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Coronavirus and the palliative care response

In unprecedented times, the EAPC knows that many of our members, supporters and colleagues are providing care in challenging circumstances.

We would like to help in any way we can and have set up a web page for our members to source and share important information and updates on caring for people with COVID-19. Please let us know if new or updated resources become available.

Latest news and first hand information will continue to be shared on our EAPC Twitter, Facebook and the EAPC blog.

 

Information from Affected Countries
Italy

Characteristics of patients who died positive for COVID-19 in Italy (information in Italian from the Italian Higher Institute of Health) 

Response and role of palliative care during the COVID-19 pandemic: a national telephone survey of hospices in Italy view pdf (preprint of a survey in press)

From the front line: Palliative care in Bologna during the COVID-19 crisis. EAPC Blog post by Dr Danila Valenti, Medical Director of UO Rete delle Cure Palliative. https://eapcnet.wordpress.com/2020/03/22/from-the-front-line-palliative-care-in-bologna-during-the-covid-19-crisis/ 

Helpful resources from our Italian colleagues. We would like to thank Società Italiana di Cure Palliative, Dott.ssa Danila Valenti, and Dott. Simone Veronese for providing the following documents:

  • Communication toolkit to help general staff with patient / family conversations – what to say and how;
  • Palliative care team referral form – to help quickly capture the relevant information
  • Example of operational guidelines  - specific to one locality, but help palliative care professionals to think through the operational steps needed
  • Word version of Communication toolkit and Pall care referral form for local adaptation if needed

View resources here translated to English

 
Important sources of information

1.     The World Health Organization (WHO)

WHO guidelines for the treatment and control of the Coronavirus

WHO specific guidelines for healthcare workers on COVID-19

WHO: Infection Prevention and Control (IPC) for novel coronavirus (COVID-19)

WHO Europe update on COVID-19

Responding to COVID-19: Real-time training for the coronavirus disease outbreak

Integrating palliative care and symptom relief into responses to humanitarian emergencies and crises: a WHO guide

Coronavirus disease (COVID-19) advice for the public: When and how to use masks

Advice on the use of masks in the community, during home care and in healthcare settings in the context of the novel coronavirus (COVID-19) outbreak

Home care for patients with COVID-19 presenting with mild symptoms and management of their contacts

Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19) interim guidance 19 March 2020

Q&A on infection prevention and control for health care workers caring for patients with suspected or confirmed 2019-nCoV

Infection Prevention and Control for the safe management of a dead body in the context of COVID-19 Interim guidance 24 March 2020

 

2.     The European Centre for Disease Prevention and Control

Daily risk assessment on COIVD-19

National information resources for the public on COVID-19 This link gives information about all European countries and key contacts to national health services.

 

3.     European Commission

Risk assessment, Prevention and Questions and answers

  

4.     Centers for Disease Control and Prevention (USA)

Key facts on Coronavirus

 

5.   National Guidelines

Palliative Care Australia Statement on Coronavirus Disease 2019 (COVID-19) March 2020

DGP, Germany DGP Handlungsempfehlung Palliative Therapie bei COVID-19

SFAP, France  have published guidances ("tools and resources" in French) on palliative care for patients with Covid-19 available here: http://www.sfap.org/actualite/outils-et-ressources-soins-palliatifs-et-covid-19 These include breathlessness (clinical guidance),
suffocation (clinical guidance), effective communication and empathy (communication skills = French translation of VitalTalk Covid-Ready), critical care utilization (ethical decisions), adapting palliative care provision to the pandemic (health care planning)

SICP - FCP, Italy press release on "Clinical ethical recommendations for the allocation of intensive care treatments in excepional, resource-limited circumstances" - SIAARTI - 6 March 2020 View pdf  Other guidance from the Società Italiana di Cure Palliative is available at https://www.sicp.it/la-questione-del-momento-epidemia-sars-cov-2/ and https://www.sicp.it/aggiornamento/linee-guida-bp-procedures/ 

Association for Palliative Medicine of Great Britain and Ireland have produced a guidance document "COVID-19 and Palliative, End of Life and Bereavement Care in Secondary Care Role of the specialty and guidance to aid care" (22 March 2020). An editable word version is also available from their site at https://apmonline.org/

NICE, UK have published a Covid-19 rapid guidance for critical care including a 1-page critical care admission algorithm view here

National Hospice and Palliative Care Organisation, USA Communications on Coronavirus (COVID-19) including factsheets and guidance for frontline staff

National Palliative Care Commission of Portugal with the Social Work task-force of the Portuguese Palliative Care Association, Good Practices for Social Work - COVID19 (english pdf)  original version in Portugese on website 

The Centre to Advance Palliative Care, USA (CAPC) are offering virtual free office hours. These provide an opportunity for the palliative care community to discuss how they are responding to challenges presented at this time due to COVID-19.  https://www.capc.org/events/ 

 

6. National Guidance in Low and Middle-Income Countries 

Interim Guidelines on Management Of Covid-19 in Kenya Covid-19 These consolidated guidelines provide recommendations for comprehensive prevention and case management strategies in Kenya [updated 24.3.20] 

