As COVID-19 engulfed U.S. hospitals in wave after wave in 2020, families were often cut off from their hospitalized loved ones, or visitation was severely limited, especially in the beginning of the pandemic.
Now, whether their beloveds lived or died, a majority of the family members themselves are showing signs of post-traumatic stress disorder (PTSD), a new study has found.
Of 330 family members surveyed three months after their kin had been hospitalized for COVID, 64% scored highly on tests measuring PTSD symptoms, the researchers found. While pre-pandemic PTSD among family members of ICU patients was about 30%, COVID more than doubled that.
The patients in question were admitted to the ICU between Feb. 1 and July 31, 2020. They were hospitalized at 12 hospitals in Colorado, Washington, Louisiana, New York and Massachusetts, said the research team led by Dr. Timothy Amass, an assistant professor in medicine and pulmonary sciences and critical care at the University of Colorado School of Medicine.
The study, published Monday in the journal Jama Internal Medicine, was one attempt to get a handle on the ancillary effects of the pandemic, beyond the millions of deaths, the effects of long COVID, and the continuing infections as variants emerge. Health care workers’ trauma is already being studied, with attempts to treat it, but the trauma flowing outward from all aspects of the pandemic has yet to be plumbed.
“Our findings suggest that visitation restrictions may have inadvertently contributed to a secondary public health crisis, an epidemic of stress-related disorders among family members of ICU patients,” said Amass in a statement.
And just as the pandemic hit some ethnicities and societal sectors harder than others, so too did it go with critically ill patients’ families.
“Higher PTSD symptoms scores were significantly associated with Hispanic ethnicity, female gender, and previous medication use for a psychiatric condition,” the authors wrote.
The experience also eroded trust.
“Family members with higher scores more commonly described feelings of distrust and concern about the need to take clinicians’ information at face value without being present to see for themselves,” the researchers said. “As the COVID-19 pandemic continues to challenge the ability of family members to build bedside relationships with clinicians, this loss of trust may translate into an increase in stress-related disorders.”
One patient described just such an experience, a gap in communication that caused a heartbreaking pivot.
“They called us and said, ‘Do you want us to pull the plug?’ " the researchers’ statement recounted. “I said how did it go from coming home to pulling the plug? ... they say that her mouth was moving and her eyes were moving, but they said she was dead ... so, they went on and pulled the plug anyway.”
The opposite was also true, with even small acts of compassion making a huge difference – something as simple as asking the family for a picture that hospital staff could hang near the patient, Amass told CNN.
At least one clinician not involved in the study called the findings significant, even if only the most at-risk family members responded.
“Even if the rates are only half of what this study found, they are still alarmingly high and point to the need for emotional support,” Dr. Murray Stein, vice chair for clinical research in the department of psychiatry at the University of California San Diego School of Medicine and a distinguished professor of psychiatry and public health, told CNN.
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