Do you have questions? Do you want to join us for a weekly webinar? Join us for ‘Time to talk: A virtual hub for the serious illness and palliative care community during the Covid-19 pandemic
Friday 3rd April 2020 13.00-1400 UK time. To join via zoom click here
Open to all who live with palliative care needs, palliative care health professionals and carers worldwide. Around the world people with palliative care needs and those caring for them are living through or preparing for Covid-19. As a community, we are all coping with different levels of resources and are in different places in the journey. This is a virtual space where you can join, chat, ask questions, answer questions, share, or just listen in silence in an open virtual space in these unprecedented times.
Organised by: ICPCN, The Worldwide Hospice Palliative Care Alliance (WHPCA), The International Association of Hospice & Palliative Care (IAHPC) and Palliative Care Voices
What is COVID-19?
COVID-19 is a disease caused by a new strain of coronavirus. ‘CO’ stands for corona, ‘VI’ for virus, and ‘D’ for disease. Formerly, this disease was referred to as ‘2019 novel coronavirus’ or ‘2019-nCoV’.
The COVID-19 virus is a new virus linked to the same family of viruses as Severe Acute Respiratory Syndrome (SARS) and some types of common cold.
How is COVID-19 spread?
It mainly spreads from person-to-person between people who are in close contact with one another and through respiratory droplets produced when coughing or sneezing. If these droplets get in the mouths or noses of nearby people or if they are inhaled then this can cause the disease to spread. It is important that you do not touch your face/mouth as it is also possible to get COVID-19 by touching a surface or object that has the virus on it. It is thought that the virus can spread prior to individuals showing symptoms, although it is most contagious when they are sick.
What are the symptoms of COVID-19?
Symptoms can include fever, cough and shortness of breath. In more severe cases, infection can cause pneumonia or breathing difficulties. More rarely, the disease can be fatal. These symptoms are similar to the flu (influenza) or the common cold, which are a lot more common than COVID-19. This is why testing is required to confirm if someone has COVID-19.
Who is most at risk?
Older people, and people with chronic medical conditions, such as diabetes and heart disease, appear to be more at risk of developing severe symptoms. As this is a new virus, we are still learning about how it affects children. We know it is possible for people of any age to be infected with the virus, but so far there are relatively few cases of COVID-19 reported among children. The virus can be fatal in rare cases, so far mainly among older people with pre-existing medical conditions, however we are aware that children receiving palliative care and with chronic life-limiting conditions are extremely vulnerable. This is a new virus and we need to learn more about how it affects children.
What is the treatment for COVID-19?
There is no currently available vaccine for COVID-19. However, many of the symptoms can be treated and getting early care from a healthcare provider can make the disease less dangerous. There are several clinical trials that are being conducted to evaluate potential therapeutics for COVID-19.
How to avoid catching or spreading coronavirus
- Wash your hands with soap and water often – do this for at least 20 seconds
- Always wash your hands when you get home or into work
- Use hand sanitiser gel if soap and water are not available
- Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- Put used tissues in the bin immediately and wash your hands afterwards
- Try to avoid close contact with people who are unwell
- Try not to touch your eyes, nose or mouth if your hands are not clean.
Advise re Personal Protective Equipment (PPE).
- Advice on the use of masks
- Questions and answers for health care workers on PPE
- Home care for patients with Covid-19
- Rational use of PPE
COVID-19 and Children with Comorbidities
The evidence for COVID-19 and children is minimal but information can be found here. There is little clinical data to inform us on the effect of COVID-19 on children with other comorbidities. Some data has been published from a liver transplant unit in Lombardy, Italy, which had 3 cases of COVID-19 in post-transplant patients who all suffered very mild symptoms.
COVID-19 and Palliative Care
ICPCN are in the process of developing some guidelines for children’s palliative care and the coronavirus and we will share these once they have been completed.
ICPCN recommends that all those caring for children with palliative care needs read and adhere to WHO guidelines to control the spread of the virus and protect their children. Below we have provided links to guidelines from which can be helpful.
- The WHO has a one stop shop for COVID-19 related issues
- The WHO has a webpage with updates on the disease and a short online course: Infection, Prevention and Control (IPC) for novel coronavirus (COVID-19)
- Comprehensive WHO guidance can be found here
- WHO infection control guidance can be found here and we encourage everyone to follow this guidance.
- WHO’s interactive map with updated data or confirmed cases and mortality rates, can be found here.
- The WHO’s guide on integrating palliative care and symptom relief into responses to humanitarian emergencies and crisis is a useful resource and can be found here.
- The WHO’s specific guidelines for healthcare workers can be found here
- OUP are currently providing free open access to the Field Manual for Palliative Care in Humanitarian Crisis.
- CAPC Covid-19 response toolkit, which has a range of helpful documents and links for online training etc.
- There is also various guidance available to help talk to healthy children about coronavirus and this could be helpful when explaining to siblings etc. For example: from UNICEF, from Child Mind Institute, on YouTube.
Some useful documents include the following:
- Applying Palliative care principles to communicate with children about Covid-19 – a paper published in the Journal of Pain and Symptom Management, (Weaver MS, Wiener L, Applying Palliative Care Principles to Communicate with Children about COVID-19, Journal of Pain and Symptom Management (2020))
- Alleviating suffering and upholding dignity in the midst of Covid-19 response: A place for palliative care
- The UK clinical guide for the management of palliative care in hospital during the coronavirus epidemic.They also have guides for different specialities including paediatrics.
- The UK RCGP and APM guidance on Community Palliative, End of life and Bereavement Care in the Covid-19 pandemic.
- Covid-19 EOLC community charter from the UK
More information about palliative care and Covid-19 can be found on the global palliative care website
Different countries and governments are following different policies on dealing with COVID-19 and it is important that individual palliative care providers take note of what their own governments are saying. Some examples from around the world include the following:
- The USA Centres for Disease Control and Prevention Key facts on Coronavirus
- The European Commission risk assessment, prevention and Q&A
- Palliative Care Australia statement on Coronavirus
- Sphere and partners Covid-19 guidance
The EAPC also has some useful resources from the response it Italy and these can be found here.
One of the challenges of COVID-19 is the impact that it is having and will continue to have, on the provision of health care, for example, the provision of home palliative care, respite care etc. As we hear of new developments we will try and keep this resource page up-to-date through signposting to the experts in the field.
Resources for Children
Several great resources have been developed for children about Covid-19 including storybooks, guides on how to talk to children about Covid etc. Some examples can be found here:
- My Hero is You: How kids can fight COVID-19 by the Inter-Agency Standing Committee
- The story of the Oyster and the Butterfly: The Corona Virus and Me to help children deal with their feelings of worry, fear, and anxiety.
- Q is for Quarantine: The ABCs of Coronavirus – a colouring book
- A Coronavirus colouring book from St Judes Children’s Research Hospital
- My 2020 Covid-19 Time Capsule – a work book to help children document their experience during the Covid-19 pandemic.
- How to best protect yourself from the new coronavirus infection from UNICEF and the Red Cross
Resources for self care
- Looking after ourselves is very important at this time, here is a useful link for a course on psychological well-being in healthcare workers in response to Covid-19.
The recording of the webinar held by WHPCA on Friday 20th March on Coronavirus and people with serious conditions and underlying issues can be found here.
The recording of the ECHO on Paediatric Palliative Care and Covid-19 from Hyderabad Centenaries for Palliative Care can be found here.