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Tuesday, June 02, 2020

Explained: Are visitors allowed to meet critically ill COVID-19 patients?

Coronavirus (COVID-19): One “particularly difficult” aspect of the pandemic is whether to allow visitors to meet their critically-ill family members.

By: Explained Desk | New Delhi | Updated: April 16, 2020 7:56:29 am
Explained: Are visitors allowed to meet critically ill COVID-19 patients? A patient who has tested positive for the coronavirus disease (COVID-19) is seen in Dos de Mayo national hospital, in Lima, Peru on April 14, 2020. (Reuters Photo: Sebastian Castaneda)

Coronavirus (COVID-19): There is no standard protocol anywhere in the world for dealing with visitors for critically-ill COVID-19 patients.

A recent article published in the New England Journal of Medicine (NEJM) points to one “particularly difficult” aspect of the COVID-19 pandemic, which is refusing to allow visitors to meet their critically-ill family members.

Why can’t COVID-19 patients receive visitors?

The NEJM article states that visitors cannot be allowed near COVID-19 patients as they are likely to be infected with the disease themselves. Even if the family is not infected themselves, a visit to a COVID-19 ward can certainly increase their chances.

Further, considering the shortage of personal protective equipment (PPE) around the world, letting family members use it will deplete an already scarce resource.

Add to this the fact that health workers will have to brief, and assist, visitors on how to don and doff the PPE, putting extra pressure on them.

The NEJM article calls for using telecommunication as a means to help isolated patients stay connected with their families. “Perhaps setting up a tablet computer facing the patient or repurposing a workstation on wheels logged in to a video chat would be a solution,” it says.

“There may be no way for families to hold patients’ hands or hug them while they are dying, but with the care and compassion of frontline healthcare workers, maybe we can harness creative solutions to help them feel some connection, while still keeping everyone safe,” it adds.

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An article in The Lancet says that ICU visits pose a risk of spreading the infection and, therefore, to minimise transmission, visits should be restricted or banned. It also recommends using video conferencing for communication between patients and family members.

In India, the Ministry of Health and Family Welfare has said the number of visitors in ICUs in government hospitals should be restricted. Further, it has directed that if visitors must enter a COVID-19 patient’s room, they should be provided with clear instructions about donning and doffing PPEs and performing proper hand hygiene. Visitors should ideally be supervised by healthcare workers.

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On its website, the New York-Presbyterian hospital says that temporary visitation may be allowed in “extenuating circumstances”. However, visitors who are sick or show other signs of illness, such as a cough, are not allowed.

UK’s National Health Service (NHS) does not allow any visitors but maintains, “We will, however, consider visitors on compassionate grounds for seriously ill patients or those receiving end-of-life care only in agreement with each individual ward.”

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