Violence and discrimination against healthcare workers in times of new coronavirus
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UPDATE ARTICLE
Violence and discrimination against healthcare workers in times of
new coronavirus
Violência e discriminação contra profissionais de saúde em tempos de novo
coronavírus
Violencia y discriminación contra personales de salud en tiempos de nuevo
coronavirus
Aydogdu , Ana Luiza Ferreira1
How to cite this article: Aydogdu ALF.Violence and discrimination against healthcare workers in times
of new coronavirus. J. nurs. health. 2020;10(n.esp.):e20104006
ABSTRACT
Objective: to reflect about the increase in violence and discrimination against healthcare workers
due to the new coronavirus pandemic. Method: theoretical reflection based on reading, analyzing
and interpreting news, scientific articles and reports on violence and discrimination to healthcare
workers who combat the novel coronavirus. Results: as it is a new disease, there are still many
uncertainties around it which can lead to violence and prejudice. That’s exactly what happened when
the population mistakenly began to see the healthcare worker as a spreader of diseases. International
organizations call on governments around the world to take action to protect health teams that have
become victims of violence and discrimination. Conclusions: hospital administrators and governments
need to create measures to stop these aggressions and discrimination.
Descriptors: Coronavirus; Pandemics; Violence; Health personnel; Communicable diseases
RESUMO
Objetivo: refletir sobre o aumento da violência e da discriminação deferidas aos profissionais de
saúde em razão da pandemia do novo coronavírus. Método: reflexão teórica baseada na leitura,
análise e interpretação de reportagens, artigos científicos e relatórios sobre violência e
discriminação aos profissionais que atuam no combate ao novo coronavírus. Resultados: por ser uma
doença nova, ainda existem muitas incertezas a seu respeito, o que pode levar ao surgimento de
violência e preconceito aos profissionais de saúde. Foi justamente o que aconteceu, quando a
população erroneamente começou a ver o profissional de saúde como um disseminador de doenças.
Organizações internacionais pedem que governantes de todo mundo tomem providências, procurando
proteger as equipes de saúde de se tornarem vítimas de violência e discriminação. Conclusões:
administradores hospitalares e governantes precisam criar medidas, visando impedir que essas
agressões e discriminações ocorram.
Descritores: Coronavirus; Pandemias; Violência; Pessoal de saúde; Doenças transmissíveis
1
Nurse. Master in Hospital Administration. Doctoral student at the Florence Nightingale Faculty of Nursing,
Istanbul University. - Cerrahpasa. Turquia (TR). E-mail: luizafl@gmail.com http://orcid.org/0000-0002-0411-
0886
This is an open access article distributed under the terms of the Creative Commons CC BY NC license. Others are allowed to distribute, remix,
adapt, and create from your work, for non-commercial purposes, provided that they give due credit for the original creation.RESUMEN
Objetivo: reflexionar sobre el aumento de la violencia y la discriminación contra los personales de
salud debido a la pandemia de nuevo coronavirus. Método: reflexión teórica basada en la lectura,
análisis e interpretación de noticias, artículos científicos e informes sobre violencia y discriminación
a profesionales que trabajan para combatir el nuevo coronavirus. Resultados: como se trata de una
enfermedad nueva, todavía hay muchas incertidumbres al respecto, lo que puede conducir a la
aparición de violencia y prejuicios. Esto es exactamente lo que sucedió cuando la población comenzó
a ver por error al personal de salud como un difusor de enfermedades. Las organizaciones
internacionales hacen un llamado a los gobiernos de todo el mundo para que tomen medidas para
proteger a los equipos de salud de violencia y discriminación. Conclusiones: los administradores de
hospitales y los gobernantes deben crear medidas para evitar estas agresiones y discriminaciones.
