reactions before leaving and after returning, and also about information received.

The majority of contact persons reported no or little concern, neither when the healthcare worker revealed the plan to leave, nor on the healthcare worker's return. The prevailing reason was trust in the judgement of 'their' healthcare worker, mainly using information received from the healthcare worker to assess risks, and relying little on other information channels. This means that the person assessing the risk was at the same time the hazard. There were indications that instructions regarding quarantine and self-isolation were less stringently followed by healthcare workers than by other aid workers in the outbreak, which could give confusing signals to the public. Simple, clear and non-negotiable rules should be preferred - also from an information perspective.