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 this 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. On the EAPC blog we have created a coronavirus category with a small but growing collection of first hand stories, Coronavirus and palliative care.
Table of Contents
Important sources of information
The World Health Organization (WHO)
- WHO guidelines for the treatment and control of the Coronavirus
- WHO Europe update on COVID-19
- Responding to COVID-19: Real-time training for the coronavirus disease outbreak on hand hygeine, PPE, infection control etc
- Integrating palliative care and symptom relief into responses to humanitarian emergencies and crises: a WHO guide
- 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 for coronavirus disease (COVID-19) and considerations during severe shortages (6 April 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
EUROPEAN Guidance
The European Centre for Disease Prevention and Control
- Daily risk assessment on COVID-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.
European Commission
European Society for Medical Oncology (ESMO) have developed structured simple care pathways to assist clinicians dealing with the palliation of patients with COVID-19 view here
The Bereavement Network Europe is gathering COVID-specific bereavement information and resources which have been developed by colleagues across Europe. view here
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. view here
National Guidance in Low and Middle-Income Countries
KENYA 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 view here
INDIA Palliative care experts in Kerala India have developed guidelines for integration of palliative care with Covid-care. PallicovidKerala’s E-book on palliative care guidelines for COVID19 (version 1) is aimed at health care professionals view here
Russian Association of Hospice Care Professionals partner of Worldwide Hospice of Palliative care Alliance, American Eurasian Cancer Alliance, PACED and other leading international palliative care groups have worked to produce a special issue of its quarterly “Pallium” magazine for all palliative care specialists working under the pressure of the COVID-19 pandemic throughout Russian Federations, CIS perimeter and beyond. English version and Russian version
National Guidelines High Income Countries
AUSTRALIA
Palliative Care Australia has formed the Australian COVID-19 Palliative Care Working Group (ACPCWG) in partnership with the Australian and New Zealand Society of Palliative Medicine (ANZSPM), Palliative Care Nurses Australia (PCNA), Australasian Chapter of Palliative Medicine (AChPM) of the Royal College of Physicians (RACP), End of Life Directions for Aged Care (ELDAC), Paediatric Palliative Care Australia and New Zealand (PAPCANZ), CareSearch and caring@home. For ACPCWG-related updates and resources view here
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 view here
BELGIUM
Palliaguide is developed by the Walloon and Brussels Federation of Palliative Care view here
CANADA
The Humanitarian Health Ethics (HHE) Research Group have produced guidance on
- What Characterizes Effective Research Ethics Review of Urgent Protocols During A Crisis?
- Alleviating Suffering and Upholding Dignity In The Midst Of Covid-19: A Place For Palliative Care View here
BC Centre for Palliative Care Guidelines with input from Palliative Care MDs & pharmacists have produced a Symptom management for adult patients with COVID-19 receiving end-of-life supportive care outside of the ICU
FRANCE
SFAP have published guidances (“tools and resources” in French) on palliative care for patients with Covid-19 available to view here 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)
GERMANY
DGP Recommendations for treatment of patients with COVID-19 from the palliative care perspective V2.0 (in English) (in German) Version 2.0 updated 30th March 2020
IRELAND
All Ireland Institute of Hospice and Palliative Care (AIIHPC) have links to useful guidance documents and web pages during the COVID19 outbreak view here
Palliative Care Nurses Ireland have produced Key Resources for Palliative Care Nurses – COVID19 view here
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 view here
The Irish Hospice Foundation have created the Care & Inform Hub which includes a range of information resources and videos focusing on the themes of Grief, Funerals in Exceptional Times, Planning Ahead and a suite of resources for Healthcare Professionals.
