Saturday, October 23, 2021

COVID-19 Hospital Visitor Rules: Families Want More Access

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The workers gave the 17-year-old a yellow vest, boots, a helmet and a ladder to climb onto a section of roof so she could look through the window and see her mother, Michelle Arbelaez, alive one last time. A year and a half into a pandemic that has killed 700,000 people in the U.S., hospitals in at least a half-dozen states have loosened restrictions governing visits to COVID patients. Others, however, are standing firm, backed by studies and industry groups that indicate such policies have been crucial to keeping hospital-acquired infections low.

Some families of COVID-19 patients — and doctors — are asking hospitals to rethink that strategy, arguing that it denies people the right to be with loved ones at a crucial time. Van Scoy agrees it made sense at the beginning of the pandemic to restrict visits because protective equipment and COVID-19 tests were in short supply and there weren’t any vaccines. But now, testing and vaccinations have vastly expanded, and doctors say screening mechanisms and personal protective equipment can keep the virus at bay.

And studies conducted before the pandemic have shown that older patients in intensive care units that restricted visits developed delirium at higher rates than those in units with more flexibility. Nonetheless, the U.S. Centers for Disease Control and Prevention still recommends against in-person visits for infected patients.

Van Scoy said many of the family members she has interviewed have shown signs of post-traumatic stress disorder. In newspaper op-ed pieces, doctors have shared conversations with patients who declined or postponed crucial treatments because of the visiting restrictions. “We need to get people thinking about that risk-benefit equation,” said Dr. Lauren Van Scoy, a pulmonary and critical care physician at Penn State who has researched the effects of limited visits on the relatives of COVID-19 patients. “The risk of getting COVID versus the risk of what we know these families are going through, the psychological and emotional harm.”

Ann Marie Pettis, president of the Association for Professionals in Infection Control and Epidemiology, acknowledged that patients benefit from having visitors but said the group still discourages it in most cases. “We do not take lightly the sacrifices we are asking individuals and their loved ones to make. We would not do so unless it was absolutely necessary,” said Nancy Foster, vice president of quality and patient safety policy at the American Hospital Association.

Jeremy Starr, a 36-year-old electric utility lineman from Jacksonville, is familiar with such heartbreak. Starr, who contracted the virus in the summer, remembers being thirsty, alone and unable to sleep while hospitalized for 14 days in an ICU. “I don’t know of any place that doesn’t try very hard because families are incredibly important for the patients’ well-being,” Pettis said. “These are heartbreaking decisions that have to be made.”

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