In an invited article, the National Comprehensive Cancer Network’s (NCCN’s) Best Practices Committee recently detailed strategies for mitigating transmission of COVID-19 among infected and uninfected patients with cancer, as well as the health care workers taking care of them, all while continuing to provide excellent cancer care.1
In order to maintain patient safety, the recommendations included prescreening and screening for COVID-19 symptoms and exposure history using telehealth platforms, and screening patients upon arrival in a dedicated unit with dedicated staff. Additionally, practices are encouraged to convert as many in-person visits to telemedicine visits as possible.
Recommended safe practices also included limiting visitors, limiting nonessential surgeries, alteration of dosing schedules to limit the necessity of in-person visits, or changing therapies to oral medications whenever possible.
Maintaining health care worker safety is also important to limit transmission of COVID-19. Among the listed recommendations for health care worker safety was use of appropriate personal protective equipment (PPE), daily screening and/or temperature checks, and use of a centralized resource or website to communicate the recommendations to health care workers as recommendations change.
“Several other measures can protect healthcare workers, including the early adoption of travel restrictions, arranging meetings over teleconference, and establishing clear guidelines on when to stay at home and when to return to work,” the authors wrote.
Any health care worker experiencing concerning symptoms or exposure history should self-isolate and stay at home. Either test-based or non–test-based strategies can be used to clear workers return to work.
According to the Centers for Disease Control and Prevention, a test-based strategy includes “at least 2 consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of 2 negative specimens) and resolution of fever without the use of medications and improvement of respiratory symptoms.” Non–test-based strategy includes returning to work “at least 3 days following resolution of fever without the use of medications and improvement in respiratory symptoms and at least 7 days have passed since symptoms first appeared.”
“The distressing global experience with COVID-19 limited and in some cases devastated the healthcare delivery systems we have relied on to provide safe and effective care to our patients,” the authors wrote. “Nonetheless, our healthcare community remains dedicated, resilient and adaptable. Most of all, the commitment we have to the patients we serve will continue to guide our response during these extraordinarily challenging times.”
In the article, the authors noted that the information used was current at the time of publication, but that recommendations about public safety and practices are changing rapidly.
- Cinar P, Kubal T, Freifeld A, et al. Safety at the time of the COVID-19 pandemic: how to keep our oncology patients and healthcare workers safe [accepted for publication on April 3, 2020]. J Natl Compr Canc Netw. doi: 10.6004/jnccn.2020.7572