Covid-19: Hospitals to allow visits for ‘end of life’ stages – but with strict guidelines

Patients with Covid-19, who are considered to be at “end of life stages”, may be allowed restricted visits by loved ones, according to new protocols released by some hospitals on Friday.

It will require the permission of hospital management and will be within strict guidelines.

“Visitation for end of life situations will continue to be arranged by the hospital general manager to ensure a compassionate approach, regardless of a patient’s Covid-19 status,” said Netcare.

“Such visitation is subject to certain conditions, which will be discussed with the patient’s family. However, Netcare hospitals will accommodate requests as far as possible.”

Melomed said: “There are no visits to people with Covid-19, but we will arrange a visit to the Covid-19 patients, who are at the end of life stage. We will provide the full [personal protective equipment] to the visitor with strict control measures.”

Families, nurses and doctors have anguished over families and loved ones not being able to visit patients with Covid-19 at hospitals.

But as hospitals return to doing elective surgeries and treating chronic conditions, which were neglected because of the fear of going to a hospital during the lockdown, there are new rules.

Different zones can be expected in a hospital, depending on the outcome of a Covid-19 test or whether a result has been received, pre-admission tests for elective surgeries, and restricted visits, with Covid-19 prevention measures being enforced.At Melomed from 1 September:

– Specialist consultations or visits: A patient may be accompanied by one person.

– Paediatric consultation or visits: Either the parent, grandparent or guardian may continue to accompany the patient;

– Antenatal visits and birth deliveries : The expecting patient will be allowed to have their birthing partner accompany them to antenatal visits;

– The partner may attend the birth delivery and stay with the mother until transferred to the room or ward;

– The partner can visit every night the patient stays;

– The partner will not be required to have a Covid-19 test, but must ensure they are not exposed to the virus; and accepts that very strict infection prevention controls will be put in place;

– This is subject to the discretion of the treating specialist;

– Nursery or Neonatal ICU: Only one person allowed in and either the mother visits for the duration of the admission, or the partner visits for the duration of the nursery admission, not both or splitting the visits;

– With the approval from the treating specialist and the hospital manager, an exception can be made for long-staying neonatal admissions with strict health, infection and safety protocols in place.

– Only one parent will be allowed to accompany the admitted child to the paediatric units. They will not have to have a Covid-19 test, but must make sure they are not exposed to the virus, and that they maintain strict hygiene protocols;

– Terminally ill patients and patients facing “end of life” situations: Visitation will be arranged and approved by the hospital manager in accordance with strict precautions, and at the discretion of the treating specialist.

– Other visits: Hospital management can be contacted for other visitation requests.

– Support groups: Antenatal classes, the monthly Saturday out-patient support group at Melomed Claremont, and the monthly post-natal classes at Melomed Tokai will resume, but a space must be booked.

Netcare said people were going out more, and were back at their places of work, but many were still hesitant to get hospital care – even when they needed it.

Jacques du Plessis, managing director of Netcare’s hospital division, said with all of the precautions in place, hospitals were among the safest places to be, and people could not continue putting off important treatments.

Limited elective surgery resumed at Netcare in May for “medically necessary time sensitive procedures” – but, on Friday, it also released its new protocol for hospitals during Level 2:

– Patients must still test for Covid-19 at least 72 hours before their planned admission; self-quarantine from the time of testing to admission; present their results on the day of their planned admission; and have digital screening.

– Antenatal visits and births : Birthing partners can accompany expectant mothers to antenatal visits at Netcare hospitals, at the discretion of their obstetrician. Partners must complete digital screening and a risk assessment questionnaire, and adhere to strict infection prevention measures;

– Birthing partners may, as was the case up to now, attend the delivery of the baby. Thereafter, the birthing partner may visit the new mother once a day.

– Visits can be arranged for “end of life” patients out of compassion, regardless of whether they have Covid-19.

– Nursery and Neonatal ICU: Only one parent at a time is allowed to visit on condition that the visitor has had no Covid-19 exposure and, if the parent visiting is not an in-patient, they will need to complete the digital screening for Covid-19 and the risk assessment questionnaire;

– Grandparents and siblings: No visits allowed.

– Paediatrics: Only one parent at a time is permitted to live in with an admitted child. The parent is required to have had no Covid-19 exposure and will need to complete the digital screening for Covid-19, a risk assessment questionnaire and comply with protocols.

The Western Cape government said on Thursday it is working on phasing in elective surgeries to public hospitals, as the surge in the province passes.

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