From the President’s Desk
Dear Members and Colleagues,
India is passing through an extraordinary healthcare challenge because of COVID-19. In this extreme situation we assure our support to those who need care, to our colleagues, who are struggling to continue palliative care services, as well as to all the health care professionals working tirelessly all over India and across the globe.
In this critical situation, our responsibilities are more; we have to care for the patients suffering from COVID-19, in addition to the task of managing those with Palliative Care needs, whom we are looking after over many days, months and years.
We have to fulfill our roles and responsibilities in a judicious manner so that we remain safe and our patients do not suffer. We also have to integrate principles of Palliative Medicine in the treatment plan for COVID-19 patients and find out strategies for this. There is no readily available protocol to follow in this sudden extraordinary Health Care Emergency. We have to formulate our own plans depending on the available resources and available evidence. However, the principle must be based on social distancing; which means a treatment plan which makes the care accessible to patients without traveling and the health care professionals can keep themselves safe from exposure to infection. Many are depending WhatsApp or e-consultation in this difficult situation. Medicines are issued for a longer period considering the condition of the patient. Helpline numbers are also provided to contact, if there is an emergency.
To keep our members updated on COVID-19, a resource page is now available on IAPC website, which will definitely help you in patient care and to keep yourself updated. I also request you to send us news or articles, or any information related to COVID -19, in case you feel it is informative and worth sharing.
IAPC salutes all the frontline healthcare workers, who are fighting to save millions of lives all over the world.
Remember, we all are in the same boat, we cannot calm the storm, but we can calm ourselves. The storm will pass. Please keep yourself calm and take care of yourself. Keep yourself well nourished and well hydrated. Mankind needs you all, to spread the message of true holistic medical care at all levels.
Dr. Sushma Bhatnagar
Why Palliative Care is Important during a Pandemic?
We are all into difficult times with the situation changing rapidly due to the COVID 19 Pandemic. Even while taking all necessary measures to contain and treat COVID 19, we also need to think of the worst possible scenario.
This country is in a lockdown; only essential services are available. In this situation access to Palliative Care, and even the availability of morphine for pain relief have become challenges in many regions. Both patients and services providers are struggling. Patients with life limiting illnesses and the elderly population are the most vulnerable groups to be affected by the Corona Virus. How to continue palliative care service in this unprecedented situation? We do not have a road map to follow. We have to try and find out.
Following are a set of documents useful for patients, carers, health care professionals, palliative care service providers and the public.
Palliating a Pandemic, “All Patients Must Be Cared For”
‘In the event of an overwhelming influenza pandemic, many health care system will implement a triage
system that would potentially deny critical care treatment to some seriously ill patients. Although all
triage systems have guaranteed Palliative Care for those who are denied Critical Care, no jurisdiction has
yet developed a plan to accommodate the anticipated “surge “in demand for Palliative Care. In this
article, the authors present a mathematical and ethical justification for a Palliative Care Surge plan and
outline some of the key elements that should be included in such plan.’
Read the article in The Journal of Pain and Symptom Management.
Epidemics of Life Threatening Infections and Palliative Care Needs
Here you can read an article on Palliative Care Needs of People Affected by Natural Hazards, Political or
Ethnic Conflict, Epidemics of Life Threatening Infections, and other Humanitarian Crises. Worth reading at
the time of COVID-19 pandemic.
Read the article here
ECHO Series on Managing Patients with COVID 19
An Initiative by IAPC
An echo series on – ‘Managing Vulnerable Adults and Children Affected by COVID-19’ – is being organised by Indian Association of Palliative Care with the support of Hyderabad Centre for Palliative Care, and Two Worlds Cancer Collaboration. The first session will be on 2nd April 2020 Thursday, at 6.30 AM to 7.30 AM. This will be followed by sessions on every Thursday for next 7 weeks. Those who want to participate are requested to register online here
WHO on COVID 19 Pandemic
WHO provides COVID-19 situation analysis report from across the globe and guidelines for Health care professionals, Governments and the Public. Please visit the website for details
Home Care for Patients with COVID- 19
Guidance by WHO
Please read the interim guidance by World Health Organization here
Keeping the Coronavirus from Infecting Health Care Workers
Here you can read the article by Dr. Atul Gawande, a well-known Surgeon, Public Health Researcher, Writer and Author of Best Selling Books. Please follow this link to read the article.
A set of Guidelines, Information Bulletins, Videos and Articles on COVID-19 are available on IAPC
Website for reference. These are useful for health care professionals as well as the public. These documents include:
- COVID 19: Be Careful, Not Fearful: AIIMS Information Bulletin
- Guidance Document for COVID-19 Surveillance by MoHFW
- Infection Control Measures
- Guidelines for Clinical Management
- Guidelines of Home Quarantine and Psychological Impacts
- Guidelines for Health Care Professionals for Caring Patients with COVID-19
- Guidelines on Dead Body Management by MoHFW
- Mock drill for Emergency Responses for Handling COVID-19 Cases
- Lab Testing Advisory
- WHO’s Recommendations for the Rational Use of Personal Protective Equipments
Please follow this link to get these documents.
