Advancing Health Equity by Translating Lessons Learned from NICU Family Visitations During the COVID-19 Pandemic

Introduction

Since its emergence in December 2019, the severe acute respiratory syndrome coronavirus 2, also referred to as the novel coronavirus 2019 or COVID-19, has created a global pandemic. To date, there are over 39 million confirmed cases worldwide and over 8 million confirmed cases in the United States. (1) Although many questions regarding children affected by the virus are unanswered, the pandemic has highlighted inequities in the US health care system and has demonstrated the potential of advocacy to influence policy changes. Although the pandemic remains a tremendous challenge, we present a perspective on how lessons we have learned during this pandemic may translate to further advocacy for equity in neonatal care.

As new data on COVID-19 are collected on both the national and international levels, guidance and policy changes have been rapidly developed and evolving. Though this disease appears to be affecting children more mildly than adults, its rapid spread and disruption of the social infrastructure has influenced advocacy and protective efforts for children worldwide. For example, policies on visitation in the NICU have varied widely in the United States and have continued to evolve throughout the pandemic. Although these visitation policies were implemented based on concerns for the safety of patients, families, and health care workers, the implications of these policies and the evidence to support them have been questioned by clinicians and family advocates. Although this advocacy has led to positive change, it brings to light the disparities that may be exacerbated by such efforts. We provide some recommendations on how to navigate these lessons learned with a centering on the social determinants of health and encourage others to critically examine further opportunities for change.