Health

COVID-19 Hospital Attendance Guidelines: Families Want More Access

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MIAMI – Jaden Arbelez, who was barred from visiting the Florida hospital room where her mother lay dying from COVID-19, shared her idea with construction workers working nearby.

“Is there a way to get there?” Arbelez asked them, pointing to a small window on the third floor of the Jacksonville hospital.

Workers gave a 17-year-old girl a yellow vest, boots, a helmet and a ladder so that she could climb a section of the roof so she could look out the window and see her mother, Michelle Arbelez, for the last time.

A year and a half after the pandemic that killed 700,000 people in the United States, hospitals in at least half a dozen states have lifted restrictions on visits to patients with COVID. Others, however, stand firm, drawing on research and industry groups that show that such policies are critical to reducing hospital-acquired infections.

Some families of COVID-19 patients and doctors are asking hospitals to rethink this strategy, arguing that it deprives people of the right to be with loved ones at a critical time.

“We need to get people to think about this balance of risk and benefit,” said Dr. Lauren Van Skoy, a Pennsylvania pulmonary and intensive care physician who researched the impact of limited visits on relatives of COVID-19 patients. “The risk of contracting COVID versus the risk of what we know these families are going through is psychological and emotional harm.”

Van Skoy said many of the family members she spoke to showed signs of PTSD. In newspaper articles, doctors spoke to patients who refused or delayed essential treatment due to visit restrictions.

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And research done before the pandemic showed that older patients in intensive care units with limited visits developed more delirium than patients in wards with more flexibility.

Van Skoy agrees that it made sense to limit visits at the start of the pandemic because protective equipment and tests for COVID-19 were in short supply and vaccines were not available. But now testing and vaccinations have expanded significantly, and doctors say screening mechanisms and personal protective equipment can contain the spread of the virus.

However, the US Centers for Disease Control and Prevention continues to discourage visiting infected patients in person.

“We are not easy about the sacrifices that we ask to bring to people and their loved ones. We wouldn’t do this unless absolutely necessary, ”said Nancy Foster, vice president of patient quality and safety policy for the American Hospital Association.

Anne Marie Pettis, president of the Association for Infection Control and Epidemiology Professionals, acknowledged that patients benefit from visiting visitors, but said in most cases, the group still disapproves.

“I don’t know of a single place that doesn’t work hard because families are incredibly important to the well-being of patients,” Pettis said. “These are heartbreaking decisions to be made.”

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Jeremy Starr, a 36-year-old electrician from Jacksonville, is familiar with such grief.

Starr, who contracted the virus in the summer, recalls feeling thirsty, alone, and unable to sleep during a 14-day hospitalization in an intensive care unit.

“Not breathing was bad enough, but the worst thing is not to see your loved ones,” he said. “It seemed to me that you were not human.”

Kirsten Fiest, an assistant professor of intensive care at the University of Calgary who studies the effects of isolation on COVID-19 patients, said family members are also caring for patients who can ease the burden of stressed health care workers in intensive care units.

“Because there are no families there, the nurses have to go out of their way to call them. They have to play a new role, even picking up the phone when someone says goodbye, ”Fieste said.

Inspired by stories from Starr, Arbelaez and the like, Darlene Guerra of Jacksonville launched an online petition asking Florida Governor Ron DeSantis for more access. DeSantis was an early proponent of opening nursing homes to visitors, saying he believed the ban was exacerbating the suffering of families.

“It’s heartbreaking for all these families,” Guerra said. “We go to work, we go to church, we go to the store, but we can’t go to the hospital and be with our loved ones?”

Justin Senor, head of the Florida Safety Network Hospital Alliance, which represents some of the largest healthcare facilities in the state, said hospital attendance policies take into account levels of COVID transmission, vaccination rates, and prevalence of cardiovascular disease. lung disease in the community.

Some doctors say health networks are worried about a shortage of nurses and are maintaining restrictions so as not to stress already exhausted healthcare workers. Others say the process of screening visitors and instructing them on how to wear protective gear also takes time from medical staff.

“I think this position is more caused by fatigue and burnout than by what is good for patients,” said Van Skoy.

Some hospitals have allowed people to visit coronavirus patients. Earlier this year, Utah Health University announced that its hospitals will accept up to two adult visitors for the duration of their hospital stay, provided they remain in the patient’s room and wear personal protective equipment at all times, are asymptomatic and vaccinated, or have recently recovered from COVID-19.

Many have made exceptions only for coronavirus patients who are about to die, as was the case at Jacksonville Hospital, where Arbelez’s mother was nursed. The family claims that the rules were inconsistent: on some days, administrators allowed only one family member to visit; others allowed several visitors. On the last day, only Arbelez’s father, Mitch Arbelez, was admitted. It was his birthday.

From her place on the roof of the hospital, the distraught girl took her mobile phone, called her father and sang “Happy Birthday” to him, looking out the window and looking at her mother, unconscious on a ventilator.

A few hours later, her mother died alone.


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