Frontline clinicians' perceptions of the stigmatization of covid-19 and suggestions to prevent future health-related stigma: a qualitative study

BACKGROUND: Most studies examining COVID-19 related stigma in the healthcare setting have focused either on the patient’s or clinicians’ own experiences of being stigmatized. Few studies have explored frontline clinicians’ perceptions about the stigmatization of COVID-19 and stigma prevention. This study aimed to better understand, through the perceptions of physicians, nurses and other frontline healthcare providers, the drivers that underlie the stigmatization of COVID-19, and strategies to prevent future health-related stigma. METHODS: Individual interviews were conducted with 19 clinicians from the states of Washington, Illinois, New York and Florida. Interview questions included perceptions about stigma related to COVID-19, drivers of stigma, and recommendations for stigma prevention. All authors participated in thematic analysis of the interviews through an iterative process of comparison, dialogue, and consensus. RESULTS: Major themes that emerged were (1) the changing nature of COVID-19 stigma over time, (2) evidence of stigma towards patients, (3) evidence of stigma towards and between providers, (4) stigma related to vaccination, (5) underlying drivers of COVID-19 stigma, and (6) how to reduce and prevent stigmatization. Drivers of stigma included existing biases, fear of infection, blame, burnout, and the way information was messaged. Suggestions for methods to prevent stigma toward COVID-19 patients and providers included humanizing patients, showing mutual respect for different ways of thinking, facilitating community cohesion, and messaging from health leaders and media to patients, providers and the public. CONCLUSIONS: Our findings provide novel, frontline observational information that can inform policy decisions and interventions to mitigate current health-related stigma and prevent future health-related stigmatization.