There were 15,250 new cases of Covid-19 in the community on Thursday, and 22 Covid-related deaths.
Video / Mark Mitchell / Dean Purcell / Michael Craig
A new study is giving an insight into the challenges whānau faced as they saw loved ones die in hospital during alert level lockdowns.
Published in the New Zealand Medical Journal today, researchers interviewed 22 people whose relatives passed away while in Wellington Hospital during the alert level 3 and 4 lockdowns in 2020.
Wellington Hospital, like others across the country, imposed a restricted visitors policy during lockdown, with no visitors allowed in level 4 except on compassionate grounds; and in level 3 one nominated visitor from the patient's bubble was allowed, provided they had no Covid-19 contacts or symptoms.
Limitation of access was a consistent theme in the responses provided by whānau.
"[It's] sad she died alone," one family member said.
"That was the hard part about it. I just feel guilty, I just feel kind of sad that she was alone, that could have been done differently.
"If one of us could have been with him at the end, that would have meant everything to us," another said.
"One of the nurses was holding Dad's hand and you're just watching [by Zoom], you're going, 'God, I wish I could get there'. So it was probably one of the most difficult things I've had to go through in my life," a respondent said.
Wellington Regional Hospital. Photo / Mark Mitchell
While acknowledging the policy's necessity due to Covid-19, the researchers pointed to how family grief could be exacerbated by losing a loved one in isolation.
Other issues raised by whānau related to the quality of clinical care, poor communication and delayed processing of Covid-19 tests.
One family member had experienced the latter, saying they had been told a test result would be returned in 12 hours, but delays and insufficient communication meant their loved one died without the comfort of family.
"I started ringing as soon as it got close to 12 hours. I kept ringing the hospital saying: 'my sisters need to get in there'.
"Third time they told me she didn't have Covid and that my sisters could go in. Fifteen minutes later, they rang me saying she had gone.
"They didn't get there in time. It was obvious she was not going to make it. It is hard, and it was hard leaving her."
Not all feedback was negative - some were grateful for the level of access the hospital could afford in comparison with aged care facilities.
"When the lockdown came through at the rest home, we were blocked from going to see him. It was fortunate he was in the hospital and we were allowed to have the day with him before he passed."
Auckland City Hospital on day one of the city's Delta level 4 lockdown. Photo / Michael Craig
A key part of the study was to evaluate what impact restricted visitation had in a cultural context.
Of the 22 whānau involved, six were Māori and they enforced the importance of health staff understanding death in Māoridom.
"The care in the hospital, from the nurses, was absolutely brilliant. It was two Māori ladies, they just knew the protocol for us. It really was [a help] because they understood where we were coming from," one respondent said.
"We told the [intensive care] staff we don't leave our people alone like this. Not having the support, it was quite hard. It was quite lonely," another said.
The researchers cited the traditional Māori practice of "unbroken accompaniment of the dying person and the body" - something adversely affected by restricted visitation.
"We just found that it was really rushed, we didn't get time to dress her ourselves. We didn't get time to really say goodbye," one whānau member said.
"I rang the funeral parlour and they were cremating her then and there. So we didn't even get to do that either; just made things a hell of a lot harder.
"It breaks your heart to watch your niece sit outside the funeral home for two weeks nearly every day with her children so that she was closer to her mum."
A triage tent set up outside Middlemore Hospital. Photo / Michael Craig
The study also revealed some hospital services usually offered to bereaved families were not available to whānau in the study due to Covid-19, including items used to convey respect for those who had passed.
Researchers recommended that plans around how to care for patients dying in a pandemic setting be established.
Suggestions included the provision of access cards for whānau, daily telephone/Zoom updates from staff, emailing photos of doctors/nurses and the room to whānau, allowing two people rather than one at the bedside, and establishing a bereavement whānau co-ordinator.
"During a pandemic, cutting back on support structures for the dying and bereaved will cause significant distress and harm," researchers said.
Hutt Valley DHB and Capital & Coast DHB provider services director, Joy Farley, acknowledged the pain felt by whānau who had lost loved ones during lockdown.
She said high vaccination levels and infection prevention methods had enabled hospitals to revise their visitor policies, such as giving priority passes to frequent visitors and referring impacted whānau to support services.
"We also allow kaitiaki to stay as long as required – including overnight – and have a priority access card so they can enter and exit without being questioned or queuing," Farley said.
"There are no visiting restrictions on kaitiaki, and a number of our rooms have now been set up with devices to enable patients to communicate with whānau and other visitors who are not able to enter the hospital."
Of yesterday's 22 reported Covid-linked deaths, one was from Northland, 10 were from the Auckland region, one was from Waikato, two were from Bay of Plenty, two were from the Lakes DHB, two were from the Wellington region and four were from Canterbury.
Two people who died were in their 50s, four people were in their 60s, three people were in their 70s, six in their 80s and seven were aged over 90.
