By Dennis Thompson
HealthDay reporter
THURSDAY, May 20, 2021 (HealthDay News) – Virginia Terrell knew she was banned from having visitors after checking into the hospital with COVID-19 late last month – half a stay easier.
“You get pretty lonely,” said Terrell, 59, who was treated at the WakeMed and Duke Health hospitals in Raleigh, NC. They have someone to hold your hand and comfort you. “
However, hospitals are aware of the personal cost of COVID-19 lockdowns, and many have started relaxing visiting guidelines over the past month as vaccination rates rise and the number of COVID cases fall.
Some hospitals relaxed their visiting rules after the U.S. Centers for Disease Control and Prevention’s new guidelines were gradually released in early April, said Ann Marie Pettis, president of the Association for Professionals in Infection Control and Epidemiology.
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The new CDC guidelines say hospitals can consider allowing patients a visitor or two if COVID levels in the community are kept under control.
“The CDC makes recommendations and the states then make regulations that we have to live by,” said Pettis. “You’re definitely waiting to see how your state will interpret it, and even from there it can be very institution-specific.”
The University of Rochester Medicine’s Pettis Hospital in Rochester, NY recently approved admitting two visitors per patient, which many other hospitals across the country have done.
The rules vary from state to state and from hospital to hospital. Generally, a visit is allowed for patients who meet certain conditions, and the two visitors to one person may need to stop by, be on a registration list, and only visit at certain times.
COVID patients like Terrell are generally not allowed to visit visitors at all. In some medical centers, such as the University of Utah Health, visitors can now even enter the rooms of COVID patients.
These visits are being conducted with great caution, said Alison Flynn Gaffney, executive director of the University Hospital of the University of Utah Health Systems.
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Visitors to a COVID positive patient will be asked if they have a proof of vaccination or a previous positive COVID test and asked about recent symptoms, Gaffney said.
“You must stay in the patient’s room and wear the required PPE [personal protective equipment]and meet all the requirements for additional screening, “said Gaffney.
“People are social beings”
The value of the visitors is known to hospital staff, said Dr. Flora Kisuule, board member of the Society of Hospital Medicine and director of hospital medicine at Johns Hopkins Bayview Medical Center in Baltimore.
“We have learned over the years that caring for patients is a partnership between the clinician, the patient and their families,” said Kisuule. “People are social beings and our wellbeing is really helped a lot by the support of the people in our families.”
At the height of the pandemic, visit bans were required to protect hospitalized patients with compromised immune systems and other conditions that put them at high risk.
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“Our hospital patients are among the most vulnerable citizens in our community, so additional mitigation measures are needed to protect them,” said Pettis. “We take it very seriously when it comes to making changes to the visits.”
But the lockdowns came at a cost.
“People didn’t have this cheerleader,” said Kisuule. “As hard as the clinicians work to be that person, they cannot replace a spouse, child, sibling, so this has been greatly missed by our patients.”
Duke Health changed its guidelines earlier this month, increasing the number of visitors per patient to one or two, said Katie Galbraith, president of Duke Regional Hospital.
“The combination of reducing the spread of COVID in our community and the communities in which we operate, and increasing vaccination in the same community has certainly led us to believe that at this point we could expand and do so safely” said Galbraith.
The logistics of extending the visit can be tricky. It’s easier to have visitors in hospitals with lots of private rooms than hospitals with lots of semi-private rooms, Pettis said.
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Medical centers must continue to be involved in COVID rates in their communities as they expand visits.
“If your COVID positivity rate is still above 3%, you will handle it differently than in a community where you are below 2% or 1%,” Pettis said.
More staff was needed to process visitors
Staff is another big problem for hospitals trying to open things, Pettis said.
In the centers, visitors can usually enter through an entry point where staff must process IDs, check for symptoms, and explain the rules. A member of staff then leads the person into the patient’s room.
In the event of a COVID patient visit, a staff member may also need to help people put on and take off necessary personal protective equipment such as robes, gloves and mask, Kisuule said.
“Many of these institutions actually make it easier to put on and take off [PPE] of their visitors, “said Kisuule.
The staff drain for hospital visits also comes at a time when these medical centers are busy more than ever and are often 120% busy, Pettis said.
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“Lots of people stayed out of hospitals and health care facilities because of fear during the pandemic, and now we’re at the seams,” Pettis said.
Terrell checked into WakeMed on April 26 because she had lost her sense of smell and taste, suffered from a bloated stomach, had difficulty breathing, and had swelling in her legs.
Doctors took her to Duke Health on April 30th because COVID appears to have damaged a donated liver that Duke surgeons transplanted into Terrell years ago, she said.
“I had no associated pain, muscle aches, or body aches,” Terrell said. “It made it a little less difficult because I didn’t feel like I was in danger of going in there and not getting out, so I guess I could handle it more.”
Although she didn’t benefit, Terrell said Duke’s extended visit was a “good thing” for non-COVID patients.
“It’s hard to be alone and not be able to process your situation or discuss it with someone who can comfort you,” Terrell said. “It will speed many people’s recovery and put them in good thinking. Being sick is hard when you are alone.”
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More information
The U.S. Centers for Disease Control and Prevention is more concerned with infection prevention in hospitals.
SOURCES: Virginia Terrell, Raleigh, NC; Ann Marie Pettis, RN, President, Association of Infection Control and Epidemiology Professionals; Alison Flynn Gaffney, MHA, executive director, University Hospital, University of Utah Health System; Katie Galbraith, MBA, President, Duke Regional Hospital; Flora Kisuule, MD, Director, Hospital Medicine, Johns Hopkins Bayview Medical Center, Baltimore
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