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Integration of palliative care into COVID-19 pandemic planning
  1. Nada Fadul1,
  2. Ahmed F Elsayem2 and
  3. Eduardo Bruera3
  1. 1 Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
  2. 2 Department of Emergency Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  3. 3 Department of Palliative Care, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Dr Nada Fadul, Internal Medicine, University of Nebraska Medical Center, Omaha NE 68198, Nebraska, USA; nada.fadul{at}


The COVID-19 pandemic is expected to surpass the healthcare system’s capacity to provide intensive care to all patients who deteriorate as a result of the disease. This poses a unique challenge to healthcare teams of rationing care during pandemic when resources are scarce. Healthcare providers will need to acquire new skills in care decision making and effective symptom control for patients who do not receive life-saving measures. In this review, we describe some of the important palliative care considerations that need to be incorporated into COVID-19 pandemic planning. The main aspects to be considered include decision algorithms for rationing care, training on effective symptoms management, alternative delivery methods of palliative care services such as telemedicine and finally death and bereavement support for surviving family members who are likely to be isolated from their loved one at the moment of death.

  • respiratory conditions
  • dyspnoea
  • end of life care

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  • Contributors NF is responsible for the overall content as guarantor; all authors contributed to the planning, outline and first draft a well as editing of paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.