More than a year after U.S. health care workers on the front lines against COVID-19 were saluted as heroes with nightly clapping from windows and balconies, some are being issued panic buttons in case of assault and ditching their scrubs before going out in public for fear of harassment.

Across the country, doctors and nurses are dealing with hostility, threats and violence from patients angry over safety rules designed to keep the scourge from spreading.

“A year ago, we’re health care heroes and everybody’s clapping for us,” said Dr. Stu Coffman, a Dallas-based emergency room physician. “And now we’re being in some areas harassed and disbelieved and ridiculed for what we’re trying to do, which is just depressing and frustrating.”

Cox Medical Center Branson in Missouri started giving panic buttons to up to 400 nurses and other employees after assaults per year tripled between 2019 and 2020 to 123, a spokeswoman said. One nurse had to get her shoulder X-rayed after an attack.

Hospital spokeswoman Brandei Clifton said the pandemic has driven at least some of the increase.

“So many nurses say, ‘It’s just part of the job,’” Clifton said. “It’s not part of the job.”

Some hospitals have limited the number of public entrances. In Idaho, nurses said they are scared to go to the grocery store unless they have changed out of their scrubs so they aren’t accosted by angry residents.

Doctors and nurses at a Coeur d’Alene, Idaho, hospital have been accused of killing patients by grieving family members who don’t believe COVID-19 is real, said hospital spokeswoman Caiti Bobbitt. Others have been the subject of hurtful rumors spread by people angry about the pandemic.

“Our health care workers are almost feeling like Vietnam veterans, scared to go into the community after a shift,” Bobbitt said.

Over Labor Day weekend in Colorado, a passerby threw an unidentified liquid at a nurse working at a mobile vaccine clinic in suburban Denver. Another person in a pickup truck ran over and destroyed signs put up around the clinic’s tent.

About 3 in 10 nurses who took part in a survey this month by an umbrella organization of nurses unions across the U.S. reported an increase in violence where they work stemming from factors including staff shortages and fewer visitor restrictions. That was up from 2 in 10 in March, according to the National Nurses United survey of 5,000 nurses.

Michelle Jones, a nurse at a COVID-19 ICU unit in Wichita, Kansas, said patients are coming in scared, sometimes several from the same family, and often near death. Their relatives are angry, thinking the nurses and doctors are letting them die.

“They cry, they yell, they sit outside our ICU in little groups and pray,” Jones said. “Lots of people think they are going to get miracles and God is not passing those out this year. If you come into my ICU, there is a good chance you are going to die.”

She said the powerful steroids that have shown promise often make patients angrier.

“It is like ‘roid rage on people,” she said. “I’ve worked in health care for 26 years. and I’ve seen anything like this. I’ve never seen the public act like this.”

Across the U.S., the COVID-19 crisis has caused people to behave badly toward one another in a multitude of ways.

Several people have been shot to death in disputes over masks in stores and other public places. Shouting matches and scuffles have broken out at school board meetings. A brawl erupted earlier this month at a New York City restaurant over its requirement that customers show proof of vaccination.

Dr. Chris Sampson, an emergency room physician in Columbia, Missouri, said violence has always been a problem in the emergency department, but the situation has gotten worse in recent months. Sampson said he has been pushed up against a wall and seen nurses kicked.

Dr. Ashley Coggins of St. Peter’s Health Regional Medical Center in Helena, Montana, said she recently asked a patient whether he wanted to be vaccinated.

“He said, ‘F, no,’ and I didn’t ask further because I personally don’t want to get yelled at,” Coggins said. “You know, this is a weird time in our world, and the respect that we used to have for each other, the respect that people used to have for caregivers and physicians and nurses — it’s not always there, and it makes this job way harder.”

Coggins said the patient told her that he “wanted to strangle President Biden” for pushing for vaccinations, prompting her to change the subject. She said security guards are now in charge of enforcing mask rules for hospital visitors so that nurses no longer have to be the ones to tell people to leave.

The hostility is making an already stressful job harder. Many places are suffering severe staffing shortages, in part because nurses have become burned out and quit.

“I think one thing that we have seen and heard from many of our people is that it is just really hard to come to work every day when people treat each other poorly,” said Dr. Kencee Graves, a physician at the University of Utah hospital in Salt Lake City.

“If you have to fight with somebody about wearing a mask, or if you aren’t allowed to visit and we have to argue about that, that is stressful.”