Constructing and Communicating COVID-19 Stigma on Twitter: A Content Analysis of Tweets during the Early Stage of the COVID-19 Outbreak.

This study focuses on stigma communication about COVID-19 on Twitter in the early stage of the outbreak, given the lack of information and rapid global expansion of new cases during this period. Guided by the model of stigma communication, we examine four types of message content, namely mark, group labeling, responsibility, and peril, that are instrumental in forming stigma beliefs and sharing stigma messages. We also explore whether the presence of misinformation and conspiracy theories in COVID-19-related tweets is associated with the presence of COVID-19 stigma content. A total of 155,353 unique COVID-19-related tweets posted between December 31, 2019, and March 13, 2020, were identified, from which 7000 tweets were randomly selected for manual coding. Results showed that the peril of COVID-19 was mentioned the most often, followed by mark, responsibility, and group labeling content. Tweets with conspiracy theories were more likely to include group labeling and responsibility information, but less likely to mention COVID-19 peril. Public health agencies should be aware of the unintentional stigmatization of COVID-19 in public health messages and the urgency to engage and educate the public about the facts of COVID-19.