Cairdeas International Palliative Care Trust website has 11 symptom guidelines developed by MPCU and shared through the Integrate THET project. They can be used in poster form or as laminated A4 on clinical areas https://cairdeas.org.uk/resources/core-resources/core-textbooks

 

7.    Worldwide Hospice Palliative Care Alliance

WHPCA partner resources for COVID-19

A WHPCA webinar on Coronavirus and people with serious conditions and underlying health issues was held at 2pm UK time on Friday 20 March listen to the recording at  https://bit.ly/3dhv3SY

 

8. International Association for Hospice and Palliative Care (IAHPC)

The IAHPC has compiled this list of resources relevant to palliative care and COVID-19 published by academia, civil society organizations, member states and special agencies of the United Nations, with links to all of the websites and documents listed. http://globalpalliativecare.org/covid-19/

 

9.    Scientific Journal Publisher Collections 

Liebert Portfolio (publisher of Journal of Palliative Medicine) have provded a direct link to access all coronavirus-related research within the Liebert portfolio: www.liebertpub.com/coronavirus for EAPC members.

SAGE (publisher of Palliative Medicine) have created a microsite with free-to-read medical research from SAGE related to the virus as well as social and behavioral research to help decision-makers deal with the outbreak and its impact: https://journals.sagepub.com/coronavirus

The New England Journal of Medicine (NEJM) has provided a collection of free papers regarding COVID epidemic – see https://www.nejm.org/coronavirus?cid=DM88311&bid=165326853  

The Journal of the American Medical Association (JAMA) has produced a COVID-19 collection, including Q&A's https://jamanetwork.com/journals/jama/pages/coronavirus-alert 

The British Medical Journal has a page covering of the coronavirus outbreak from across the BMJ's journals and learning resources. All articles and resources are freely available. https://www.bmj.com/coronavirus 

Recent content from BMC and SpringerOpen journals relevant to coronavirus research, as well as additional commentary on this topic, has been shared by the publisher at https://www.biomedcentral.com/collections/coronavirus  

The Lancet has created a Coronavirus Resource Centre bringing together content from across The Lancet journals as it is published. All COVID-19 content is free to access. https://www.thelancet.com/coronavirus 

 

10.    Palliative care related publications and articles

We can’t be squeamish about death. We need to confront our worst fears Newpaper article The Guardian, UK

Palliative care in humanitarian crises: a review of the literature Open access paper from the Journal of International Humanitarian Action

Palliating a Pandemic: ‘‘All Patients Must Be Cared For’’ article from the Journal of Pain and Symptom Management

How Hospitals, Hospices & Care facilities can use Skype to reduce loneliness during the Coronavirus (COVID-19) pandemic BMJ blog post from James Norris, Director of the Digital Legacy Association, London @JamesNorris

Symptom management for adult patients with COVID-19 receiving end-of-life supportive care outside of the ICU adapted from BC Centre for Palliative Care Guidelines with input from Palliative Care MDs & pharmacists

Coronavirus/covid-19 emergency: 10 Steps for talking to your children about it   Guidance produced and translated to English from the Patrizio Paoletti Foundation. The original version is available to view in Italian at Emergenza Coronavirus: 10 passi per parlarne con tuo figlio

The National Health Library and Knowledge Service (NHLKS) librarians, Ireland have collated a selection of key evidence sources on the Coronavirus Covid-19 including point of care tool summaries, articles collections and evidence summaries

Start thinking about palliative care in times of a pandemic: The case of corona … Blog by Professor Dr Christoph Ostgathe EAPC President https://eapcnet.wordpress.com/2020/03/20/start-thinking-about-palliative-care-in-times-of-a-pandemic-the-case-of-corona/

Selection of free access journal articles dedicated to the covid 19/ sars Cov- 2 pandemic (collated by colleagues from SCIP, Italy) view here

VitalTalk (Seattle, USA) have produced a playbook to provide some practical advice on how to talk to patients and families about some difficult topics related to COVID-19 https://www.vitaltalk.org/guides/covid-19-communication-skills/ This is available to download in the following lanugages: English ,  Spanish / Español ,  French / Français ,   German / Deutsch , Portuguese / Português ,  Arabic / العربية ,  Dutch / Nederlands ,  Hebrew / עברית  ,  Russian / Русский , Tagalog / Tagalog ,  Japanese / 日本語  ,  Norwegian / Norsk

The Digital Health Cooperative Research Centre (DHCRC) Australia have produced a webinar recording and associated resources [18.3.20]. COVID-19 and digital technology: The roles, relevance and risks of using telehealth in a crisis https://www.digitalhealthcrc.com/telehealth-webinar

St Christopher's Hospice, UK have produced a set of four videos designed to help people maintain strength and function and also to aid relaxation at home

FutureLearn have developed two free online courses for the general public and healthcare staff:

  • COVID-19: Tackling the Novel Coronavirus course developed over the last few weeks by the London School of Hygiene & Tropical Medicine Join now (commenced 23.3.20)
  • Managing COVID-19 in General Practice led by experts at St George’s University of London. For front-line clinicians, healthcare workers and professionals to access up-to-date, reliable advice to keep a healthcare practice running safely. This course is open for enrolments now and starts on April 6th.