The Covid-19 resurgence highlights the dangers we continue to face until a safe and effective vaccine can successfully control the pandemic. However, equally dangerous are the elements of discrimination in the midst of our global battle against infectious disease.
Filling up the MySejahtera form and similar screening surveys have become a routine process in this Covid-19 new norm. For many of us, the screening is only as a cursory procedure. We can answer ‘No’ to the questions and be deemed ‘Low risk’, and we are allowed to enter a premise without the blink of an eye.
But what if we get Covid-19 one day?
As more and more people get infected, the risk for more and more people to get infected also increases. For the front-liners, the men and women who serve strangers every day as part of their livelihood, the risk of contracting Covid-19 is even higher.
While Malaysia monitors daily reports of new Covid-19 cases, we anxiously wait to see once again a drop in numbers, signalling that the peak is past and the worst is over.
But even as most states in the country enter the conditional movement control order (MCO) 2.0, we must all contend with the fact that this subsequent wave will get much worse before it gets better. And Malaysia is not alone; many countries around the world are once again seeing new waves, and greater daily increases than before.
Leading that list since March 2020 is the United States. A country previously known for its American Dream, turned into a post-apocalyptic nightmare when led by a federal government that is blatant in discriminatory policies and is proudly against public health and science advice at a most untimely moment in recent history in favour of a false economy—eventually becoming a hotbed of Covid-19 transmission itself.
Indeed, if someone pitched this story to producers at Netflix it probably would not have been green-lit because it sounds nuts.
Now, Joe Biden now looks forward to helming a fractured nation with 10.2 million people confirmed with Covid-19, and 3.5 million of them still under treatment after narrowly winning the presidential race against Donald Trump.
Before the pandemic is over, at least 3 in 100 people in the US will have survived or died from Covid-19. These figures are only worse in areas with more elderly, people with chronic illnesses, obesity and/or less access to care—and may be fueled further by the recent elections. Yet, even with the disease rampaging through the country, over 90% of the population are still at risk to get Covid-19 given the time and the opportunity.
These numbers are sobering because they warn us of what can happen even to one of the great powers of the world if everyone - especially those in leadership - do not take prudent public health measures. Such measures must continue to address the crucial
1) reducing the spread of the virus by testing and isolation strategies, while preventing the risk of sudden outbreaks from large physical gatherings of otherwise socially separated groups of people in crowded and confined spaces,
2) equitable access to care and treatment, including for chronic conditions that exacerbate Covid-19 or arise post-infection, and
3) socioeconomic and mental health support for anyone directly affected by the virus or the effects of the pandemic. Critically, these measures must be applied without discrimination, without causing further disparity and without neglecting the disenfranchised members of our community.
Discrimination in infectious disease are as old as infectious diseases, and research has shown that discrimination is a real barrier in disease control.
The term ‘leper’ was a derogatory way to outcast millions of people infected with leprosy, caused by Mycobacterium leprae. Until today, people infected with Mycobacterium tuberculosis continue to face discrimination when they develop tuberculosis. Consequently, tuberculosis is the main cause of death from an infectious disease in Malaysia. Yet,
decades of activism to reduce discrimination against people living with HIV, together with improved testing and treatments has rapidly improved the control of a disease that was once seen as a death sentence.
Discrimination does not reduce disease transmission. Highlighting places where a person diagnosed with Covid-19 has been and circulating it on social media does not reduce disease transmission. Instead, it gives energy to unnecessary stigma and places undue burden to patient mental health. Discriminatory practices discourage people
from getting tested for fear of being discriminated against if they contract an otherwise undiscriminating virus, in many cases, due to no fault of their own.
We know that discrimination associated with an infectious disease disappears if the disease infects a majority of society, becoming as common as say, the common cold.
But Covid-19 is too deadly to wait until a majority of the population catches the virus before members of society stop discriminatory behaviour towards people who have, had or may have the disease.
Ultimately, our quest is not just to control Covid-19, but it is to protect public health—in all sense of the word. This means protecting against infectious disease, as well as chronic diseases, and mental health.
This means prioritising and investing sufficiently in our health systems and the people who continue to witness the true extent of our humanity.
These are the people who see us at our weakest moments and rejoice with us in our triumphs of recovery. They and their families are at even higher risk to be among those who contract Covid-19, and sadly join the millions who may suffer fatality, illness, trauma and stigma if we do not take active measures to stop discrimination.
We all know what its like to be sick. So why do we punish the ill when we are healthy? In these uncertain and challenging times, we must exercise our empathy and try to walk in the shoes of another.
As the nation and the world look to living with Covid-19 in days to come, we must start asking: if I get Covid-19 one day, how would I feel if people looked at me like I was a criminal or reported my whereabouts on social media?
How would I feel if a screening test at a premise is done in a stigmatising way that infringes my privacy and inflicts further trauma?
How would I feel if I am discriminated and prevented from access to essential services because of my health condition?
There are no easy answers. But hopefully if we start asking these questions, we remember that discrimination is never part of the solution.
Dr Khayriyyah Mohd Hanafiah is senior lecturer in Medical Microbiology at Universiti Sains Malaysia, and an affiliate of Young Scientists Network-Academy of Sciences Malaysia. She is active in science communication and infectious disease biomedical research. She was the first female Asian champion of FameLab, the world’s longest running science communication competition, in 2018. The writer’s views are her own.
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