Nursing home visitation restrictions during COVID-19-Balancing compassion and safety.

To the Editor:

It has been nearly a year since COVID-19 was first described, and the current surge in cases coincides with the holidays, which is a difficult time to be alone. We acknowledge and lament that nursing home residents and their families have borne the brunt of this loneliness. We agree with the charge by Storr and colleagues to consider the unintended consequences of isolating nursing home residents in the name of safety during a global pandemic. We agree with their call for a more holistic and humane approach to infection prevention in nursing homes, encouraging the collaboration between staff, friends, and family to meet the medical and nonmedical needs of nursing home residents.

Our letter was written early in the pandemic when our understanding of COVID-19 transmission was limited. For instance, we did not initially understand that COVID-19 patients were infectious before symptoms, nor did we understand which personal protective equipment was most important for reducing transmission (ie, that masks and eye protection are more important than gowns and gloves). Given these knowledge gaps and the personal protective equipment shortages, we restricted all visitors including family and friends to prevent the introduction of COVID-19 into our nursing homes. As our understanding of transmission improved, we began to reopen visitations to include brief, socially distant outdoor visitation and end-of-life care, all with symptomatic screening and strict enforcement of hand hygiene and face coverings for residents and their visitors. Like others, nursing home staff and residents have learned to use technology (eg, Zoom, Facetime, and Skype) to connect with their loved ones, which—while not a replacement for in-person interactions—has allowed them to interact with family and friends from far away. We will never take normal visitation for granted again, and we are optimistic that the advent of vaccination and better point of care testing will soon facilitate the restoration of normal visitation to a population that needs it the most.