COVID-19 - Coronavirus Pandemic
This brief Advance Decision to Refuse Treatment is a response to the current Coronavirus crisis. Your Advance Decision to Refuse Treatment will only come into force if you lose the ability to make your own decisions.
Due to the pandemic, it might not be possible for this to be included in your GP or hospital notes. Nor does Coordinate My Care (CMC) allow documents to be attached to your record.
It is, therefore, your responsibility to ensure that this Advance Decision to Refuse Treatment (or copies) is both widely known about (by family, friends, carers) and is readily available should you become ill.
MyLivingWill suggests that you have copies of this document in a few prominent places in your home. If you choose to go to hospital, then you should take copies of this document with you and ensure that the health care professionals are aware of your Advance Decision to Refuse Treatment.
For vulnerable groups who may develop Coronavirus infection, the possibility of suffering severe respiratory difficulty is high. Treatment for the severe complications of Coronavirus requires hospital admission. The current evidence suggests that of those patients with Coronavirus infection who are admitted to hospital 30% will require critical care and of those over 80% will die. Due to anticipated high demand hospitals may be forced to limit admission especially to intensive care.
The British Medical Association, CQC and Royal College of GP also advise you to plan and take control should you get Coronavirus infection. These are the critical points to consider.
- Do you wish to remain at home or go to hospital?
- If you choose to go to hospital and your condition deteriorates so that you experience breathing difficulties, there are three possibilities:
- No mechanical breathing support. You would still receive oxygen via a face mask or nasal specs (nasal canula). There is a serious possibility that you may die.
- Non - invasive ventilation. This requires a mask over your face; the mask is connected to a ventilator providing either positive or negative pressure to support your breathing.
- Full ventilation. The ventilator is connected to you either via a tube through your mouth or nose passing into your windpipe (endotracheal tube) or using a tracheostomy (which involves the ventilator tube passing directly into your airway through a surgically placed hole in your neck).
Full (invasive) mechanical ventilation has serious side effects, which include, aside from the risks of other organ failures, the likely development of new infections and significant muscle weakness. It usually takes months to years of rehabilitation to get back to anywhere near baseline physical function. As one gets older, has pre-existing medical problems or frailty, it is increasingly difficult to return to the level of function that you had before.