Descriptores: Coronavirus; Pandemias; Violencia; Personal de salud; Enfermedades transmisibles
INTRODUCTION
It was in December 2019, when There are approximately 59 million
the government of China informed the health personnel worldwide.14 Health
World Health Organization (WHO) facilities in Brazil employ about 3.5
about an outbreak of pneumonia in the million workers.15-16 Most of them are
city of Wuhan1 that the world began to currently combating COVID-19.
undergo transformations. In March Unfortunately, healthcare workers are
2020, WHO reported that it was a being seen by the population not as a
pandemic of new coronavirus (SARS- solution to solve the pandemic, but as
CoV-2).2 On April 21, the total number a focus of disease contamination.8
of cases worldwide accounted for Health personnel, who had
2,492,963, while 171,152 people had already been suffering from acts of
died, due to the disease.3 At the same
violence in the workplace,17 also
time, in Brazil there were 43,079 cases became victims of extramural
and 2,741 deaths.4 Following the WHO aggressions after the emergence of
recommendations to prevent the COVID-19.8,12 It is possible through
spread of the disease, governments of news, internet and social media to
several countries established social have access to information about
isolation,5 in some places in more rigid
violence and discrimination against
ways, in others not so much.6-7 healthcare works. The aggressions can
However, for healthcare workers be verbal and even physical.18-21 Acts of
there is no possibility of isolation, discrimination and humiliation range
quite the opposite, they are the ones from insults to expulsion from public
who are on the frontline against transport22-23 and hotels.24 This kind of
COVID-19, at great risk of becoming occurrences have been observed in
infected,8 suffering with the lack of several countries such as Turkey,
Personal Protective Equipment (PPE)9 Mexico, Philippines, United States of
and also suffering due to their use.10 As America, India, United Kingdom and
if all of those problems were not Brazil.18-20,25-28 Organizations are
enough, violence and discrimination concerned about the situation and ask
against healthcare workers increased the authorities to have no tolerance for
since the pandemic emerged.8,11-13 verbal, physical and psychological
J. nurs. health. 2020;10(n.esp.):e20104006 2violence against health addressed the theme of violence and
8,11,29-30
personnel. Laws have been discrimination against health
changed, aiming to punish more professionals who work to combat
effectively those who attack COVID19.
11,31
healthcare workers. The main
reason for the aggressions and RESULTS AND DISCUSSION
discrimination is the fear of
contracting COVID-19, but there are The fear of the unknown, in this
also other reasons for them to occur. case SARS-CoV-2, brings reactions that
are often meaningless, such as
The purpose of this article is to attacking those who should be exalted
reflect about increase in violence and for doing a so high-risk job, such as
discrimination against healthcare caring for patients with COVID-19.
workers due to the COVID-19 Generally, the aggressions against
pandemic. health personnel are for fear of
contagion.
METHOD
However, they can be committed
It is a theoretical reflection based for other reasons. There is aggression
on reading, analysis and interpretation because the patient considers himself
of reports, scientific articles and news infected and does not accept the
about violence and discrimination negative diagnosis,32 there is also
against professionals who are fighting aggression on the part of a patient who
against SARS-CoV-2. receives a suspicious diagnosis and
does not accept it.33 There are cases in
The bibliographic material was
which healthcare workers are attacked
collected between April and the first
by family members who wish to visit
week of May 2020. The search for
reports on violence and discrimination relatives hospitalized and are
prohibited due to the risk of
against health personnel, who combat
contamination.34
SARS-CoV-2 around the world was
carried out through from Google, using Around the world, an increase in
keywords like “Health care the occurrence of verbal, physical and
professionals” AND “Violence” AND psychological aggressions against
“Discrimination” AND “Coronavirus” healthcare workers has been reported.
OR “COVID-19”. Professionals are attacked inside and
outside their workplaces.
The selection of scientific articles
Professionals, who should be proud of
and other official documents were
what they do in such a tragic moment,
made through Google Scholar using the
are actually afraid to be recognized on
same descriptors above mentioned.
the streets.
Consultations were also carried out on
the websites of councils and Healthcare workers were already
associations of healthcare workers and victims of many threats, hostilities and
international organizations in order to aggressions even before the COVID-19
access reports about the subject. pandemic. They felt apprehensive at
There were discussed studies that work. Health institutions are identified
J. nurs. health. 2020;10(n.esp.):e20104006 3as places where acts of violence and also take care of those who are
against employees occur most. Such already sick. To stay healthy when
actions may come from patients, working at a health facility, which in
patients’ family members or even from normal times is already a stressful
coworkers.35-39 According to WHO, environment and which, in the midst of
from 8% to 38% of health personnel an epidemic, is in danger of becoming
worldwide are victims of physical a chaos, can be very difficult,
violence at some point in their especially if the professionals feel that
professional lives.40 Authorities from their lives are threatened in the
some countries felt the need to change workplace as well as outside it. It is
laws regarding to aggression against necessary to keep in mind that the
healthcare workers, speeding up trials aggressor's stress level is also high, as
and increasing punishments.31,41 it is driven by fear and lack of
Violence and discrimination knowledge.
