TORONTO -- There is perhaps nothing more harrowing than dying alone. But for many of the sickest victims of COVID-19, this may be how it ends.

Once unfathomable, it almost became a harsh reality for 81-year-old Bernice Fiala and her three daughters: coming to terms with the knowledge that Fiala’s final days would be spent alone after the hospital banned visitors to protect its patients.

“It’s like a knife. I don’t know that it can get worse than this,” said daughter Joanne King, who stayed connected with a nightly phone call after she was no longer allowed to visit.

“It’s agonizing and gut wrenching. I can’t even put it in words what it feels like.”

Fiala was admitted to Chatham-Kent Health Alliance, a hospital in Southwestern Ontario, on March 16, where she tested positive for COVID-19. She is now on life support and her daughter Joanne was the only visitor allowed until this week when the hospital initially said visits with her dying mother were now banned.

The hospital appeared to have a change of heart after it was contacted by CTV News, saying all patients who were imminently dying could have a loved one with them.

So if Fiala is taken off life support, her daughter, Joanne, will be there.

But not everyone is so lucky.

When Mubarak Popat became infected with COVID-19 earlier this month, it took just over two weeks for the disease to claim his life. Popat’s daughter, Nooreen and his son-in-law Rick, are both doctors and work in the hospital where he died.

It was heartbreaking, they said, not being able to be with him in his final moments. The experience was “devastatingly isolating” and heartbreaking for Popat’s daughter, knowing that his father would have felt alone in his final moments.

It is the cruelty of this virus -- to stop its virulence from spreading, to protect loved ones, it forces everyone to stay physically apart. It deprives the dying of comfort from loved ones, and the healthy from saying goodbye.

Medical ethicists say what would once have been considered inhumane is now the reality in this new pandemic world. There are no national guidelines for how hospitals should handle end of life COVID-19 cases.

“As deaths from COVID-19 increase, more and more families will face this situation,” said Ron Butcher, a medical ethicist based in London, Ont.

For Fiala at least, she will have her family with her via an iPad in her final moments, with her daughter Joanne by her side.

With files from CTV Toronto’s Sean Davidson