Developing the hospital visitation policy is one of the many incredibly difficult tasks we face in this pandemic. In some places (NYC), the policy is simple: no visitors, no exceptions. Goodbyes are said by phone, if at all. 1/ https://twitter.com/cdichang/status/1252376849113427972">https://twitter.com/cdichang/...

In these circumstances, one of the more touching extended roles of healthcare professionals has been to collect words or observations at the bedside to share later with families of lost loved ones: https://twitter.com/columbiasurgery/status/1250785728394559488?s=21">https://twitter.com/columbias... 2/ https://twitter.com/columbiasurgery/status/1250785728394559488">https://twitter.com/columbias...

In other places, where pandemic has not hit as hard, and where some PPE is available, we have the luxury of letting in a small handful of visitors, usually only for certain circumstances: end of life moments, small children, patients with specific care needs. 3/

This feels compassionate, and yet once an exception is made, the complexity explodes. How do you balance infection control with the desire to give a final goodbye? How do you balance empathy & good PPE stewardship, which protects everyone? How do you make exceptions equitably? 4/

In normal times, we advocate for the best interests of individual hospital patients: in these kind of times, every kindness comes with a huge potential cost to other patients, all hospital workers, and the entire community outside. 5/

It’s people like me - a sucker for kindnesses with immediate emotional kick back - who have the potential to do real harm with visitation exceptions. Public health measures can have a cold edge.