COVID-19 Guidelines for Vulnerable Groups and Caregivers
Community preparedness towards prevention of COVID-19 among people with disabilities, chronic illnesses, autoimmune diseases and rare diseases, and preventive measures to control the spread of infection among their family members and care givers are challenging in present situation. This article provides guidelines for prevention for vulnerable groups and care givers. Read it here
“COVID-19 Pandemic: Ethical Board is Essential in Decision Making”
A zoom session on COVID -19 and palliative care was organized by Pallium India INC and IOWA University on 25th March 2020.
Dr. M. R. Rajagopal, a global leader in palliative care from India emphasized the importance of having an ethical board in every hospital to make decision on assigning ICU beds, ventilators and resuscitation when this pandemic takes hold and cases increase. He says, this will spare the intensivists the added burden of making decision and enable them to care for their patients without further distraction. Read a brief summary of the program here
What It’s Like Treating Patients with COVID-19 in Isolation
A Touching Note by an Indian Doctor
“Sometimes I feel that I am giving them false hope by saying they will soon be united with their family. I know some of them are losing the battle of life. As a doctor, I cannot let them give up hope” – says Dr. Mrs. Kataria, who is in charge of treating 14 Italian tourists visiting India, who tested positive for Coronavirus.
Did she feel any hesitation to take up the cases?
“It was easy for me to have delegated the job to someone else, but then I had to lead it by example“ – said the doctor. But it wasn’t however an easy decision to make, as the doctor would need to take precautions even around her immediate family.
“My husband is suffering from inflammatory arthritis and the medication used for this makes him more vulnerable to severe infection. So we had to send him to our farm house.“
Her son was attending 10th Board exam. It has been 15 days since she met her husband or entered her children’s room. Continue reading here
“If they don’t report; they are risking the lives of their loved ones”
– Says Delhi’s First COVID-19 Patient
“People should come forward in case they have any symptoms of COVID-19 and accurately report their travel histories. If they don’t they are risking the lives of their loved ones” – says Delhi’s first COVID-19 patient, who got cured after two weeks treatment. Read his experience here
APHN Published COVID 19 Guidelines
Please visit APHN website for details
COVID 19- Resources by WHPCA
Please get the documents here
Corona Virus: The Chronically ill are the Most Vulnerable
As the number of COVID- 19 cases rises around the world, those who depend on and provide Palliative and Hospice Care are fearful. They are the most vulnerable to infection, but they may be able to provide insight into how to deal with end of life care during the current pandemic. This was the sentiment of an international webinar on COVID-19 and Palliative Care, which drew over 500 participants. Please read the opinion of global leaders in Palliative and Hospice Care here
COVID-19: Webinar by AIIMS, New Delhi
Please see the schedule of webinar being organised by AIIMS New Delhi here
COVID-19: Resource pages on UpToDate.com
To help our front line healthcare professionals to fight against Covid-19, here are some resources for free. Access to the contents related to COVID-19 at the website www.UpToDate.com is absolutely free to all individuals, clinicians and hospitals till 30th April, 2020.
- Latest evidence and clinical updates on the Coronavirus:
- Society guidelines:
- For your patients:
- Acute Respiratory Distress Syndrome:
Best Health Care Professional of Telengana
Dr. Gayatri Palat received Enadu Vasundhara 2020 “Best Health Professional of Telengana” award on the occasion of International Women’s Day.
Palliative Care Sensitization Campaign
Cancer Awareness Program and Palliative Care Sensitization Campaign was organised by DNip Care on Women’s Day with special focus on different types of Cancers affecting Women. The program was held at St. James Orthodox Church, Mayur Vihar Phase 3, Delhi on 8th March, 2020.
Palliative Care foundation course in Meghalaya
The Directorate of Health & Family Welfare, Govt. of Meghalaya in collaboration with Pain and Palliaitve Care Unit, NEIGRIHMS conducted a ten days foundation course in Palliative Care for doctors and nurses.
Nurses get Palliative Care Tips at DMCH
A workshop for Nurses was organized by Dayanand Medical College and Hospital (DMCH), Ludhiana. The End-of-Life Nursing Education Consortium (ELNEC) workshop was held on 7th March 2020.
Palliaitve Care Sensitization Program
Palliaitve Care sensitization program was organized for CMOH and MS of 27 District Hospital in West Bengal on 13th March, 2020.
MSc in Palliative Medicine
Apply now for Commonwealth Scholarship
Cardiff University and the Commonwealth Scholarship Commission (CSC) offer Scholarship to support 10 healthcare professionals in India and neighbouring commonwealth countries to enroll for MSc in Palliative Medicine.
Details of the course can be found here
IAPCON 2021, AIIMS, Patna, Bihar
Pre-Conference workshop: 18th February, 2021.
Conference: 19, 20 & 21 February, 2021.
For donations to IAPC and for further information write to firstname.lastname@example.org