Allow loved ones to be with dying coronavirus patients, says charity

Families should be allowed to visit dying coronavirus patients in their final moments where possible and be provided with full personal protective equipment to help them do so, bereavement experts have said.

Symptoms are defined by the NHS as either:

• a high temperature - you feel hot to touch on your chest or back

• a new continuous cough - this means you've started coughing repeatedly

NHS advice is that anyone with symptoms should stay at home for at least 7 days.

If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

After 14 days, anyone you live with who does not have symptoms can return to their normal routine. But, if anyone in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start. Even if it means they're at home for longer than 14 days.

If you live with someone who is 70 or over, has a long-term condition, is pregnant or has a weakened immune system, try to find somewhere else for them to stay for 14 days.

If you have to stay at home together, try to keep away from each other as much as possible.

After 7 days, if you no longer have a high temperature you can return to your normal routine.

If you still have a high temperature, stay at home until your temperature returns to normal.

If you still have a cough after 7 days, but your temperature is normal, you do not need to continue staying at home. A cough can last for several weeks after the infection has gone.

Staying at home means you should:

• not go to work, school or public areas

• not use public transport or taxis

• not have visitors, such as friends and family, in your home

• not go out to buy food or collect medicine – order them by phone or online, or ask someone else to drop them off at your home

You can use your garden, if you have one. You can also leave the house to exercise – but stay at least 2 metres away from other people.

If you have symptoms of coronavirus, use the NHS 111 coronavirus service to find out what to do.

Source: NHS England on 23 March 2020

Marie Curie, the end-of-life charity, urged clinicians to show compassion and make efforts to allow close family to be with loved ones, saying it was an “important part of their duty of care”.

It follows the death of 13-year old Ismail Mohamed Abdulwahab in London’s King’s College hospital on Monday without his family by his side. They said on Wednesday that their devastation had been made more difficult by not being with him.

Many hospitals are operating a no-visit policy to restrict the spread of infection, with exceptions only made by special arrangement at the end of life and only for one person. Some provide tablet computers and smart phones as an alternative, but relatives have spoken of their distress at not being allowed to be there as loved ones die. King’s College hospital is operating a guideline that allows end-of-life visits by one person, but it is not clear if this includes Covid-19 sufferers.

A statement on a fundraiser web page for Ismail’s funeral, which had raised nearly £60,000 by Wednesday afternoon, said: “Sadly he died without any family members close by due to the highly infectious nature of Covid-19.”

Family friend and spokesperson Mark Stephenson told Good Morning Britain: “One of the saddest things in this whole situation is that he died alone.

“As you know, when someone has got this infection they’re in isolation. So how difficult it is for a mum not to be able to be with her son at this time when he’s sick?”

Ismail’s family called on the public to follow the government’s social distancing rules as it was clear the virus was attacking people of all ages. They urged people to “stay at home as much as they possibly can, to protect the NHS and save lives”.

“Ismail was a loving son, brother, nephew to our family and a friend to many people who knew him,” they said. “His smile was heart-warming and he was always gentle and kind. He leaves behind six siblings who are completely devastated and this has been made more difficult not being able to be with Ismail while he was in the hospital.”

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Young people remain many times less likely to die of Covid-19 than the elderly. In China, the average age at which people died from Covid-19 was very similar to the average age at which people died normally, according to a Brookings Institute study.

Earlier this week, Tricia Conroy, the daughter of Frank Hammond, 83, who died in Stepping Hill hospital in Stockport, described the “horrendous, heartbreaking” experience of being in contact with him on the phone before he died when they had wanted to be by his side.

Marie Curie urged clinicians to consider the wishes of the dying when considering whether visits are possible.

“We need to get through to the people making these decisions that we understand the complexity of the situation and the dilemma they are in,” said Simon Jones, director of policy at the charity. “But take a moment to think about what is achievable. Is it achievable to isolate the individual in a room? Is it possible to give a small group of people close to them the full personal protective equipment they need to be with them in their last hours?”

“People want to depart this world in the comfort of those who love them wrapped around them,” said Jones. “Someone holding their hand, resting a hand on their forehead or cradling them – it’s a human emotion to want to help someone through the passage from life into death. The experience of being there when someone takes their last breath for many people is very helpful in the grieving process.”

He said taking steps to bring people together, if possible without spreading infection, could have “an important impact on where this nation is in terms of the grief and bereavement left behind”.

Shirley Potts, regional development director of Child Bereavement UK, said: “There will be awful consequences of people who feel the way their loved one died has impacted greatly on their grief. We have an innate concern to have people die close to members of their family. If it was one of my children or grandchildren I would desperately want to be with them.”

But she said medics had to weigh this with limiting the spread of the virus and she added that in many cases, the dying person may not be aware of what is going on around them.