It seems that hospitals around the globe are feeling the violent effects of the coronavirus. In the international weekly medical journal, The Lancet, a recent paper suggested that COVID-19 exacerbates violence against health workers. It says that hundreds of COVID-19- related incidents of violence and harassment have been recorded, but these are likely to be just the tip of the iceberg according to medical officials. More than 600 global incidents of violence, harassment, or stigmatization took place against health-care workers, patients, and medical infrastructure in relation to the COVID-19 pandemic, the International Committee of the Red Cross (ICRC) said in a statement on Aug 18.
The ICRC said that 611 incidents were recorded between Feb 1 and July 31, 2020. Although patients and medical infrastructure were often targeted, 67% of incidents were directed at health-care workers. More than 20% involved physical assaults, 15% were incidents that the ICRC classed as fear-based discrimination, and 15% were verbal assaults or threats.
Threats in the U.S.
Late this past March, the reality of hospital security and the growing tsunami of the coronavirus collided in Belton, Missouri, a suburb of Kansas City. A 36-year old man, who had been under federal surveillance for months during a domestic terrorism investigation was killed in a shootout with FBI agents thwarting a potential attack on a local hospital because he was apparently frustrated with local government action to stop the spread of coronavirus.
According to an NBC news report, a potentially violent extremist known to express racial and religious hatred and anti-government sentiment wanted to commit an act of terrorism, specifically a bombing and had considered several targets, including a school with a large population of black students, a synagogue and a mosque. But as the coronavirus pandemic spread across the country and local officials in Missouri issued stay-at-home orders, FBI officials said the man became aggravated. The FBI said that with the current health crisis, the man decided to accelerate his plan to use a vehicle-borne improvised explosive device in an attempt to cause severe harm and mass casualties. After considering various targets, he settled on an area hospital.
Boston Strong
Hospitals have suddenly become the litmus test of failed government health policies, the staging ground for potential violence against healthcare workers and a quilt-work of social distress that challenges both security and hospital administrators. Battling the security and social challenges of a pandemic was not in Connie Packard’s original job description. Packard is the Chief of Public Safety for Boston Medical Center and brings over 36 years of experience in safety work in both the public and private sectors and is currently the incident commander for Boston Medical Center for emergency and crisis response.
Boston Medical is a triage center and safety net hospital for South Boston’s poor and indigent. Packard and her team began preparing for the COVID-19 onslaught in mid-January and saw their first patient in February.
“We would have debriefings twice a day. We wanted to talk about bed capacity, we wanted to talk about if we needed vents, if we needed PP needs, how we were going to screen patients, how we were going to screen employees. Everything had to be centered through this command center. It was the only way you could ensure everybody was getting the correct information. Then we could spread that throughout the rest of the hospital. We didn't have people working in silos, it was all generated through incident command,” explains Packard.
The hospital reviewed pandemic plans that hadn’t been dusted off since 2001. From PPE supplies to new methods of access control, her team has been in the thick of it all. She admits that some of the access control challenges, especially during shift changes, have been monumental considering the hospital could have four to 500 people coming in at a particular shift change. Staff would be queuing up at the side doors waiting to get their masks or PPEs. “That became a problem, particularly in cold or rainy weather, so the access control was very challenging, and we had shut down most of the buildings,” she admits.
Packard and Boston Medical are still fighting the good fight as the pandemic spikes and predications for more turmoil this winter persists. But she does feel they can now cope. They have come to understand the warning signs of potential violence and the triggers for emotional distress in both staff and patients. They have learned the value of cross-training and safety supply distribution. Perhaps most importantly, they have created a working environment BMC staff can survive and feel that the lessons learned will only prepare them for future crisis situations.
