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Observational Study
. 2021 Sep;29(9):4895-4898.
doi: 10.1007/s00520-021-06183-z. Epub 2021 Apr 2.

Visitation policies at NCI-designated comprehensive cancer centers during the COVID-19 pandemic

Jonathan C Yeh #  1 , Ishwaria M Subbiah #  2 , Natasha Dhawan  3 , Benjamin W Thompson  4 , Zachary Hildner  5 , Areeba Jawed  6 , Eric Prommer  7 , Christian T Sinclair  5
Affiliations
Observational Study

Visitation policies at NCI-designated comprehensive cancer centers during the COVID-19 pandemic

Jonathan C Yeh et al. Support Care Cancer. 2021 Sep.

Abstract

Purpose: Family/caregiver visitation provides critical support for patients confronting cancer and is associated with positive outcomes. However, the COVID-19 pandemic brought historic disruptions including widespread visitation restrictions. Here, we characterize in-depth the visitor policies of NCI-designated comprehensive cancer centers (CCCs) and analyze geographic/temporal patterns across CCCs.

Methods: The public-facing CCC websites, including archived webpages, were reviewed to abstract initial visitation policies and revisions, including end-of-life (EoL) exceptions and timing of visitation restrictions relative to regional lockdowns. Chi-squared and Fisher's exact tests were employed to analyze associations between geographic region, timing, and severity of restrictions.

Results: Most CCCs (n=43, 86%) enacted visitation restrictions between March 15 and April 15, 2020. About half barred all visitors for COVID-negative inpatients (n=24, 48%) or outpatients (n=26, 52%). Most (n=36, 72%) prohibited visitors for patients with confirmed/suspected COVID-19. Most (n=40, 80%) published EoL exceptions but the specifics were highly variable. The median time from initial restrictions to government-mandated lockdowns was 1 day, with a wide range (25 days before to 26 days after). There was no association between timing of initial restrictions and geographic location (p=0.14) or severity of inpatient policies (p=1.0), even among centers in the same city. Outpatient policies published reactively (after lockdown) were more restrictive than those published proactively (p=0.04).

Conclusion: CCCs enacted strict but strikingly variable COVID-19 visitation restrictions, with important implications for patients/families seeking cancer care. A unified, evidence-based approach to visitation policies is needed to balance proven infection control measures with the needs of patients and families.

Keywords: COVID-19; Oncology; Supportive care; Visitation.

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Conflict of interest statement

The authors declare no competing interests.

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