Risk communication has likely also contributed to perceptions of the virus. Guidance issued by public health authorities including the U.S. Centers for Disease Control and Prevention (CDC) has often focused on the actions of individuals, from the “just stay home” days of spring 2020 to more recent advice about wearing protective respirators like N95s.

“There’s been so much emphasis on prevention and mitigation,” Gieck says. When someone follows all the “right” steps and gets sick anyway, “it can result in a sense of having done something wrong.” Many people are also afraid of COVID-19, and fear can exacerbate negative emotions when someone does test positive, Gieck says.

Guilt and shame are closely related, but not identical. “Guilt is, ‘I feel bad about what I did,’ and shame is, ‘I am bad because of what I did,’” says Sonya Norman, a professor of clinical psychiatry at the University of California, San Diego. While guilt can at least motivate people to make more conscientious decisions moving forward, shame is rarely productive, she says. Internalizing shame can be damaging to mental health and is linked to depression and low self-esteem. Shame is also associated with poor anger regulation and interpersonal problems, Hamama adds.