Concerns about violence against nurses and other medical personnel have increased during the COVID-19 pandemic. However, as of yet, limited systematic knowledge of such violence is available. Addressing this gap, we analyse the geographical distribution of, motivations behind, and contexts of collective attacks against health workers in the context of the COVID-19 pandemic. To do so, we systematically recorded and coded attack events worldwide from 1 March 2020 to 31 December 2021. We identify high-risk countries, attack characteristics, and the socio-economic contexts in which attacks tend to occur. Our results show that opposition against public health measures (28.5%), fears of infection (22.3%), and supposed lack of care (20.6%) were the most common reasons for attacks. Most attacks occurred in facilities (often related to a supposed lack of care) or while health workers were on duty in a public place (often due to opposition to public health measures). However, 17.9% of all attacks took place in off-duty settings. Democratic countries with high vaccination rates and strong health systems were relatively safe for nurses and doctors. Distrust in the skills of health workers and the science underlying health interventions is a major driver of collective attack risks and should be addressed before it turns violent. This study was not registered.
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