Family Member Visits to Critically Ill Patients During COVID-19: A New Pathway (Telemed J E Health 2020. [Epub ahead of print]; DOI: 10.1089/tmj.2020.29040.rb)
Dear Editor,
We read with great interest the study by Bashshur et al.,1 “Telemedicine and the COVID-19 Pandemic, Lessons for the Future.” This study was enlightening educationally. The authors report a series of important meanings of telemedicine on disease diagnosis and treatment during the COVID-19 outbreak, as well as thinking about the future. This prompted us to start reviewing the new pathway that family members visit critically ill patients—one that we have adopted.
COVID-19 is a serious public-health concern. In China, about a quarter of hospitalized patients should be admitted to a respiratory intensive care unit, although 80% of patients’ conditions are relatively mild.2 Patients who are admitted to a respiratory intensive care unit for illness have mortality rate of up to 49%.2 In the face of the obvious mortality rate, doctors, patients, and their families are usually helpless and opinions are conflicting. Effective treatment for critically ill patients is a common dilemma faced by doctors, patients, and their families. In addition, there are conflicting views over whether family members should be allowed to visit patients during the epidemic. If we adopt a ruthless one-size-fits-all protocol, some severely ill patients will lose the chance to see their families for the last time, which will be a departure from humanitarian practice. Furthermore, the psychological stress brought by the outbreak epidemic may be another important factor that makes the patient’s condition worse. It may be beneficial for patients with severe illness to receive care and comfort from loved ones.
Furthermore, compared to the respiratory intensive care unit, other intensive care unit departments (such as the neuro-intensive care unit, coronary care unit, etc.) also face the pressure of family visits, forcing medical system staff to explore new, scientific, and feasible visiting protocols. We decided to make a new visiting protocol based on the original intention of isolating the virus but not of isolating love. On this basis, we looked at several feasible visiting protocols. We want to share our experience in order to provide a reference for the development of new visitation pathways in intensive care units. It is worth noting that the following protocol has been implemented in some parts of China and has been supported and recognized by the government, medical workers, and patients’ families.
| 1. |
Use of social-networking software based on voice and/or video to visit critically ill patients (this not only avoids direct contact between patients and health professionals, but also could alleviate patient anxiety); |
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| 2. |
Use of a mobile visitation system based on voice and/or video to visit critically ill patients. With the support of network video technology, voice and video communication via LAN is convenient and fast, and can effectively protect patients’ privacy from being leaked. During the operation of the new pathway, patients and their families were very satisfied, and expressed their affirmation and support for the work of medical staff in intensive care units; and |
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| 3. |
Use of a 5G + virtual reality visitation system, opening up a new pathway for remote visits and expert consultation. Under the 5G network, the system can realize bidirectional and real-time transmission of voice and video and support multi-terminal mode. It can also conduct panoramic observation with 360° field of vision and transform the range of sight at will. |
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It is necessary and urgent to adopt a new visiting protocol. Only in this way can we isolate the virus without isolating love, and provide humanistic care for patients who are already facing severe illness.
Ultimately, we hope, this global crisis started with the virus and should end with the elimination of the virus.
Disclosure Statement
The authors report no conflicts of interest in this work.
Funding Information
No funding was received for this article.
References
- 1. . Telemedicine and the COVID-19 pandemic, lessons for the future. Telemed J E Health 2020. [Epub ahead of print];
doi.org/10.1089/tmj.2020.29040.rb . Link, Google Scholar - 2. Rising to the challenge of the novel SARS-coronavirus-2 (SARS-CoV-2): Advice for pulmonary and critical care and an agenda for research. Am J Respir Crit Care Med 2020. [Epub ahead of print];
doi.org/10.1164.rccm.202003-0741ED . Crossref, Medline, Google Scholar