Restricting family presence due to COVID-19: The harms we do not see

Policies that limit family presence during acute illness, such as the widespread visitation restrictions enacted during the COVID-19 pandemic, are harmful to patients, family members, and clinicians. These consequences have not been balanced by evidence that these restrictions have accomplished their intended goal of limiting COVID-19 spread, nor that such restrictions reduce staff distress or improve their efficiency. While we continue to accumulate evidence of the negative impact of policies restricting family presence, the absence of family members in the hospital most often leads to invisible harm. Health care systems do not regularly measure or document the impact of their clinical practices and policies on family members. Therefore, the consequences of family separation during an acute illness can be difficult for inpatient clinicians to recognize because many of the individuals affected are not physically present in the hospital. Although clinicians may be aware of the downstream consequences of visitation restrictions for patients, including an increased risk of delirium and delayed decision-making, they may not always attribute these challenges to the absence of family members.