Prevention of Social Stigma Related to Coronavirus Disease 2019 (COVID-19)

As a result of the global crisis related to coronavirus disease 2019 (COVID-19), confusion, anxiety, fear, and some psychological effects have been created among the general population in this global village. Unfortunately, these factors have provoked inappropriate behavior converting the infection to the virus to a social stigma, which can affect the dignity of people died due to COVID-19. In addition to the patient, the stigma can also affect interpersonal relationship among nurses, family members, friends, as well as social relationships. In this critical situation, we need to take care of each other with empathy, which is the key to successfully cope with the issue and prevent social stigma associated with COVID-19. This commentary evaluates the effects of social stigma related to COVID-19 and suggests some practical measures for the world communities to deal with this global public health problem.


Introduction
Hopefully, the coronavirus disease 2019 (COVID-19) pandemic will be controlled, but in the meantime the very important issue is our behavior towards each other, which is being recorded in history. As a result of the global crisis related to COVID-19, confusion, anxiety, and fear have been created among the general population in our global village. Unfortunately, these factors have provoked inappropriate behavior converting the infection to the virus to a social stigma, which can affect the dignity of people died due to COVID-19. In addition to the patient, the stigma can also affect interpersonal relationship among nurses, family members, friends, as well as social relationships. Even individuals who are not infected with the virus but they have common features with COVID-19 patients may be irritated with the social stigma related to the disease.
Certainly, the consequences and social problems related to social stigma can be more dangerous than the disease itself. In this regard, some of the effects of social stigma related to COVID-19 have been presented as follows: • Not revealing the illness due to fear of discriminatory behavior • Reducing the tendency of COVID-19 patients to perform diagnostic tests and adopt healthy behaviors such as washing hands, wearing a mask, observing social distance rules, staying home, etc.
• Prohibition of access to treatment and other health care services • Lack of commitment to treatment among COVID-19 patients 1-3 The manner of talking to people about COVID-19 disease is very important in helping them to take effective and efficient measures to fight this new disease and prevent the increase of fear and notoriety in them. The type of words chosen is important in reducing or increasing the social stigma associated with COVID-19 disease. For example, some words such as 'isolation' and 'quarantine' may have a negative impact on people and worsen the outlook in relation to the disease. Hence, we should avoid exaggerated terms such as 'catastrophic disease' and 'mass murder' that cause fear among members of the society. We should never use phrases such as 'virus transmitter' , 'dispenser of COVID-19 disease' , 'infectious persons' , etc. because these phrases may convey the meaning of intentional spread of the virus to the listener, and as a result, this may cause embarrassment in the COVID-19 patients. From a medical point of view, COVID-19 disease is less lethal than other respiratory diseases such as influenza; however, the psychological aspects of the pandemic have caused COVID-19 patients face with derogatory and discriminatory behaviors, and even experience losing their social dignity. 1,4 In this letter, we aimed to present the necessary practical measures for the world community to deal with the social stigma associated with COVID-19 disease as follows: 1-We have a heartfelt belief to this slogan: "not fear, but the expression of truth will prevent the spread of novel coronavirus". Therefore, expressing and spreading the truth in society is very important. We believe that incorrect information about the COVID-19 disease should be corrected as much as possible and senior managers of health system should provide accurate information about the disease. This information should be expressed in simple language and senior managers of the health system should avoid expressing specialized medical words and phrases. With this important point in mind, social phobia will be prevented among the public people. These figures should emphasize the importance of prevention, testing, and immediate treatment for other people in the community. Political leaders in society must refrain from negative aspects and threatening messages. 2-Involving influential people in society is helpful in this regard. The support provided by influential celebrities such as religious leaders, artists, and athletes is another important step in combating the social stigma associated with COVID-19 disease. 3-Everyone in the community, regardless of age, gender, or race, is at the risk of being infected with the virus. So, we should not attribute the disease to certain places or people.

4-Creating campaigns and a friendly environment,
showing attention and sympathy, and adopting supportive behaviors can be helpful in combating the social stigma associated with COVID-19 disease. In these campaigns, it is better to express the experiences of people who have recovered after being infected. Also, it is better to express the feelings of people who have supported their loved ones until full recovery. Establishing and supporting a 'heroic campaign' to honor nurses and healthcare staff is also very useful in this regard.

5-News sources such as social media and newspapers
should avoid overemphasizing the efforts to find a treatment and vaccine for COVID-19 disease, because it can create helplessness and hopelessness among the communities. Ethically, it is the duty of journalists to avoid creating a sense of disability to control COVID-19 pandemic among the people. 1,2,4,5 In this regard, Tedros Adhanom Ghebreyesus, director-general of the World Health Organization expressed on 30 January 2020: "We must act now to help countries prepare for the following: 1-this is the time for facts, no fear; 2-this is the time for science, no rumors, and 3-this is the time for solidarity, not stigma". 6 These statements remind us the importance of social stigma associated with COVID-19 in this critical situation. Therefore, let's not stigmatize COVID-19 patients and take care of ourselves and others. In this critical situation in which each person in this global village is involved, we need to take care of each other with empathy, which is the key to cope with this health problem and prevent social stigma associated with COVID-19.

Ethical Approval
Not applicable.

Conflict of Interest Disclosures
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.