We can do better for our patients and their families, says Ammar Waraich
I am a medical registrar in the NHS, caring daily for many patients with covid-19 in hospital. It is one of the most traumatic times in my professional life, made much worse by watching patients suffer and die alone.
This is enabled by a blanket policy in many hospitals, which prevents any family members from physically visiting patients in hospital with covid-19, unless the patient is deemed to be at the very end of their life. While at face value this may appear to be a sensible policy to prevent further infection, in reality, it is unnecessary, cruel, and inhumane.
It is unnecessary for the following three reasons. Firstly, family members have frequently been infected with covid at the same time as the patient and recovered. Through this, they will have built up a natural immunity that protects them against further covid infection in the short term, which is precisely when they need to visit their relatives in hospital the most. Some family members may have even had the vaccine and should be protected through that too.
Secondly, personal protective equipment (PPE) and maintaining distance can enhance safety for these visits, especially if the visit is short and consists of only one or two family members. To put this into perspective, if it is deemed safe for medical staff to wear PPE and work for extended periods with patients at close proximity, why should it not be equally safe for brief family visits at a distance too?
Thirdly, the risk can be reduced even further by mandating that relatives self-isolate after visiting the patient. My experience of breaking bad news to many families has taught me that family members would happily have accepted a period of isolation in return for being able to properly visit their loved ones.
This policy is also cruel and inhumane. Seeing loved ones can be immensely therapeutic for patients and can give them the will to survive during one of the most challenging times of their lives. Caring for patients with covid daily, I see how some patients lose hope and refuse treatment as they cannot see the point of struggling on alone.
Moreover, it is deeply traumatic for the family if their loved one dies from covid within weeks of being otherwise healthy. Having spoken to many such families, there are things often left unsaid and affairs unresolved. It is cruel to not allow families the chance to properly say goodbye while they still can. By the time we eventually do allow family members into the hospital, many patients are usually at the end stage and too weak to communicate—or they are paralysed, sedated, and intubated, awaiting death.
Obviously, some family members may not have had covid and will want to protect themselves. We can continue facilitating communication via video calls for them. But for those families who are at lower risk and who are able to wear PPE and self-isolate afterwards, we should not continue to bar them from their loved ones because of a one size fits all policy.
The alternative is to continue facilitating phone calls for all patients via staff. However, the NHS is grossly unprepared to handle the present volume of family calls—there is not enough staff or time. As a result, families do not get regular updates, live in anxiety, and lose family members very suddenly and unexpectedly, with bitter regrets about not saying goodbye. I think we can do better for our patients and their families than this.
Ammar Waraich is a medical registrar in the NHS. He was a Fulbright Scholar to Harvard University, where he completed a master’s degree in public policy, and was a Democracy in Difficult Places Fellow.
Competing interests: None declared.