Preparedness to face the COVID-19 pandemic in palliative care services in the asia-pacific region: A rapid online survey

Background: Palliative care improves COVID-19 patient management who are highly vulnerable and facing higher risk of dying. However, evidence regarding palliative care preparedness and response plans is limited in the Asia-Pacific region. Aim: To evaluate the preparedness of palliative care services in the Asia- Pacific region to respond to the COVID-19 pandemic. Method: An online cross-sectional survey was developed based on prior methodology guidance and the International Health Regulations. It was emailed to the Asia-Pacific Hospice and Palliative Care Network subscribers (n=1551) and organisational members (n=185) from 10th June to 1st July 2020. Descriptive analysis was used for reporting. Results: Ninety-seven respondents completed the survey. Around half of services were hospital-based (n=47, 48%), and public-funded (n=46, 47%). Half of services reported to have confirmed cases (n=47, 49%). Staff perceived moderate stress of being infected by COVID-19 (median: median: 7 on a 1-10 scale). > 85% of respondents reported they had up-to-date contact list for staff and patients, however one-third revealed challenges to keep record of relatives (n=30, 31%) and patients visited in communities (n=29, 30%). Majority of services (60%) obtained adequate infection control resources except face mask. More than half had no guidance on Do Not Resuscitate orders (n=59, 66%) and bereavement care (n=44, 51%). One-third considered they had capacity to train nonpalliative care specialists in using protocols. Conclusion: Recommendations to strengthen the palliative care preparedness include: 1) improving the access to infection control materials such as face mask and hand disinfectants;2) acquiring stress management protocols for staff when unavailable;3) reinforcing the contact tracing system for relatives and patients visited in the community and 4) developing guidance on patient and family care before and after patients' deaths.