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After COVID-19 crisis in Italy, serious restrictions have been introduced for relatives, with limitations or prohibitions on hospital visits. To partially overcome these issues “WhatsApp” has been adopted to get family members to participate in clinical rounds. Family members of patients admitted to the acute palliative care unit and hospice were screened for a period of two weeks. Four formal questions were posed: 1) Are you happy to virtually attend the clinical round? 2) Are you happy with the information gained in this occasion? 3) Do you think that your loved one was happy to see you during the clinical rounds? 4) This technology may substitute your presence during the clinical rounds? The scores were 0 = no, 1 = a little bit, 2 = much, 3 = very much. Relatives were free to comment about these points. Sixteen of 25 screened family members were interviewed. Most family members had a good impression, providing scores of 2 or 3 for the first three items. However, the real presence bedside (forth question) was considered irreplaceable. They perceived that their loved one, when admitted to hospice, had to say good-bye before dying.

Italy was the first Western country to face COVID-19. It was endemic in Northern Italy,1 but minor in Southern Italy, particularly Sardinia and Sicily. On 9 March the government issued a complete lockdown to prevent contagion. The decree included serious restrictions and prohibitions on visits to patients in hospital.2 As a consequence admission to hospice stopped. After long negotiations, patients might be admitted—but alone, and after death just one relative was allowed see the body. This continued until the last week of May, when relatives (just one) were again allowed to stay in the mini-apartment in hospice. We analysed hospice activity before and after the COVID-19 crisis. The 10-bed hospice opened in November 2019 to support the existing acute palliative care unit with 8 beds, in a comprehensive cancer centre. The latter unit has its own peculiarities, being particularly devoted to symptom management during active antitumour treatments. Simple available technologies provided temporary communication models, but did not substitute for physical presence. One relative reported: ‘After hospice admission, I will not see him/her anymore’.3 …