Pandemic plans and their considerations of palliative care aspects in Germany

Background: The effects of the COVID-19 pandemic are apparent in a special way in the palliative care of patients and their caregivers. The German PallPan-consortiums is analyzing nationwide palliative care aspects aiming at developing recommendations. Aims: The objective of the study was to survey the consideration of palliative care aspects in current pandemic plans (PP) in Germany. The study started 11/2020 and data lock was 2/2021. Methods: We performed an investigation by direct contacting of administrative facilities of all cities > 100.000 inhabitants) as well as the two most populated counties of each federal state of Germany via email. We searched for PP via the WWW and by direct contacting (telephone). Here, we report on preliminary results of an ongoing analyses of the contents of the PP. Results: The PP for all 16 German federal states (GFS) and the national PP were openly accessible. In contrast, PP of the other levels were only available for analyses in a limited number due to limited open access or responses. Overall 37 PP (cities n=12, others n=9) were analyzed. Authors were mentioned in 83% and 67% respectively. In no case a palliative care expert was mentioned as an author. The tables of contents were very heterogeneous including no palliative care sections. We then scanned for relevant contents in regards to palliative care i.a. by screening for words of interest. (e.g. 'palliative', 'dying'). Of note, none of the PP included the word 'palliative'. Conclusions: Pandemic plans are difficult to access for the scientific community as well as others. Palliative care aspects have so far not been included in the German PP. Clear recommendations for dealing with seriously ill or dying patients and their families have to be developed and must be included in future PP. This research is sponsored by Federal Ministry for Health (BMBF) and part of the joint project 'PallPan - Nationale Strategie fur Palliativversorgung in Pandemiezeiten'.