ITALY
SICP – FCP, 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/
SIAARTI – Aniarti – SICP – SIMEU joint document COMMUNI CoViD How To Communicate With Families Living In Complete Isolation
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)
Società Italiana di Cure Palliative, Dott.ssa Danila Valenti, and Dott. Simone Veronese have provided documents in English covering key communication and palliative care referral guidance view here
PORTUGAL
National Palliative Care Commission of Portugal with the Social Work task-force of the Portuguese Palliative Care Association have produced Good Practices for Social Work – COVID19 (english pdf) Also view original version in Portugese here
SPAIN
SECPAL (Spanish Society of PC) have a page dedicated to information on relevance to COVID-19 view here (in Spanish)
SCBCP (Catalan Society of Palliative Care) Have produced self-care recommendations to professionals in time of pandemia in Spanish, Catalan and English view here
SWITZERLAND
Palliative ch, Switzerland, have produced guidance for professionals available to view in English, German and French view here
UNITED KINGDOM (UK)
King’s College London and the European Lung Foundation have jointly produced two versions of a factsheet – one directly for the patient and one for family and friends of the patient https://www.europeanlung.org/en/covid-19/covid-19-information-and-resources/covid-19-hospital-factsheets The factsheet, availble in 24 lauguages, explains what will happen once a person goes into hospital, how their symptoms will be managed and what will happen if they get put on a ventilator.
The Royal Society of Medicine COVID-19 learning hub gives healthcare workers on the frontlines regular updates from healthcare leaders on COVID-19. view here
Association for Palliative Medicine of Great Britain and Ireland have developed an open access webpage on COVID-19 – Resources for Healthcare Professionals view here
NICE have published a Covid-19 rapid guidance for critical care including a 1-page critical care admission algorithm view here
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 view here
FutureLearn have developed two free online courses for the general public and healthcare staff:
- COVID-19: Tackling the Novel Coronavirus developed 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 (commenced 6.4.20).
VERDIS ‘Real Talk’ Project, UK have produced ‘COVID-19: evidence-based advice about difficult conversations’ for people who are likely to be having – and training people who will have – difficult conversations in the care of people with COVID-19
UNITED STATES of AMERICA (USA)
National Hospice and Palliative Care Organisation, USA Communications on Coronavirus (COVID-19) including factsheets and guidance for frontline staff
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. 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 view here This is available to download in the following lanugages: English, Spanish, French, German, Portuguese, Arabic, Dutch, Hebrew, Russian, Tagalog, Japanese, Norwegian
Centers for Disease Control and Prevention (USA) have a webpage dedicated to providing a comprehensive overview of COVID-19 targeted at healthcare professionals and the public. view here
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 for EAPC members view here
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: view here
The New England Journal of Medicine (NEJM) has provided a collection of free papers regarding COVID epidemic view here
The Journal of the American Medical Association (JAMA) has produced a COVID-19 collection, including Q&A’s view here
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. view here
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 view here
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. view here
Wolters Kluwer have mde their UpToDate resources on Clinical Effectiveness COVID-19 Resources free to access view here
Palliative care related publications and news 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
Bajwah S, Wilcock A, Towers R, et al. Managing the supportive care needs of those affected by COVID-19 [published online ahead of print, 2020 Apr 8]. Eur Respir J. 2020;2000815. doi:10.1183/13993003.00815-2020
Etkind SN, Bone AE, Lovell N, et al. The role and response of palliative care and hospice services in epidemics and pandemics: a rapid review to inform practice during the COVID-19 pandemic [published online ahead of print, 2020 Apr 8]. J Pain Symptom Manage. 2020;S0885-3924(20)30182-2. doi:10.1016/j.jpainsymman.2020.03.029
How coronavirus has transformed the grieving process article written by Lucy Selman, University of Bristol, UK
International COVID-19 palliative care guidance for nursing homes leaves key themes unaddressed This paper by Gilissen et al [published online ahead of print, 2020 May 10] reports on the first directed documentary and content analysis of guidance documents from across the world concerning palliative care in nursing homes in the context of COVID-19. Findings can support future palliative care guidance development for COVID-19 in nursing homes, by highlighting unaddressed topics that require urgent attention.