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Hospice care pathways and COVID-19
  1. Sebastiano Mercadante,
  2. Fausto Giuliana,
  3. Lidia Terruso and
  4. Gianluca Albegiani
  1. Pain Relief and Supportive Care, Private Hospital La Maddalena, Palermo, Sicilia, Italy
  1. Correspondence to Dr Sebastiano Mercadante; terapiadeldolore{at}

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Italy was the first Western country to face COVID-19. It was endemic in Northern Italy,1 but minor in Southern Italy, particularly Sardinia and Sicily. On 9 March the government issued a complete lockdown to prevent contagion. The decree included serious restrictions and prohibitions on visits to patients in hospital.2 As a consequence admission to hospice stopped. After long negotiations, patients might be admitted—but alone, and after death just one relative was allowed see the body. This continued until the last week of May, when relatives (just one) were again allowed to stay in the mini-apartment in hospice.

We analysed hospice activity before and after the COVID-19 crisis. The 10-bed hospice opened in November 2019 to support the existing acute palliative care unit with 8 beds, in a comprehensive cancer centre. The latter unit has its own peculiarities, being particularly devoted to symptom management during active antitumour treatments. Simple available technologies provided temporary communication models, but did not substitute for physical presence. One relative reported: ‘After hospice admission, I will not see him/her anymore’.3 …

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  • Correction notice This article has been corrected since it was published.

  • Contributors All authors SM, FG, LT and GA contributed equally in planning, conducting, reporting of the work described in the article. SM is responsible for the overall content as guarantor.

  • 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.