Manitoba moves to loosen COVID-19 hospital visitor restrictions

By | June 3, 2020

Patients in hospital may soon be able to have visitors by their bedside again — but the province hasn’t said who will get priority or when the rules might change.

Manitoba Shared Health plans to release guidelines later this week to ease some visitor restrictions in place since March because of COVID-19.

“We have developed some guidelines for in-patient visits. They’re just going for consultation now,” Chief Nursing Officer Lanette Siragusa said Monday.

“It will ease the burden I know many of you are feeling,” she said.

For nearly three months, visitors have been banned from all acute care facilities at Manitoba hospitals, with certain exemptions including compassionate or end-of-life reasons.

But many families with dying relatives described confusion and frustration over what they called arbitrary rules. In some cases, they were only allowed by their loved ones’ bedsides in their dying moments.

This week, Victoria Hospital started a pilot program that allows for short patient visits outside. But it’s only a very small number — each day, a total of six patients are able to have one 45-minute visit with one other person.

Patient advocates said while well-intentioned, the hospital visitor restrictions were brought in across the country in a hurry, without consultation from patients.

“I don’t think we anticipated the patient safety consequences for patients who were all alone,” said Jan Byrd, senior program manager with the Canadian Patient Safety Institute.

“The policies around ‘no visitors’ have to change.”

Physical and psychological effects

The restrictions have psychologically hurt many patients and their families, Byrd said.

“We’ve heard so many stories from people about how negative that’s been,” she said.

Patients physical health has been impacted too, she said.

“When we don’t have those extra sets of eyes at the bedside there can be really dire consequences,” Byrd said.

When a family member is with a patient, she said, they are more likely catch when medication is incorrectly given to the patient, stop their loved one from falling, and help advocate for them when they’re too tired or ill to speak up.

Byrd said with its low COVID-19 infection rate, Manitoba could be a leader for other provinces in how it loosens its restrictions.

Patient safety advocate Jan Byrd says while blanket visitor restrictions were initially brought in to protect patient safety, policy makers are now seeing the ban has had detrimental impacts on the psychological and physical health of patients. (Jeff Stapleton/CBC)

Winnipeg epidemiologist Cynthia Carr said health-care facilities have to balance bringing back desperately needed visitor support, while still keeping staff and patients safe.

Part of what makes this confusing for families is that each hospital needs to decide whether they’re able to welcome visitors, which can change from day to day.

“They have to assess, is the ICU full right now? How dangerous is it to have somebody else come into the system? How many patients do we have that have COVID-19 or other infectious disease?” she said.

There also needs to be enough protective equipment for staff before giving any to visitors. The supply of things like masks, gloves and gowns was a real concern at the beginning of Manitoba’s COVID-19 cases, Carr said.

Allowing each hospital to make its own decisions allows for more flexibility, but can also put a lot of pressure on staff to make difficult judgment calls during a pandemic no one had dealt with before.

“When you didn’t know, the default for somebody in health care would be to say, ‘Right now I need to say no, because I need to protect the safety of our staff … and all patients.” she said.

The decision to open hospitals to visitors comes with more risk than opening other things like restaurants or gyms, Carr said, because hospital workers are at higher risk of getting the disease because of how close they work with patients.

While the percentage of Manitobans who could have COVID-19 is low right now, a person who is ill in hospital has a weaker immune system, meaning they could be more likely to catch the virus than the average person.

That risk increases when you’re having a conversation within six feet for more than 15 minutes, she said.

“When you go to see somebody in the hospital, the first thing you do is you lean in, you want to touch them, you want to fix their hair, fix their gown, those kinds of things,” she said.

Winnipeg epidemiologist Cynthia Carr says hospitals have to balanace letting visitors in, while making sure the facility can still keep staff and patients safe within enough personal protective equipment. (John Einarson/CBC)

Manitoba’s current visitor guidelines limited

While provinces across Canada have all brought in visitor restrictions, they vary in how detailed they are. Unlike Manitoba, some of them allow visitors for patients who are in ICU or undergoing major surgery.

Saskatchewan and Alberta have their restrictions more clearly outlined, and currently allow visitors for patients with mobility, visual, hearing, or memory impairment. Saskatchewan also allows visits for patients who have a  “high risk” for loss of life, not just those who are deemed palliative.

Island Health in BC even offers a helpline visitors can call to see if they’re allowed inside.

Manitoba Health Minister Cameron Friesen said Monday the province will work to make sure patients and families understand the guidelines once they’re released.

“We would expect in a very, very short time, that we would be able to land on a proposal that we’ll put in place across our acute settings, but then also communicate broadly and well with people so that they can understand,”

Victoria Hospital piloting small number of outdoor visits

In the meantime, a small number of visits are being piloted at Victoria Hospital, the Winnipeg Regional Health Authority said.

Families who want to visit can call and request, with priority being given to patients who have been in the hospital for longer.

In order to have a visit, the family member needs to pass a screening for COVID-19, while the patient needs to be medically able to be walk or be wheeled down to visit.

The hospital will look at expanding visits in the future based on how the pilot goes, the spokesperson said.

Victoria Hospital is piloting a small number of visitors in its miracle garden. Each patient is allowed 45 minutes with one visitor. Staff stay nearby in case the patient needs medical assistance. (Avneet Singh/Courtesy Winnipeg Regional Health Authority)

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