Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun;26(Suppl 1):S8-S16.
doi: 10.4103/IJPC.IJPC_131_20. Epub 2020 Jun 30.

Responding to Palliative Care Training Needs in the Coronavirus Disease 2019 Era: The Context and Process of Developing and Disseminating Training Resources and Guidance for Low- and Middle-Income Countries from Kerala, South India

Sunitha Daniel  1   2 , Chitra Venkateswaran  3   4 , Poornima Sunder  4 , Shoba Nair  5   6 , Rajashree K Chittazhathu  5   7   8 , Athul Joseph Manuel  1   9 , Biju Raghavan  10 , M M Sunil Kumar  7 , Vineetha Rijju  11 , Geetha Vijay  1 , Seema Rao  12   4 , Anupama V Prabhu  4 , Uma Parameswaran  4 , Odette Spruijt  13 , M R Rajagopal  7 , Mhoira Leng  14   15
Affiliations

Responding to Palliative Care Training Needs in the Coronavirus Disease 2019 Era: The Context and Process of Developing and Disseminating Training Resources and Guidance for Low- and Middle-Income Countries from Kerala, South India

Sunitha Daniel et al. Indian J Palliat Care. 2020 Jun.

Abstract

Background: Palliative care has an important role to play in the global coronavirus disease 2019 (COVID-19) pandemic. It is integrated and is a key component in the governmental and community structures and services in Kerala, in India. Palliative care in the state has grown to be a viable model recognized in global palliative care and public health scene. The community network of palliative care, especially the volunteers linking with clinical teams, is a strong force for advocacy, relief support including provision of emergency medications, and clinical care.

Objective: To develop a palliative care resource tool kit for holistic care of patients affected with COVID-19 and to support the health-care workers looking after them to enable palliative care integration with COVID-I9 management.

Methods: The Kerala State government included senior palliative care advisors in the COVID-19 task force and 22 palliative care professionals formed a virtual task force named Palli COVID Kerala as an immediate response to develop recommendations. Results: Developed a palliative care in COVID-19 resource toolkit which includes an e-book with palliative care recommendations, online training opportunities, short webinars and voice over power point presentations.

Conclusion: Integrated Palliative care should be an essential part of any response to a humanitarian crisis. The e resource tool kit can be adapted for use in other low- and middle-income countries.

Keywords: Community participation; India; Kerala; coronavirus disease 2019; guidelines; health system; low- and middle-income countries; palliative care; triage.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Pyramid of clinical care for coronavirus disease 2019 treatment planned by Kerala State Government
Figure 2
Figure 2
Support Systems and treatment facilities at panchayat level. ASHA: Accredited Social Health Activist
Figure 3
Figure 3
Palliative care in COVID-19 resource toolkit
Figure 4
Figure 4
Domains covered by the E-book
Figure 5
Figure 5
Decision-making and Ethical Framework Algorithm *World Health Organization Performance status ** Multiple organ dysfunction syndrome ***should be incorporated at all stages
Figure 6
Figure 6
Algorithm for management of breathlessness
Figure 7
Figure 7
Algorithm for management of delirium and agitation
Figure 8
Figure 8
Making sense of distress algorithm
See this image and copyright information in PMC

References

    1. World Health Organisation. WHO Director-General's Opening Remarks at the Media Briefing on COVID-19 – 11 March 2020. 2020. [Last accessed on 2020 May 04]. Available from: https://wwwwhoint/dg/speeches/detail/who-director-general-s-opening-rema... .
    1. World Health Organisation. Coronavirus Disease (COVID-19) Outbreak Situation. 2020. [Last accessed on 2020 May 04]. Available from: https://wwwwhoint/emergencies/diseases/novel-coronavirus-2019 .
    1. Radbruch L, Knaul FM, de Lima L, de Joncheere C, Bhadelia A. The key role of palliative care in response to the COVID-19 tsunami of suffering. Lancet. 2020;395:1467–9. - PMC - PubMed
    1. Radbruch L, De Lima L, Knaul F, Wenk R, Ali Z, Bhatnaghar S, et al. Redefining palliative care – A new consensus-based definition. J Pain Symptom Manage. 2020 pii: S0885-3924(20)30247-5. - PMC - PubMed
    1. Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, et al. Estimates of the severity of coronavirus disease 2019: A model-based analysis. Lancet Infect Dis. 2020;20:669–77. - PMC - PubMed

LinkOut - more resources