against health personnel increased in When healthcare workers develop
many countries due to COVID-19 psychosocial problems, in addition to
pandemic. At a moment when the being exposed to the risks arising from
population should be focused on their own profession, there is also a
fighting the disease, they turn against decrease in the quality of the care
healthcare workers, who feel provided by them, what threatens
increasingly persecuted by the shadow patients’ lives.38-40,45
of violence and discrimination, which When healthcare workers are
is now also pursuing them outside the attacked, population is not aware that
workplace.11-12 Due to all that, is actually attacking those who will be
healthcare workers are more
42-43 the only ones to be by its side in the
depressed and anxious. event of a hospitalization. Social
Just as the use of physical force is media, news and internet that so well
a type of violence, acts with a high risk inform about acts of violence can also
of causing deprivation, psychological be used to report that healthcare
damage or inappropriate development workers are precisely the most suitable
are also agressions.44 There is a lack of people to help the population in
PPE at health institutions of several preventing and combating COVID-19. It
countries,9 which can bring is vital to recall that health personnel
irremediable physical and take necessary measures, preventing
psychological consequences for those the spread of the disease and should in
who work in such places. The lack of no way be harassed and accused of
PPE is also institutional and spreading diseases.
governmental violence against health Countries will not be able to
personnel. control the pandemic without
During a pandemic caused by a healthcare workers.46 Measures are
virus that spreads so quickly, the being taken by institutions around the
professional needs to be physically and world to increase the motivation of
mentally healthy so as not to be health personnel and also to reduce
contaminated, not spread the disease the occurrence of verbal, physical and
J. nurs. health. 2020;10(n.esp.):e20104006 4psychological aggressions against discrimination against health
them. After the emergence of the personnel can be penalized
COVID-19 pandemic, in face of the immediately and more strictly;
increase of violence against health 3. To provide psychosocial
professionals, laws are being
11 assistance to those professionals who
changed. WHO asks that professionals are victims of violence and/or
also take care of their mental health discrimination;
and immediately report to their
superiors in case of danger of any 4. To increase security in health
kind.12,47 institutions, so that employees feel
more secure in the workplace;
In Brazil, healthcare workers are
attacked even during a silent act in 5. To ensure that healthcare
memory of colleagues, who lost their workers are not attacked or
lives fighting against COVID-19.48 discriminated on the streets or on
Brazilian authorities and health public transport;
institutions administrators also need to 6. To inform the population about
make efforts to inform the population the transmission of COVID-19,
correctly and protect health describing that healthcare workers are
personnel, so that they can do their specialists, that well know the disease
best in a situation as difficult as the and preventive measures;
one we are going through.49
7. To make the population
FINAL CONSIDERATIONS become an ally of health personnel,
recognizing their value and supporting
COVID-19 is a very serious threat them in such a difficult time as the one
to Brazil and to the world. It is vital we are going through;
that the population worldwide has the 8. To take political measures to
same objective and follows preventive make healthcare workers feel safe and
measures correctly for the pandemic to supported by the government.
be controlled. Healthcare workers
have very important roles in this It is hoped that this article will
battle, and they must be protected and raise awareness among the authorities
not attacked. In face of the current about the situation that healthcare
situation that points to an increase in workers are going through. When
discrimination and violence against planning strategies aimed to control
health personnel, institutions and the COVID-19 pandemic, they should
authorities must develop measures to also create strategies to protect
prevent such acts. The following points healthcare workers against violence
seem to be of paramount importance: and discrimination, making the
population aware of the importance of
1. To create a phone number to those professionals. To protect the
which healthcare workers can call in general population, healthcare teams
case of violence and discrimination; must be specially protected, since they
2. To revise the penal code so are fundamental to the control of the
that acts of aggression and pandemic.
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