It’s worse for those who have Covid-19 or are being tested for Covid-19. These patients are still prohibited from receiving visitors unless they are at the end of their lives. And even then, we have to negotiate to get more than two people into the room at the same time.
“Who am I to decide that?” Asked one of the care managers who is tasked with accepting or rejecting exceptions to visitor restrictions in the intensive care unit. Another nurse, desperately looking for a way for her patient’s five adult children to all say a short prayer by the bedside, wondered if she could find a side door to smuggle them in. She could not. They had to pray in shifts.
My colleagues and I who work in the intensive care unit find indulgence and secure exemptions where we can. But here, too, there is undreamt-of damage. In retrospect, I know that I fought more for some patients and families than for others. Maybe it’s the family that pushes the most, maybe it’s the family that somehow aligns with mine. It shouldn’t be so arbitrary. So we need rules that allow all of our patients to see the people they love. Until we do that, there is a real risk that our exceptions and inconsistencies will compound the inequalities in access that already plague our health systems.
Hospital policy must also shift the focus away from the end of life as the time when visitors are most important. I have often spent weeks looking after lonely and scared Covid-19 patients only to make them worse and finally get a visit when they are so sick they can barely communicate with loved ones.
This has to come to an end. There will of course be challenges to fully reopen our hospitals to visitors. Before visitors can enter, security guards check them for coronavirus symptoms and a flow of visitors could be logistically difficult. Before the pandemic, our ICU waiting rooms were filled with loved ones camping on the couches and even on the floor. I understand that it will be some time before hospitals can reopen these rooms to visitors who may or may not be vaccinated. But we can certainly do that. We have accepted isolation as the narrative of this pandemic, but that can change.
And it can change for sure. Regardless of their vaccination status, visitors should be able to make their own decisions about risks when it comes to visiting a loved one with coronavirus, and hospitals should offer them personal protective equipment to ensure the safest possible visit. When it comes to patients without coronavirus, with low community prevalence and persistent masking requirements in hospitals, we don’t have to drastically limit the number of visitors. CDC and state health officials can take the lead to drive this change.
A few days after talking to my patient’s wife, he developed new pneumonia and his oxygen levels began to drop. My team sedated him again. When he got so bad that we were worried that he might die, we called his wife and told her that she could – finally – come to him.