“The coronavirus is a conspiracy theory,” insisted a friend of mine recently. Many people in Pakistan believe this new virus is fake. They say it’s a way for the “west” to stop Muslims from going to mosques, or a way for the Pakistani government to make money off donations.
But my friend is a doctor. He works in a hospital. He sees Covid-19 patients. “I used to be really careful about taking all precautions to avoid the disease,” he told me recently. “But not anymore. I don’t think it’s that serious. I think it’s all made up.”
Why does my friend think this way?
Pakistan has largely avoided the worst ravages of the coronavirus so far – with over 100,000 confirmed cases, we’ve had just over 2,000 deaths. Compare this with Brazil, which has a comparable population, but the number of confirmed cases there is above 711,000 and the number of deaths is above 37,000.
And yet, Pakistan is not out of the woods, while complacency is helping spread the disease further. But our government – federal and provincial – isn’t engaging the community effectively, or undertaking social mobilization to ensure factual information reaches the public.
Instead, conspiracy theories and misinformation are swirling about. Even worse, a sense of shame or stigma is now surrounding the disease.
I’ve heard people say that they can’t contract the coronavirus because they pray five times a day or because they are good Muslims, implying thereby that those who do contract the disease are somehow dirty or lesser Muslims. And that’s led to an increase in the stigma surrounding this disease, which, to many, isn't even a real disease. Such is the confusion many people live in right now.
One patient who recovered from COVID-19 told me that his friends do not even return his greetings, his salams, anymore. “People think I can still give them the disease,” he said – and they will not even treat him as a member of society as a result.
The stigma is also killing people. Sick people are refusing to get treatment, as they’re afraid of going to the hospital. Others go when it’s already too late to get proper medical care. These are very much part of the reason why the death rates for Covid-19 are so high in KP.
Policies haven’t helped much either. Weeks after the pandemic began spreading, authorities prevented families from participating in burial rites. This resulted in sick people staying away from hospitals. After all, nobody wants to die alone or be buried by strangers. This also led to the spread of rumors that the caskets being used to transport dead bodies to graveyards were empty. Otherwise, the theory goes, the authorities would have allowed the family members to attend the ceremony. Later, the protocols were changed, but the damage had been done.
Pakistan has been making enormous efforts to deal with the technical and medical aspects of this disease. But what we health workers can see now, more than two months into this pandemic, is that it has ignored the equally important social and cultural aspects. It has not dealt with the misinformation pandemic. It means that conspiracy theories and stigma abound, and it’s killing people. The government could have avoided much of this by engaging community members and building mutual trust.
Public health officials should know this. The World Health Organization published interim guidelines to deal with the cultural and social aspects of the Covid-19 pandemic, and it’s widely available. The government should be ensuring that accurate information is reaching the public in their languages, in ways they can understand.
There’s no space in a pandemic for shoulder-shrugging, for dismissing people as being ignorant or "jahil" – this kind of elitism is not only fatal in a pandemic, it ignores the decades of neglect in our country’s education system, which has, in turn, created generations of illiterate men and women. A successful communications strategy has to reach everybody – not just people with access to Facebook or Twitter.
Authorities can engage other agencies, organizations, community planners, social scientists, clerics, community elders, local politicians and influential people. They should monitor messaging and keep modifying content to ensure that it is effective while also allaying people’s fears.
We – health workers, public officials, frontline workers – are fighting two pandemics: a physiological disease, and misinformation. But we only seem to be focusing on one.