Infodemic

Death, stress and supply shortages: Any doctor who’s done it will tell you that working in Covid intensive care units is hell. But as the global anti-Covid vaccine movement grows and conspiracy theories around the pandemic thicken, ICU doctors around the world now face the added burden of defending themselves against attacks and disinformation. 

Unsurprisingly, many of these attacks originate online. Telegram and Facebook groups opposing Covid-19 vaccinations are now issuing instructions to users on how to refuse medical interventions for loved ones receiving treatment in ICUs. 

This week I spoke with six doctors and nurses working in ICUs across America, all of whom had recently dealt with so-called  “against medical advice requests” where patients’ relatives make treatment decisions that contradict hospital advice. Due to patient confidentiality all of the medical professionals I spoke to wanted to remain anonymous, but all said that they are seeing more and more cases of patients whose behavior is driven by conspiracy theories that have ICUs at their center. 

The claim that hospitals are trying to rack up Covid-related death statistics in order to receive more money from governments has been around from the start of the pandemic. It has now given birth to dozens of satellite myths that are costing lives of patients around the world. 

The most common conspiracy doctors told me they have encountered is that  people die from being put on ventilators. I spoke to one nurse from the Midwest who told me about her 34-week pregnant patient whose husband opted to take her to hospice instead of putting her on a ventilator. 

“I was almost in tears, I begged him to reconsider,” wrote another nurse on reddit about a patient who was choosing to die because “people on the internet told me to decline intubation”. 

One assistant professor in surgery from University Hospital in Augusta, Georgia told me that he recently had a patient die, because his wife refused to allow the hospital to intubate him, even though the patient himself agreed to the procedure. “The wife was very upset and family members started accusing us of trying to kill him deliberately,” the doctor told me. The family threatened to take the man home. The man died before the argument between the family and hospital was resolved.

“It’s been a long year and we are all tired of dealing with this ignorance,” his doctor told me. He said that even just a year ago, he would have reasoned with families more, but as more and more of his patients refuse medical advice, doctors are losing the stamina needed to argue with them. 

To be sure, doctors around the world have continually updated their covid treatment protocols as they have learnt about the novel coronavirus and its many variants affect patients. Some of this learning has been around when to intubate a patient. Yet there is a clear difference between technical discussions among medical professionals and uninformed speculation on social media.

It’s not just the United States. As the global anti-vaccine movement grows, more and more online groups are boasting cases of “successful removal” of patients from ICU beds across the globe. In Australia, where anti-vaccine groups on Facebook have grown by a whopping 280% between January 2020 and March 2021, hundreds of people are also turning against hospitals in their posts. 

In Ireland, far-right activist and conspiracist Antonio Mureddu recently ‘rescued’ a 67-year-old man, whom he met online, from the hospital. In the video, recorded by Mureddu himself, you can hear doctors telling the patient that he would not make it with home care. The patient passed away soon after his supposed rescue. 

It’s not clear why the anti-hospital and anti-ICU feelings have picked up more recently. Doctors and nurses I spoke to are too exhausted and too busy to have an answer. 

GLOBAL ROUND UP

Lagging vaccination rates are taking a toll across Eastern Europe this fall. From Latvia to Romania, Georgia and Russia, vaccine uptake has slowed while case numbers keep climbing. Latvian, Romanian and Russian authorities have reintroduced strict lockdowns, with authorities in Moscow ordering unvaccinated people over 60 to stay home until late February. In Latvia, hospitals have cancelled most planned operations and the president of Romania called the current situation a national “catastrophe.” Vaccination rates in Georgia, where a number of shots are readily available, are some of the region’s lowest with just 30% of the adult population vaccinated.

In China’s Henan province, police detained a single mother after she asked authorities to investigate her daughter’s death. 12-year-old Li Boyi fell ill two days after having her first vaccine shot on August 10 and died in a hospital a fortnight later. The hospital diagnosed the girl with a “brain dysfunction” and said there was no link between death and the vaccine. But the mother was not satisfied with the explanation and she recently petitioned the authorities to investigate her daughter’s death. Instead, Jiang was detained on charges of “picking quarrels and provoking trouble.” This catch-all phrase has become popular with the Chinese government, who have levelled it against journalists, activists and lawyers deemed to spread fake news about the virus.

Katia Patin and Isobel Cockerell contributed to this week’s Infodemic.