As COVID-19 cases continue to rise, the pandemic has spotlighted the heroic efforts of our nation’s healthcare workers. Healthcare workers are providing much needed front-line patient care. However, in doing so, they also place themselves at risk of exposure to infectious disease, psychological distress, and burnout. But as the COVID-19 pandemic continues, another concern for healthcare workers has gained visibility – increased violence.
A history of violence
Violence against healthcare workers is not a new phenomenon associated with COVID-19. A blog from The American Journal of Managed Care discusses the commonality of workplace violence with many healthcare workers believing it’s “just part of the job.” The American College of Emergency Physicians found that almost half of emergency physicians reported an episode of physical assault. According to their analysis, 70% of emergency nurses had been hit or kicked while on the job. During the Ebola crisis in 2019, an attack on healthcare workers within the Democratic Republic of Congo left four dead and at least six others injured.
Violence against healthcare workers and COVID-19
In many instances, healthcare workers’ interaction with infectious patients is the root of violence and stigmatization. For example, both a recent Medical Care letter to the editor and an article in the New York Times discuss how violence has increased toward healthcare workers in Mexico and elsewhere. In the Philippines, a nurse was attacked and doused in bleach. A nurse was punched in the face on a city bus in Chicago. Another healthcare worker coming to assist with the COVID-19 response in New York was prohibited from staying with his relative out of fear he would transmit the virus to others in the building. The list goes on, and as of April 2020, the World Health Organization confirmed more than 35 “serious” incidents across 11 countries.
Further, front-line healthcare workers are not the only recipients of violence and threats. A recent article in The Washington Post discusses the increased number of public health officials who are resigning due to threats received around enforcing COVID-19 related restrictions. If these issues continue, there will be significant implications for filling those jobs in the future.
Types of violence
To better understand COVID-19 and healthcare worker violence, a recent BMJ blog post groups emerging patterns of violence into three categories:
- Violence from patients or their families: Violence can stem from healthcare workers enforcing COVID-19 prevention and control measures. These measures might limit a family member’s ability to visit or attend to the body of a recently deceased loved-one.
- Aggression from the general public: People make verbal threats or become physically aggressive with healthcare workers. Perpetrators typically believe the healthcare worker’s interaction with infected patients will result in additional infections within the community.
- Clashes with law enforcement: This typically occurs when healthcare workers stage demonstrations to demand protective equipment and improved working conditions.
What to do next?
Healthcare worker violence is a complex problem without sufficient information to guide how it should be addressed. Additional research is needed to assist healthcare professionals (both front-line and public health officials) in mitigating potentially violent situations. Further, healthcare professionals need help addressing increased levels of emotional distress. For instance, the platform “Be+ against COVID” was developed to help healthcare workers address stress reactions. Healthcare institutions also need to protect and support their healthcare staff both while at work and outside of work. Tools, such as those developed by OSHA, provide violence-prevention models.
Finally, we should educate people about the precautions healthcare workers are taking to prevent the spread of COVID-19. Threats and violence against healthcare workers are often fueled by misinformation. The general public needs to understand that healthcare workers do not pose a threat to their community. One method of combating misinformation is translating evidence into easy to understand plain language. This would allow the public to better understand what healthcare workers are doing to protect them.
To learn more about evidence translation and curbing the spread of misinformation during the COVID-19 pandemic, check out this earlier Medical Care Blog post by Jennifer Uhrig, Megan Lewis, Jon Poehlman, and Brian Southwell.
Alexa Ortiz