• Massimo Costantini, Katherine E Sleeman, Carlo Peruselli, and Irene J Higginson.
• Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
• Palliat Med. 2020 Jul 1; 34 (7): 889895889-895.

BackgroundPalliative care is an important component of health care in pandemics, contributing to symptom control, psychological support, and supporting triage and complex decision making.AimTo examine preparedness for, and impact of, the COVID-19 pandemic on hospices in Italy to inform the response in other countries.DesignCross-sectional telephone survey, in March 2020.SettingItalian hospices, purposively sampled according to COVID-19 regional prevalence categorised as high (>25), medium (15-25) and low prevalence (<15) COVID-19 cases per 100,000 inhabitants. A brief questionnaire was developed to guide the interviews. Analysis was descriptive.ResultsSeven high, five medium and four low prevalence hospices provided data. Two high prevalence hospices had experienced COVID-19 cases among both patients and staff. All hospices had implemented policy changes, and several had rapidly implemented changes in practice including transfer of staff from inpatient to community settings, change in admission criteria and daily telephone support for families. Concerns included scarcity of personal protective equipment, a lack of hospice-specific guidance on COVID-19, anxiety about needing to care for children and other relatives, and poor integration of palliative care in the acute planning response.ConclusionThe hospice sector is capable of responding flexibly and rapidly to the COVID-19 pandemic. Governments must urgently recognise the essential contribution of hospice and palliative care to the COVID-19 pandemic and ensure these services are integrated into the health care system response. Availability of personal protective equipment and setting-specific guidance is essential. Hospices may also need to be proactive in connecting with the acute pandemic response.

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