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The problematic unknowns of how stigmatization helps coronavirus spread in Toronto

Click to play video 'Some people in Toronto coronavirus hotspots afraid of association to COVID-19' Some people in Toronto coronavirus hotspots afraid of association to COVID-19
WATCH ABOVE: Areas of high inequality continue to struggle with COVID-19 cases in Toronto, creating fears of having an association with the disease. That fear of stigmatization could be a big problem for contact tracing. Matthew Bingley reports – Oct 22, 2020

Inequality has been one of the driving factors in the spread of COVID-19 in Toronto, but what is less known is the extent to which stigmatization is helping spread the disease.

The areas which have continued to see some of the highest cases of the virus, have been predominantly in areas of the city with high rates of poverty, population density, and those with highly racialized populations.

In the Jane and Finch neighbourhood, speaking with those who have first-hand experience with COVID-19 is no easy task. In part, because of a fear of being associated with it.

“It’s around a fear of having people look at them as if they’re somehow contagious,” said Pablo Vivanco, the program director at the Jane/Finch Centre, adding tensions are already high in the area, which has been among the hardest-hit regions of the city.

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“Everybody’s feeling it … you walk by somebody, you think they’re too close and all of a sudden people get tense.”

Pointing to the nearby construction of the Finch West LRT, Vivanco said the area hasn’t seen many changes when it comes to investments to improve the region.

Local residents, many of whom have essential jobs, don’t have the luxury of working from home, and finding themselves packed onto crowded buses or in crowded apartments have been contributing to rising anxieties.

“Folks that have had a level of exposure, that have been impacted or worse, have been infected, they don’t want to come out and talk about those things out of fear that they’re going to be wearing that as they move around,” he said.

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That fear of stigmatization is a worrying factor for Dr. Raywat Deonandan. The epidemiologist from the University of Ottawa said fears of being negatively associated with COVID-19 could spell trouble for contact tracing.

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“Now that we’re asking infected people to do the follow-up with their contacts, the stigma might be a disincentive to participate,” he said.

Deonandan compared it to the discomfort of contacting a previous sexual partner if someone contracted a STD.

“Imagine you are infected with a sexually transmitted disease and now you have to call your sexual contacts and tell them, ‘Hey, you might have been exposed to herpes,'” he said.

“That stigma is quite a disincentive to participate in that voluntary networking endeavor, so the same thing applies here.”

Dr. Vinita Dubey, Toronto’s associate medical officer of health, said stigma and discrimination have long been issues to access health care.

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“Every neighbourhood in Toronto has been impacted by COVID-19 since the pandemic began. Anecdotally, we have heard about discrimination and harassment experienced by residents who are cases,” she wrote in a statement to Global News.

“We have continued to stress that where someone lives does not necessarily indicate where they picked up COVID-19. It is important to reiterate that there is not one area of the city that has not been impacted by COVID-19.”

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With many people in so-called hot spots living in congregate settings, the concern over stigmatization could be increasingly problematic.

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“Suddenly if you disclose that you are infected or potentially infectious, that compromises everybody around you,” said Deonandan.

In this case, he said there isn’t enough messaging from public health units that contracting COVID-19 shouldn’t be associated with shame.

“A public education campaign to remind us that no one gets this deliberately and for a very large number of people, they get it despite their best efforts,” said Deonandan.

“That would help a lot.”

Vivanco isn’t so sure if targeted public information campaigns would make much of a difference.

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“Telling people ‘it’s not their fault’ doesn’t necessarily allay the anxieties that people have around their health and also the health of their families and also their ability to manoeuvre around in their communities,” he said.

When it comes to studying COVID-19, Deonandan said when it comes to COVID-19 no area is studied enough. But with so much attention on treatment, the socio-economic and psycho-social elements are being neglected. And that, he said, is a problem.

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“It’s going to have a lasting impact on our society going well beyond the termination date of the pandemic itself,” he said.