Deaths in isolation have been treated as a painful memory, not as a problem that hospitals need to address. He was one of the few ICU patients whose face I saw in early 2021, when COVID raged through Los Angeles. As a palliative-care physician, my job was to meet, over Zoom, with the families of intubated patients to ensure that they had complete medical updates and to help them make difficult medical decisions on behalf of their loved one, particularly when that person faced death. But in a surreal departure from my usual practice, I’d never once seen these patients myself: At the time, to minimize exposure to COVID, the only people permitted to enter the ICU regularly were members of the ICU team.
This particular patient had survived several risky surgeries the year before; he’d returned to the hospital that winter after he became short of breath and began to gasp for air, his wife panicking as she watched his lips turn blue. He’d quickly required intubation and medications to increase his dangerously low blood pressure. His wife told me that during his many previous illnesses, she had slept every night in his hospital room, making sure he asked for pain medications and watching movies with him to pass the time. “He fought harder to live when I was there,” she told me. I dreaded explaining to her, and to all my patients’ families, that our hospital would allow a visit only if a patient became irreparably sick; even then, just one family member, unrecognizably ensconced in layers of PPE, could spend 10 minutes in their room before a physician removed life support. I struggled to tell those families that many of my patients still died alone, their condition sometimes worsening too suddenly and unpredictably for a loved one to arrive in time.
The tragedy of people suffering and dying alone is one of the enduring and unaddressed traumas of the pandemic. During early surges, we restricted visits to stop COVID from spreading. Yet even when the number of infections dropped and rates of transmission slowed, many of these strict policies remained in place, despite the immense damage they did to patients, families, and hospital staff.