|LETTER TO THE EDITOR
|Year : 2020 | Volume
| Issue : 2 | Page : 143-144
Severe acute respiratory syndrome coronavirus 2: Concerns for palliative care physicians
Prashant Sirohiya1, Brajesh Kumar Ratre2
1 Department of Anaesthesia, ABVIMS and Dr. RML Hospital, New Delhi, India
2 Department of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, New Delhi, India
|Date of Web Publication||06-Aug-2020|
Dr. Prashant Sirohiya
Department of Anaesthesia, ABVIMS and Dr. RML Hospital, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sirohiya P, Ratre BK. Severe acute respiratory syndrome coronavirus 2: Concerns for palliative care physicians. Indian J Pain 2020;34:143-4
Coronavirus disease 2019 (COVID-19) caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 has caused a large global outbreak and is a major public health concern. On March 11 2020, COVID-19 was declared a pandemic by the World Health Organization (WHO). The WHO estimates global mortality of 3.4% with the geriatric population and those with comorbidities are at increased risk.
Conventionally, medical management has primarily focused on saving lives and has lacked a holistic approach to relieve suffering. However, the compassionate approach is to prevent and alleviate human suffering. Palliative care should be a key component of health-care management in COVID-19 pandemic, which can contribute to symptom control, psychological support, supporting triage, and complex decision-making. Palliative care has encouraged people about advanced care planning especially in elderly patients suffering from comorbidities and chronic illness.
We wish to highlight two different sets of concerns for palliative care physicians in this COVID-19 pandemic as their role is to provide the best possible care to patients suffering from COVID-19 as well as to those suffering from chronic illness, for example, cancer etc., [Table 1]., One of the major concerns in this pandemic is to have effective communication with patients and families as poor communication can result in increased symptom burden and loss of trust in the healthcare system in this pandemic. Early discussion about goals of care should be separated from the delivery of bad news, it may facilitate advanced care planning, improved end-of-life care, and reduced use of potentially inappropriate life-sustaining treatments.
As intensive care beds are approaching their capacity, to save more lives, the triage system should give more chances to those patients who have the highest probability of survival from intensive care. These complex triage decisions should be taken by a multidisciplinary team involving a palliative care physician for better patient management. All patients must receive palliative care.
During this pandemic outbreak in India, actions taken by the government to limit the spread of COVID-19 disease such as isolation and quarantine can exacerbate psychological suffering among patients suffering from a chronic debilitating illness. The poor patients, having no family support, refugees, etc., are vulnerable to suffering and death. A large proportion of medical facilities are diverted mainly in treating patients suffering from COVID-19. In addition, healthcare systems in some areas may be resource-limited, unreachable, or overburdened. Specific palliative care strategies during such a pandemic are of utmost importance.
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Conflicts of interest
There are no conflict of interest.
| References|| |
Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19 Global Epidemic. JAMA 2020;323:1439.
Bernard C, Tan A, Slaven M, Elston D, Heyland DK, Howard M. Exploring patient-reported barriers to advance care planning in family practice. BMC Fam Pract 2020;21:94.
Borasio G, Gamondi C, Obrist M, Jox R. For the COVID-19 Task Force of Palliative Ch. COVID-19: Decision Making and Palliative Care; 2020. Available from: https://smw.ch/article/doi/smw. 2020.20233
. [Last accessed on 2020 Jun 28].