# “It becomes more difficult when people don’t empathize with us”: COVID-19-related stigmatization experienced by survivors in Nepal

## TL;DR

This study explores how survivors in Nepal faced stigma during the pandemic, showing the need for better communication and health policies to prevent future stigma.

## Contribution

The study provides new insights into the drivers and impacts of COVID-19-related stigma in a low-resource setting like Nepal.

## Key findings

- Stigma among survivors included social rejection and internalized shame.
- Misinformation and weak health systems were key drivers of stigma.
- Stigma affected trust and help-seeking behaviors during the pandemic.

## Abstract

The COVID-19 pandemic caused widespread social disruption, with stigma emerging as a significant challenge for individuals who survived infection. This qualitative study explored the forms, drivers, and impacts of COVID-19-related stigma among survivors in Eastern Nepal. In-depth interviews were conducted with 15 COVID-19 survivors who had reported stigma in a preceding cross-sectional survey. Due to pandemic-related restrictions, interviews were conducted over the phone. Data were analysed thematically following the process outlined by Braun and Clarke. COVID-19 stigma was multifaceted, including social rejection, internalized stigma, and discriminatory practices by community members. Key drivers of stigma included self-directed fear of infection and death, misinformation and limited awareness about COVID-19 transmission and prevention, and a fragile health system and policy responses. Although COVID-19-related stigma may have declined as the pandemic evolved, the findings illustrate how stigma can emerge rapidly during health emergencies that can have social consequences related to trust, disclosure, and help-seeking behavior in future crisis. The study highlights the importance of outbreak preparedness strategies that integrate clear communication, strengthened health system capacity, and social protection measures to mitigate stigma and its harms during future public health crises.