Symptoms and Stereotypes: Perceptions and Responses to Covid-19 in Malawi and Zambia

• Published date: 01 October 2023
• DOI: http://doi.org/10.1177/00104140231152753
• Author: Karen E. Ferree,Boniface Dulani,Adam S. Harris,Kristen Kao,Ellen Lust,Cecilia Ahsan Jansson,Erica Ann Metheney
• Date: 01 October 2023
• Subject Matter: Articles

Article

Comparative Political Studies

2023, Vol. 56(12) 1795–1823

© The Author(s) 2023

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DOI: 10.1177/00104140231152753

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Symptoms and

Stereotypes: Perceptions

and Responses to

Covid-19 in Malawi and

Zambia

Karen E. Ferree

1

, Boniface Dulani

2

, Adam S. Harris

3

,

Kristen Kao

4

, Ellen Lust

4

, Cecilia Ahsan Jansson

4

,

and Erica Ann Metheney

4



Abstract

A large literature documents Covid-19’s health and economic effects. We

focus instead on its political impact and its potential to exacerbate identity

divisions, in particular. Psychologists argue that contagious disease increases

threat perceptions and provokes policing of group boundaries. We explore

how insider-outsider status and symptoms of illness shape perceptions of

infection, reported willingness to help, and desire to restrict free movement

of an ailing neighbor using a phone-based survey experiment administered

three times in two neighboring African countries during different stages of the

pandemic: Malawi, from May 5 to June 2, 2020 (n= 4,641); Zambia, from July 2

to August 13, 2020 (n= 2,198); and Malawi again, from March 9 to May 1, 2021

(n= 4,356). We study identities that are salient in Malawi and Zambia but have

not induced signif‌icant prior violence, making our study a relatively hard test

of disease threat theories. We f‌ind that symptoms more strongly shape

1

University of California, San Diego, La Jolla, CA, USA

2

University of Malawi, Malawi

3

University College London, UK

4

University of Gothenburg, Sweden

Corresponding Author:

Karen E. Ferree, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-

0521, USA.

Email: keferree@ucsd.edu

perceptions and projected behavior than insider-outsider status in both

countries and across time, suggesting that there are limits to the ability of

pandemics to independently provoke identity politics de novo.

Keywords

health politics, social policy, health policy, Covid-19, disease threat, prejudice,

stereotypes

Introduction

A large and growing literature documents Covid-19’s catastrophic health and

economic effects. In this article, we focus on its political effects, in particular

the potential for Covid-19 to exacerbate identity group divisions. Research on

epidemics by psychologists (Schaller, 2011) and political scientists (Aarøe

et al., 2017;Adida et al., 2018;Albertson & Gadarian, 2015;Arriola &

Grossman, 2021;Casey, 2015;Dionne & Turkmen, 2020;Kam, 2019;

Lieberman, 2007;Onoma, 2020) suggests that Covid-19 could intensify

group conf‌lict and lead to greater discrimination against racial minorities and

those viewed as “foreign.”We consider a mechanism underlying this work:

the emergence of disease-based stereotypes around insider-outsider identities.

Stereotypes precede and enable discriminatory behaviors and the stigmatizing

of groups as bearers of disease. We pay particular attention to how insider-

outsider identities and symptoms shape perceptions of who carries disease and

behavioral responses to perceived disease threat. Earlier research suggests that

disease threat may not ref‌lect epidemiological data and actual risk of infection,

with individuals dismissing or ignoring symptoms of insiders while associ-

ating disease with outsiders even when symptoms are absent (Dionne &

Turkmen, 2020;Harell & Lieberman, 2021;Lieberman, 2009;Onoma, 2020).

The relationship between identity and symptoms seems particularly important

in the case of Covid-19, a disease often transmitted through asymptomatic

individuals. A core contribution of our work is therefore to explore how

symptoms and stereotypes shape perceptions about and reactions to disease.

We examine the emergence of stereotypes through a phone-based survey

experiment administered three times in two neighboring African countries

during the pandemic in 2020 and 2021: Malawi, from May to June 2020 (n=

4,641); Zambia, from July to August 2020 (n= 2,198); and Malawi again,

from March to May 2021 (n= 4,356). Our surveys occurred at different stages

of the pandemic, ranging from very early, when cases were low, to advanced,

when the disease had spread extensively. This staggered survey design enables

us to examine how time shaped responses in two frequently compared, de-

veloping countries that share a border and many common characteristics. To

1796 Comparative Political Studies 56(12)