Dying Alone Due to COVID-19: Do the Needs of the Many Outweigh the Rights of the Few—or the One?

The COVID-19 pandemic, caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been striking the world since it was first identified in December 2019 in China. The World Health Organization (WHO) declared the outbreak a “public health emergency of international concern” on January 30th, 2020, and recognized its pandemic status on March 11th. The pandemic has caused universal psychosocial impact (1) and global economic disruption. Discourse andmeasures have been discussed focused on lockdown strategies, healthcare policies (2), application of emerging treatments, accelerated clinical trials, among others. Management guidelines are continuously updated based on emerging findings (3). However, as the disease spreads through a community, suffering deepens due to strict procedures that, arguably, may be questioned from an ethical standpoint. The pandemic has sufficiently disrupted and impaired people’s livelihood worldwide, and every effort to prevent any additional suffering must be made. Many have died in isolation. Dying alone is not justifiable, even in times of infection with a pandemic virus, particularly when the impact of imposing such a radical measure on the course of the epidemic is, at least, questionable. Indeed, some have reported that the concern and anxiety of being discriminated against delay the presentation to healthcare services, and delayed diagnosis is associated with more severe disease, mainly in the elderly and in vulnerable groups (4). The fear of being alone in hospital is another barrier in seeking healthcare, and as the number of infected individuals increases within a community, more information on this “loneliness” is perceived and feared. One may argue that the situation, and the subsequent delay in seeking healthcare, would result in negative feedback that ends up sustaining disease spread in a population that is not willing to let their elders die in isolation. Patients with severe COVID-19 are hospitalized and left alone in a room where “spaceship-dressed” health professionals visit them, speaking behind their mask and shields, trying to keep their own social distance with the patient. When patients are transferred to medium or intensive care units, they completely lose connection with their family and friends. They stay in isolation, and in many cases, eventually die, without ever having had a chance to share a final world with their beloved ones.