Page 20 - Palliative Care, Trials and COVID-19 Tribulations: First-hand experience shared by the experts at ground zero

Who Requires Palliative Care?

When you are going into COVID-19 wards, who are the patients who require palliative care?
(i) I think that all patients with severe COVID-19 with low oxygen saturations or on oxygen
therapy should be someone that you need to look out for; (ii) any patients who have
distressing symptoms of dyspnoea, restlessness, severe cough and pain; (iii) those who have
pre-existing advanced malignancies or chronic medical illnesses requiring symptom
management and; (iv) for those whereby we feel that the prognosis may be very poor and
uncertain, and there may be a situation where for some reason we cannot actually escalate
therapy. So, this is where we need to think of palliative care.

Misconception of Palliative Care

Now, I want to explain something because I think that there is often a great misconception
about the term “palliative care”. People tend to think that it always means something like
terminal care or end-of-life care, but I would like to actually kind of clarify this
misconception.

Today, we talk about an integrated model of palliative care, where palliative care actually
must happen concurrently alongside disease-modifying treatments. Just because the patient
still has active interventions, such as antiviral, steroid therapy, and even ventilation support, it
is still valid to actually consider palliative care interventions to keep them comfortable
throughout their journey, throughout their trajectory as they face this very difficult illness.

Figure 10: Integrated Model of Palliative Care