Groups labelled COVID-19 superspreaders represent some of the most vulnerable categories in Indian society

A simple search for the phrase “superspreader” in the LexisNexis database of Indian news sources (from March 1 to June 1, 2020) brings up more than 650 articles. It is an indicator of the relevance of this word during the COVID-19 pandemic.

Broadly speaking, the term means an individual who transmits infection to many others than is typical. It emerged in the context of the research on transmission of a wide range of infectious diseases such as tuberculosis, Ebola, and Severe Acute Respiratory Syndrome (SARS), which shows that 80% of the infections in a population are transmitted by only 20% of those infected — the so-called 20/80 rule.

Challenge of containment
Why some individuals tend to be superspreaders is a question epidemiologists continue to grapple with, more so in the context of COVID-19, the science around which continues to evolve. Initial evidence indicates that factors such as the mode of transmission through finer aerosols that can be suspended in the air for long, an individual’s ability to shed higher loads of virus than is typical of others, and the presence of an infected individual in indoor, closed spaces could make such persons superspreaders. A particularly challenging aspect of this pandemic has been the large proportion of asymptomatic infected patients who can shed high virus loads before experiencing symptoms and can spread infection to many contacts without their knowledge. Because of this complexity, practices such as universal masking, social distancing, and hand hygiene have become key to containing the pandemic.

Varied mix of profiles
Our review of the news articles brings up an interesting mix of individuals labelled as superspreaders across geographies. They include a Sikh religious guru in Punjab returning from an affected country, a person who runs a private technical school in Odisha, an employee of a reputed firm in NOIDA, a fruit vendor in Vadodara, a police officer in Jammu, a truck driver in Vijayawada, and a housekeeping staff at a hotel in Bengaluru. More interestingly, as opposed to the focus of epidemiologists on individuals as superspreaders, a number of groups are labelled superspreaders. Prominent examples of such groups include those who attended the Tablighi Jamaat religious congregation in Delhi, workers providing essential services (vegetable/fruit vendors, pharmacists, garbage collectors, grocery and milk sellers, bus conductors), and migrant workers returning to their hometowns. In the category of essential workers, the vegetable vendors in Ahmedabad city and the Koyambedu vegetable market in Chennai have received significant media attention.

The labelling of a group — as Howard Becker in his book published in 1963 argued — can lead to stereotyping of the group based on oversimplified images attached to the label and shared widely among the other sections of society.

For example, as vegetable vendors are labelled widely as superspreaders, the implicit meaning attached to the label (i.e., an infected individual capable of infecting those the person comes in contact with) becomes a shared belief among sections of the society. This belief creates an image of a vegetable vendor as an infectious superspreader. Subsequently, in evaluating the vegetable vendor, the image associated with the stereotype (i.e., a superspreader) becomes more salient than the image of a vegetable vendor as a service provider.

Going further, one may attach the images of the stereotype to a random person whose perceived characteristics match that of a member of the stereotyped group. Research also shows that mass media plays a significant role in creating, and often perpetuating, negative stereotypes, with severe consequences.

Stereotyping a group will have undesirable consequences for its individual members, if the label carries negative evaluation. In the discourse on COVID-19 in India, there are signs of superspreader becoming such a negative label. In response to a question in his press conference on May 21, 2020, the Kerala Chief Minister expressed concerns over rising infections in Kerala after the State borders were reopened, but suggested that “it was wrong to dub expatriates as super spreaders”. A local newspaper in Ahmedabad had a headline, “Ahmedabad, beware of super spreaders” while reporting that the number of vegetable vendors and kirana store owners testing positive for COVID-19 in Ahmedabad had been on the rise. The Dadra and Nagar Haveli and Daman and Diu administration banned vegetable vendors from Gujarat to enter the Union Territory with the fear of vegetable vendors being superspreaders.

The fallout
Research documents a range of negative consequences (direct and indirect) associated with negative stereotyping, such as discrimination and hostility, negative attitudes, and a lingering effect of lack of self-control and aggression. Such outcomes are already visible in India. Incidents of people, particularly Muslims, being harassed for their suspected affiliation with Tablighi Jamaat have been reported. The Orissa High Court, in its order early May (which was stayed by the Supreme Court), required migrants, returning from other parts of the country, test negative before they were allowed to enter the State, without specifying who would pay for the cost of tests and the fate of those who would test positive.

The groups labelled superspreaders represent some of the most vulnerable groups in Indian society. Vegetable vendors and others that supply essential services during this crisis are not only more vulnerable for infection because of the nature of their profession but are also more likely to face adverse outcomes, if infected, because of their marginality. These groups are less likely to have access to good health care, more vulnerable to economic shocks caused by the illness, and little voice in the political process to defend their rights.

Government support is key
The Ministry of Health and Family Welfare had urged the citizens to “not label any community or area for the spread of COVID-19”. State and local governments are undertaking testing drives to identify the infected among these groups. But by simply excluding them from their livelihoods, if found positive, and providing them no other form of support, they are failing to protect them from the consequences of negative stereotyping and marginality. Beyond exhortations and free testing, the governments should develop a supportive infrastructure for these groups. For example, the governments could provide them cost-free masks and sanitisers and support the families of infected individuals. Public officials and the media could also refrain from the indiscriminate use of the term superspreaders, when referring to these groups, to avoid the resultant negative stereotyping and its adverse effects on these groups.

Rama Mohana R. TuragaGeorge KandathilJoshy Jacob
The Writers are faculty members at the Indian Institute of Management Ahmedabad. The views expressed are personal

Courtesy The Hindu