Sadness, despair and anger when a patient dies alone from COVID-19: A thematic content analysis of Twitter data from bereaved family members and friends

Lucy E Selman*, Charlotte A Chamberlain, Ryann Sowden, Davina Chao, Daniel Selman, Mark Taubert, Philip Braude

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

11 Citations (Scopus)
37 Downloads (Pure)


To inform clinical practice and policy, it is essential to understand the lived experience of health and social care policies, including restricted visitation policies towards the end of life.

To explore the views and experiences of Twitter social media users who reported that a relative, friend or acquaintance died of COVID-19 without a family member/friend present.

Qualitative content analysis of English-language tweets.

Data sources:
Twitter data collected 7–20th April 2020. A bespoke software system harvested selected publicly-available tweets from the Twitter application programming interface. After filtering we hand-screened tweets to include only those referring to a relative, friend or acquaintance who died alone of COVID-19. Data were analysed using thematic content analysis.

9328 tweets were hand-screened; 196 were included. Twitter users expressed sadness, despair, hopelessness and anger about their experience and loss. Saying goodbye via video-conferencing technology was viewed ambivalently. Clinicians’ presence during a death was little consolation. Anger, frustration and blame were directed at governments’ inaction/policies or the public. The sadness of not being able to say goodbye as wished was compounded by lack of social support and disrupted after-death rituals. Users expressed a sense of political neglect/mistreatment alongside calls for action. They also used the platform to reinforce public health messages, express condolences and pay tribute.

Twitter was used for collective mourning and support and to promote public health messaging. End-of-life care providers should facilitate and optimise contact with loved ones, even when strict visitation policies are necessary, and provide proactive bereavement support.
Original languageEnglish
Pages (from-to)1267-1276
Number of pages10
JournalPalliative Medicine
Issue number7
Early online date21 May 2021
Publication statusPublished - Jul 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: LS and RS are funded by a Career Development Fellowship from the National Institute for Health Research. PB is funded by Research Capability Funding from North Bristol NHS Trust.

Publisher Copyright:
© The Author(s) 2021.

Structured keywords

  • Covid19


  • Bereavement
  • Grief
  • Pandemics
  • Coronavirus Infections
  • Social Media


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