A committee hearing last week revealed how angry the public still is with the health care system’s patient isolation policies during the Covid pandemic, and how the health care system itself would probably do it all over again, if needed.
The House Health and Social Services Committee heard from Alaskans from across the state last week about the horrors of people dying alone during the Covid-19 pandemic, without a loved one to hold their hand. People told their stories of having been prohibited from being with their husbands, grandparents, and children as they died or were on the brink of death in hospitals during the pandemic, when hospitals enacted strict “no-visitor” rules.
Rita Trometter from North Pole describe how, several years ago, her adult-age son came down with a terminal medical condition.
“As parents, we promised him that he would never be alone,” she said. She, her husband, and friends would take turns being with him in the hospital.
“He was with persons he trusted and felt comfortable with 24-7,” Trometter told the committee. “Yes, I slept in his room, even when medical staff made it less than desirable. This is what we do for our family and especially our children.” Having her son not feel alone made all the surgeries, medical procedures, paperwork, and doctor interactions less stressful.
“No matter the age, your child is always your child,” she continued. “During the ‘plandemic,’ those options of making your child or loved ones and oneself feel secure disappeared. The result is that any future government control upon our lives for medical care will diminish the small amount of trust that is left in the field of medicine.”
Kristin Hills of Big Lake described how her grandmother in 2020 was diagnosed with a brain tumor and entered hospice care, “where she was held as a prisoner for five months. She would call home depressed and angry and scared and alone, and she wanted her family there with her … She had no one.” The family had always promised her she would not die alone, but their hands were tied.
The idea that isolating her grandmother would prevent her from getting Covid didn’t work, Hills said, because the staff brought the virus in and she was infected with it anyway.
“Family couldn’t kill her, but staff could kill her. My grandmother died with no one being able to go and sit with her … She ended up saying goodbye to her family on a Zoom call. She died in the night and we now live with pain knowing we could not give grandma her last wish — not dying alone.”
Hills also described how a family member who is mentally disabled, with the intellectual ability of a five-year-old, was diagnosed with Covid and ended up so dehydrated that he needed to be hospitalized. He was in MatSu Regional Hospital for six days without his family being able to be with him.
“I am appalled that we are even discussing in a free society whether or not we can sit with our loved ones when they are sick or when they are dying,” Hills said. “This is the exact same thing that happened in Nazi Germany and yet here we are allowing the same thing to happen in our country.”
Others called into the committee with similar stories of their loved ones dying alone in the hospital — and not necessarily dying from Covid but being kept in isolation from family due to the contagious disease that had caused hospitals to enact their strictest policies.
HB 52 is sponsored by Rep. Sarah Vance of Homer with cosponsors Rep. Kevin McCabe of Big Lake and Rep. Ben Carpenter of Nikiski. Vance brought a similar measure to the House in 2021, when she introduced it as an amendment into a telehealth bill during a special session. Her amendment was supported by the majority of the members. But then it got tangled in politics and the bill was tabled a the request of the hospital association.
Bernadette Wilson, state director of Americans for Prosperity Alaska, reminded the committee of Marvin Abbott, who spent a month camped on the lawn at Providence Alaska Medical Center, while his medically fragile daughter was alone in side in critical care for asthma. Several others from Anchorage joined the Kodiak man in his protest on the lawn of the no-visitor policy during the Covid pandemic.
But Rep. Zack Fields, a Democrat from Anchorage who appears to favor the hospital no-visitor policy, challenged Wilson by asking her why Americans for Prosperity was advocating for more regulations on hospitals. Wilson responded that AFP has always been pro-freedom and pro-family, and that she would be happy to sit down with him and go over the group’s priorities and how the group’s support for HB 52 fits within the concept of personal freedom.
Rep. Dan Saddler asked Jared Kosin, who runs the Alaska Hospital and Health Care Association trade group, if the hospitals intended to apologize to people who were torn from their families because of the no-visitor policies.
