A MESSAGE FROM PHPCI COUNCIL REGARDING COVID-19
Public health has always been and will continue to be about connections between people. Amidst the changes we are all making daily to our lives and social connections, there is a need for compassion in our communities like never before.
The coronavirus has given us physical distancing and containment on a global scale, but it has also reminded us that community is central to all that we do and who we are as human beings. In order to change the course of this pandemic, we need to stay apart and follow the public health advice. Despite this people and communities are reaching out across this physical separation to find ways to stay connected.
At the moment we are remembering what it is like to rely on each other.
The challenges of the public health crisis of COVID-19 are complex and disruptive. For many of us already working in the public health palliative care space, we know how central the community is in the care and support of people who are dying and their families and all the usual caring, dying, and grieving continues on around us. Yet this pandemic has brought this into light our dependence on each other and the fragility of our healthcare system. In the most profound ways, it has sharpened our understanding of our interdependence. This interdependence runs not only within communities and between people but across healthcare services and professionals. What this interdependence is showing us is that we as individuals and communities rely on health services when we are sick, as much as health services rely on us.
The message we are hearing from our leaders is that we don’t have enough beds, nurses and doctors to care for all our dying at this time. The Public Health Palliative Care message is that healthcare services – palliative care services in particular – must work WITH communities in responding to the changing needs of dying people and carers. This means working with neighbourhood, workplace, faith groups and social clubs to assist them in ensuring that physical isolation does not translate into social isolation and that grief and bereavement are addressed as a civic response rather than a toll on already strained bereavement services. We hold that a public health response at this time is essential to enable optimal health and wellbeing of dying people and their carers, and those who are bereaved. As noted by our colleagues in Italy, “Western health care systems have been built around the concept of patient-centered care, but an epidemic requires a change of perspective toward a concept of community-centered care.”
We strongly advocate that community-centered care is the approach that provides a critical way forward. This is not only about providing community-based health care services but hospitals, homes care services, communities and individuals working together to address these urgent needs.
Like you we have many questions. In such a rapidly changing context, it seems there are more questions than answers. PHPCI Council is committed to advocating for public health strategies for the issues surrounding dying, caregiving and loss during and after this pandemic and urges all citizens to make inquires about the whereabouts and actions being designed by their local Compassionate Community or Compassionate City. A list of Compassionate Cities and their contacts can be reviewed on the PHPCI website. Cites or communities who do not have compassionate public health strategies in their own city can contact one of the Compassionate Cities in their country to receive advice about how they can start one in their local region/area/city. For the whereabouts of their closest compassionate community, interested readers should contact their local hospice or palliative care service to inquire about these or ask about how they can be assisted/supported to establish a compassionate community in their area.
In the days and weeks ahead, PHPCI Council will promote a range of forums for the sharing of ideas, strategies and feedback about how public health palliative care approaches are and can be utilised throughout the world. This will include webinars, twitter chats, videoconferencing and a repurposing of the PHPCI website homepage to accommodate the open access to this information.
Remember, end-of-life care is EVERYBODY’S business. Social connection, mutual support and civic action are the cornerstones of public health palliative care and the coronavirus pandemic makes these an imperative. Now more than ever we must catalyse this work in our families, neighbourhoods, hospitals and communities and reach out across physical divides, using technology and other innovative means to connect and build communities in these times of death, loss and suffering. If you don’t have a compassionate community or city in YOUR area – the time is NOW to establish one. Contact your local hospice or palliative care service and start asking how.
Join PHPCI http://phpci.info/ and join the global family that views the COVID-19 pandemic as a civic as well as a health care crisis which must have health care and civic solutions.
Dr John Rosenberg
President
On behalf of the PHPCI Council