COVID medics face ‘abusive, menacing and threatening’ families

The Age has been told of instances where families of patients critically ill with coronavirus have requested potentially dangerous treatments including ivermectin, a medicine used to kill parasites in animals and humans, over proven treatments such as ventilators.

Other families have expressed fear their loved one who is dying from COVID-19 in hospital is being used as a part of a global experiment.

In rare, but nonetheless disturbing cases, the misinformation about the virus is so entrenched that families have made threats to kill or sue medical staff if their relative succumbed to a virus they do not believe is real.

Australian College of Critical Care Nurses representative Michelle Topple said she had heard reports where families believed ICU staff were purposely making their loved one sicker.

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“There have been cases where family members have filmed nurses during telehealth calls and made accusations, which is extremely distressing for the nurses because they are the patient’s advocate,” she said.

“Everything they do is to support the patient.”

Western Health intensive care director Craig French told The Age last week that the level of “verbal assault” his clinical staff had been exposed to in the past six to eight weeks was something he had never experienced in his career.

Australian Medical Association Victorian president Roderick McRae said he had heard reports from several Melbourne hospitals that staff were being confronted with a rising wave of COVID-19 conspiracy theories.

The anesthetist said he knew of cases where patients’ families were requesting that COVID-19 was not put on their death certificates.

“Despite their family members dying after contracting the disease they do not believe that is what caused their death,” Dr McRae said.

Professor Warrillow said there was often a moment when a patient’s family came to the realisation that the virus is “very real” and their loved one could die.

“There is a pause on the other end of the phone and you can almost hear the penny drop,” he said.

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This realisation is often compounded by the shame of not having encouraged the person to be vaccinated or even immense guilt for being the person who unwittingly exposed somebody they loved to the virus.

“At a human level it really doesn’t get much more confronting than that,” Professor Warrillow said.

Despite the challenges posed by these conversations, he said healthcare workers always seek to respond with empathy.

“It’s helpful to try to understand how that would feel to suddenly realise that you’ve been misinformed and that due to that misinformation, someone that means the absolute world to you has become critically ill to the point where they might die,” he said.

“It would feel horrific. That is not to excuse the threats or menacing behaviour, but it gives you an insight into the emotional overlay. It helps you to meet that person where they are at and support them through it.”

When confronted with such scenarios, Professor Warrillow said he explains to the family that coronavirus is “absolutely real” and staff have carefully looked at all other possibilities for the person’s illness.

He runs through all the treatments that are used in the ICU for COVID-19, detailing their evidence base and safety profile.

There have been isolated cases where families have not wanted their relative to be hooked up to a ventilator due to their beliefs about the virus.

Such decisions are extremely time-critical and in these instances, where there is no advance care directive from the patient, ICU staff will do everything they can to save a patient’s life, even if that means intubating them.

“If we are firmly of the view we can save this person’s life or they at least need a chance, we will make that call and then have ongoing discussions with the family,” Professor Warrillow said.

He said he did not know of a single case in Victoria where the life of COVID-19 patient had been saved and the patients’ family, or patients themselves, had remained angry or upset about the treatment used to reach that outcome.

Australian Nursing and Midwifery Federation Victorian Secretary Lisa Fitzpatrick said occupational violence had been exacerbated by the pandemic due to misinformation spreading on social media.

“It’s an indictment of society,” she said. “Sadly, violence and aggression towards nurses and midwives is a growing experience that all healthcare professionals put up with.”

She believes misinformation of the COVID-19 vaccination in particular has fuelled harassment of healthcare workers and led to an increase in abuse for those working at vaccination hubs.

“It has brought out an ugly side that we’ve never seen before,” she said.

Psychologists and mental health care professionals have been brought in to support healthcare workers treating COVID-19 patients in hospitals across Melbourne.

On the other end of the spectrum, some hospitals are still dealing with the result of infections caught months ago.

Many patients who got sick, in August or September for example, were planning to get vaccinated eventually, before being outrun by the virus.

“Some of them were scared. Some of them didn’t understand the need for the vaccine or how severe the illness could get and then COVID went through their communities quite quickly,” said the deputy director of Cabrini’s ICU, David Brewster.

Associate Professor Brewster said all their families had been “very kind” to the ICU staff. After a long time on a ventilator, many patients ask “when can I get vaccinated?”

Head of the Department of Critical Care at the University of Melbourne, David Story, said pre-COVID-19, families were at the heart of the ICU, often by the patients’ bedsides every day.

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They shared a trusted relationship with the ICU staff, having built up a close personal rapport with them. He believes much of the hostility towards staff would dissipate if families were inside the ICU and could see firsthand the work being done to save their relative’s life.

“The staff are working desperately hard every day to care for these people,” he said.

Professor Story said regardless of a person’s beliefs or vaccination status, they will always receive the best care possible at a Victorian hospital.

“Whether or not they’re vaccinated or believe in COVID, we will always do whatever it takes to save their life,” he said. “We will only ever do it that way.”