Local public health departments experienced nearly 1,500 cases of harassment during the first 11 months of the pandemic, mirroring the reports of verbal and physical attacks on clinicians and other healthcare workers.
Between March 2020 and January 2021, 57% of the 583 surveyed local health departments reported incidents of harassment targeting leadership or staff, according to a study by Johns Hopkins Bloomberg School of Public Health.
During this time period, 222 public health officials left their positions across local and state departments, more than a third of whom had experienced some form of harassment.
The data in the study comes from a Forces of Change survey by the National Association of County and City Health Officials that identified 1,499 harassment cases experienced by local public health departments.
Since health departments are generally in charge of data, vaccine distribution, testing and infection prevention, including masking policies and protective guidelines, their harassment has caused friction and led to a lack of access to important information, said Beth Resnick, assistant dean for public health practice at the Bloomberg School.
"It's happening everywhere," Resnick said. "It's not just a red state issue or a blue state issue. And it's not okay. This is not how we should be treating our public health officials."
Public health departments and health systems need to prioritize worker well-being and safety by implementing policies that reduce undermining, ostracizing and intimidating behaviors toward clinicians and public health leaders, she said.
Most of the disclosed assault on public health officials came in an online form, with 296 local health departments reporting social media harassment. Of these, 194 incidents specifically targeted local health department leaders.
State and local health officials left their positions in 42 states, totaling 48 state health department officials and 174 local health department officials. Nationwide, there are an estimated 2,500 public health departments.
In order to have a sustainable public health system, these departments need to train leaders to respond to political conflict, improve support networks, invest in long-term public health staffing and establish workplace violence reporting systems and legal protections, according to Resnick.
On a clinical side, attacks against healthcare workers have evolved and increased during the COVID-19 era.
Around 31% of hospital nurses said they have faced a small or significant increase in workplace violence since the start of the pandemic, attributing the escalation to decreased staffing levels, patient population changes and fewer visitor restrictions, according to National Nurses United's July 2021 nationwide survey of more than 5,000 registered nurses.
During the first half of 2020, 611 incidents of violence, harassment, or stigmatization took place in care settings, 67% of which were directed at healthcare workers, the International Committee of the Red Cross found.
The American Journal of Managed Care said violent attacks in particular lead to physician burnout and negatively affect the delivery, quality and accessibility of healthcare.
"If you have to walk past screaming protesters to get to work to do your job saving lives, it just wears on you," said Matt Wolf, director and healthcare senior analyst at RSM.
The harassment comes on top of hundreds of thousands of clinicians leaving the industry due to public health emergency stresses, which has placed an enormous toll on the health labor market and the quality of care provided, Wolf said.
Some providers have begun offering safety escort services to their workers and trying to forge interactions between clinicians and positive members of the community to help nurses and physicians remember why they entered into healthcare in the first place, he said.