In his novel, A Journal of the Plague Year, published in 1722 after the bubonic plague devastated Europe, author Daniel Defoe writes about families forced into quarantine due to an infected family member. He states that it was generally from such houses that dismal shrieks and cries of poor people were heard — they were terrified and even frightened to death, by the sight of the condition of their dearest relations, and of being imprisoned as they were. In an interview to the New York Times in 1988, author and Nobel laureate Gabriel Garcia Marquez said: “Plagues are like imponderable dangers that surprise people. They seem to have the quality of destiny.” Defoe’s nearly 400-year-old account and Marquez’s definition of destiny seem to have returned to haunt the world as we struggle to contain the COVID-19 pandemic.
Pandemics and the measures taken to control them invariably lead to severe mental stress, as has been shown by many scientific articles. Enough scientific literature is available to show that the disease and the so-called remedy — the lockdown — caused significant mental stress to the people subjected to it during the ongoing pandemic. This stress can translate into different kinds of action. In deeply traditional and religious societies like ours, compounded by the paucity of education, scientific temper and logical thinking, these actions can be extremely treacherous.
On April 24, a 34-year old man was reportedly attacked in Kalyan, Maharashtra, on the suspicion of being a COVID-19 patient. He died, following the attack. In another case, a 25-year-old man was injured in Aligarh, Uttar Pradesh, on the suspicion of being a COVID-19 patient. Similar incidence of violence against people suspected of harbouring the notorious virus has been reported from all around the country. Besides the general public, doctors, nurses and other health personnel have also been targeted. Junior doctors from my hospital have been issued notices by their landlords, requesting them to vacate their rented accommodation because of the neighbourhood’s hostility. All in all, it didn’t take long for the COVID-19 pandemic to take the shape of a stigmatised, contagious beast in India. This needs to be carefully evaluated and understood because, sadly, it is a reflection of the society we have become.
The stigma attached to COVID-19 in India is not without reason. We have a penchant to attach stigmas to various phenomena. Besides ill-founded traditions, the commonest stigmas go with diseases. People with mental health issues, neurological diseases like epilepsy, physical disabilities, tuberculosis, skin disorders and leprosy are shunned, mistreated and not considered equals by our society.
But the stigma attached to a pandemic with high infection rates is unique in many ways. It’s unique because it comes from extreme fear. The paranoia which has been constructed around COVID-19 in the last three months has made matters worse. The hasty lockdown and the unfortunate migration of the poor out of cities on foot have only compounded the fear. The poor migrant has unsurprisingly carried hatred against us, the citywallahs, and fear of the disease to wherever he went in the hinterland. The general public remained ill-informed or misinformed on many aspects of the disease. The undemocratic lockdown, even if it can be argued as being necessary, led to further strengthening of a notion that we are dealing with a disease which was so contagious and so lethal that it can lead to the death of anyone who comes in contact with an infected person. It was unfortunate that the government puffed its chest in claiming that this was the strictest lockdown in the world. Visuals of police atrocities in implementing the lockdown played their part in fortifying the notion that we are dealing with a disease “worth the stigma”. I believe that the strictness of the lockdown played its part in inducing fear in the minds of the general public, thereby attaching more stigma to the disease.
In the initial phase of the lockdown in Delhi, the government started a process of marking homes of people advised to be in quarantine or homes with actual patients. This is an old practice, which is still prevalent in many European countries. But such a “marking out” in a country like ours reinforced the fear around COVID-19. There are better and more discreet methods to implement a quarantine. In Kerala, which has the best results in the country in terms of containing the disease, ASHA workers were deployed and tele-counselling services were provided to families with suspected infected patients or those under quarantine.
The role of educating the masses cannot be overemphasised during such an outbreak. An effective way would have been to use the village health workers in a door-to-door campaign. In this respect, the Kerala government’s initiative, called “Break the Chain”, is worth a mention. The campaign aimed to educate people about the importance of personal hygiene and simple methods like hand washing techniques.
Scientific or logical behaviour in society evolves over time. It is both culturally derived and individually ingrained. Unfortunately, the last few years have seen a sequential erosion of science and scientific temper in our country. Sadly, this erosion has been accelerated by the unscientific rhetoric from the highest offices of the executive. Even sadder is the silence of the scientific community on this erosion. The lack of scientific thinking has been unabated even in the times of the COVID-19. Promotion of Ganga jal and gau mutra as a cure for COVID-19 and the concomitant misinformation, rumours and speculation about the pandemic on social and other media, have only added to further confusion and fear.
There is a subtle difference between caution and fear when it comes to containing a pandemic of this scale. Caution helps in salvaging the self while fear consumes both the self and those around us. Stigmatisation comes from fear. If we want to come out of the ruins of this pandemic and from the consequences of the lockdown, we have to remove fear and stigma from this awful disease. We have to let our minds be governed by science, and not fakery. We must remember that illnesses are as old as civilisation and our only hope in fighting diseases lies in our undeterred faith in science and reason.
The COVID-19 pandemic is no exception to this thumb rule.
This article first appeared in the print edition on May 26, 2020 under the title ‘The contagion of fear’.
The writer is professor of orthopaedics, AIIMS, New Delhi. Views are personal
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