by Adriana Gomez Licon
MIAMI (AP) – Banned from the Florida hospital room where her mother was dying of COVID-19, Jayden Arbelaez gave an idea to construction workers working nearby.
“Is there a way I can get there?” Arbelez asked him, pointing to a small third-floor window at the hospital in Jacksonville.
Activists gave the 17-year-old a yellow vest, shoes, a helmet and a ladder to climb on a part of the roof so that he could look out the window and see his mother, Michele Arbelez, alive for the last time.
In a year and a half of a pandemic that has killed 700,000 people in the US, hospitals in at least half a dozen states have eased restrictions governing visits to COVID patients. Others, however, stand firm, supported by studies and industry groups, which indicate such policies are key to keeping hospital-acquired infections down.
Some families of COVID-19 patients – and doctors – are asking hospitals to reconsider that strategy, arguing that it denies people the right to be with loved ones at critical times.
“We need people to think about that risk-benefit equation,” said Dr. Lauren van Skoy, a pulmonary and critical care physician at Penn State Health who has visited relatives of COVID-19 patients with limited visits. Effects have been researched. “The risk of getting Covid versus the risk that we know these families are going through psychological and emotional loss.”
Van Skoy said that many of the family members she interviewed showed symptoms of post-traumatic stress disorder. In op-ed excerpts from the newspaper, doctors share conversations with patients who have declined or postponed important treatments because of restrictions on visits.
And studies conducted before the pandemic showed that older patients in intensive care units developed delirium at higher rates than units with more resilience.
Van Skoy agrees that it made sense to restrict visits at the start of the pandemic because protective equipment and COVID-19 tests were in short supply and there were no vaccines. But now, testing and vaccination have expanded greatly, and doctors say screening mechanisms and personal protective equipment can keep the virus at bay.
Nonetheless, the US Centers for Disease Control and Prevention still recommends against in-person visits to infected patients.
“We do not take lightly the sacrifices we are asking for individuals and their loved ones to make. We will not do this unless it is absolutely necessary,” said Nancy Foster, vice president of quality and patient safety policy at the American Hospital Association.
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.
“I don’t know of any place that doesn’t put a lot of effort in because families are incredibly important to the well-being of patients,” Pettis said. “These are heart-wrenching decisions that have to be made.”
Electric utility lineman Jeremy Starr, 36, of Jacksonville, is familiar with this kind of heartbreak.
The star, who contracted the virus over the summer, remembers being thirsty, being alone and unable to sleep during a 14-day hospitalization in the ICU.
“Non-breathing was bad enough, but not seeing your loved ones is the worst,” he said. “It’s like you’re not human.”
Kirsten Fiest, an associate professor of critical care medicine at the University of Calgary who is studying the effects of isolation on COVID-19 patients, said family members are also caregivers who stress health care in the ICU. Can ease the burden of the employees.
“With no family there, the nurses have to go out of their way to call them. He has to take on a new role, even holding the phone when someone says goodbye,” Feist said.
Inspired by the stories of Starr, Arbelaez, and others like them, Darlene Guerra of Jacksonville started an online petition asking Florida Gov.’s Ron DeSantis to inspire more outreach. DeSantis was an early proponent of reopening nursing homes to visitors, saying he felt banning them contributed to families’ suffering.
“It’s heartbreaking for all these families,” Guerra said. “We’re going to work, we’re going to church, we’re going to the store, but we can’t go to the hospital and be with our loved ones?”
Justin Sr., head of the Florida Safety Net Hospital Alliance, which represents some of the state’s largest medical facilities, said when setting rules for visits, hospitals take into account the transmission level of COVID, vaccination rates and cardiovascular prevalence. Huh. Lung diseases in the community.
Some doctors say health networks are concerned about a shortage of nurses and impose restrictions to avoid adding stress to already exhausted health care workers. Others say the process of screening visitors and instructing them to wear protective equipment also takes time from health care workers.
“I think the condition is coming from a place of fatigue and irritation, rather than what is good for patients,” Van Skoy said.
Some hospitals have allowed people to meet coronavirus patients. The University of Utah Health announced earlier this year that its hospitals would allow up to two adult visitors throughout the hospital, provided they remain in the patient’s room and are wearing personal protective equipment at all times, do not have symptoms and either Have been vaccinated or have recently recovered from COVID-19.
Many have made exceptions only for coronavirus patients who are about to die, which was the case caring for Arbelez’s mother at Jacksonville Hospital. The family says the rules were inconsistent: on some days, administrators allowed only one family member to visit; On others, multiple visitors were allowed. On the final day, only Arbelez’s father, Mitch Arbelez, was allowed. It was his birthday.
From her perch on the roof of the hospital, the distraught teenager picked up her cellphone, called her father and sang “Happy Birthday” to him as she peered out the window and saw her mother, who was unconscious on a ventilator.
Hours later, his mother died, alone.
This story has been edited to clarify that Dr. Lauren Van Skoy is a physician at Penn State Health, not Penn State.