“You said there was no change in visitation policies, but there was implementation of existing policies that had rarely been implemented. In other words, this was not new policy, this was just extremities, which resulted in the denials of visitation,” said Rep. Saddler.
“Visitation had never been restricted to this degree, never, that we know of, in our lifetimes,” Kosin said over the phone to the committee. “And so pre-Covid and through covid, the written policies around visitation did not change. The policies and the way they were written were used accordingly, based on the situation.”
The policies contemplated clinical situations where visitation would need to be restricted, Kosin said. “It’s got to be reasonable judgment, it’s up to the clinical team, basically. What I’m saying is, those policies never changed during covid, those medical teams exercised those policies as written.”
Rep. Saddler was not quite satisfied.
“Mr. Kosin, I did hear a bit of a mea culpa in your comments. You said, you did acknowledge the horrific situations that came about, and I think I also hear you saying that should there be another pandemic of a high-infectious disease in the future, that the same policies that allowed the visitation limitations in the past would be applied in the future. So I’m going to offer you this opportunity. Is there any way that you think the health care industry might implement those policies differently should we have another pandemic?” Saddler asked Kosin.
“The problem is we’re all trying to predict what a future pandemic may be,” Kosin responded. “We have no idea what it will be. We have no idea if it’s something that’s going to target adolescents, we have no idea if it’s going to be something that goes back to The Plague in Medieval times.” The policy allows hospitals to deal with circumstances that are, as of now, unknown. There are situations that call for clinical judgment where visitor limitations “may be necessary,” he said.
Later in the hearing, Saddler tried again with Kosin, “Without exposing your association or any health care practitioner to liability, we seem to have a conflict here between humanity and epidemiology. Is there any way the health care industry might express an apology to the families of people whose loved ones died alone?
Kosin disagreed: “I’d be the first person to say we’re all sorry for anyone who has to experience a situation where you can’t have loved ones come and visit … But we’re all human beings, and we all went through something, and saw things in very different ways, and I guess I would have you pose your question to nurses, doctors, support staff who were at the hospital, who had friends die, who saw trauma … and ask them for the same apology.”
Kosin ended up dominating the hearing, and several Alaskans were not able to be heard.
Jennifer Kadake of Kake testified on behalf of people living in rural Southeast Alaska and had a non-Covid story that illustrated the problem from a different angle — that of informed consent and the need for patients to have their own advocates with them. She described how she was involved in a vehicle accident in which, while her wounds were severe, her vital signs were stable and she was coherent.
“If I had had the ability to have with me a support person of my choice during my medical treatment, a very painful experience that continues to actually give me nightmares, would have been absolutely avoided,” she said. “If I had the right to have a support person of my choice with me, my support person would have informed the medical providers that they were treating someone with a background in the medical field, trained to perform emergency medical intervention, like an intraosseous infusion, also known as an ‘I.O.'”
During her emergency treatment at her home village health center, the medical provider could not get intravenous access, resulting in the choice to proceed with the excruciating I.O. She said that because she had no support person with her, she was forcefully restrained by the local volunteer emergency care team and given the painful procedure, which involves gouging a needle into the bone until it reaches the marrow.
“If I had had the right to have a support person of my choice with me, my begging and screaming refusing the I.O. procedure would not have been ignored,” she said. The medical provider missed the first attempt and the painful procedure was reattempted. “That was about the time I passed out from pain.”
Kadake said that informed consent is not being practiced, and that patients need an advocate with them, if possible. She pointed out that for small communities like hers, patients are not told of their rights to a support person of their choice at rural emergency medical facilities, “much less information given to the patient of their patient rights at all.” She said the people in Alaska seeking medical treatment in any capacity have the right for support.
Others who testified in favor of HB 52 included Barbara Tyndall of North Pole, former Rep. Chris Tuck of Anchorage, Larisa Fonov of Wasilla, Kelli Toth of Chugiak, Alison Libby of Anchorage, Connie Graff of Anchorage, Peggy Rotan of Anchorage, and Evelyn Dutton of Anchorage.
