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COMMENTARY: COVID-19 Diary Day 10: So Many Questions, No Answers

COMMENTARY: COVID-19 Diary Day 10: So Many Questions, No Answers

What your doctor is reading on Medscape.com:

APRIL 17, 2020 — Today I made my way through our empty clinic and into the back, where I sat with my team. Scanning my schedule, I saw two 1-hour visits: people with a new cancer diagnosis.

Cancer never got the COVID-19 memo. It wasn’t following any stay-at-home orders; it was still disrupting people’s lives, as ever, and my role in helping them make sense of this life-changing diagnosis wasn’t stopping either.

Since coming to Lifespan Cancer Institute, I’ve taken on a new program as lead medical oncologist for sarcoma. Fortunately, I have a great mentor in Brad DeNardo, MD, a pediatric oncologist who specializes in it, particularly in the adolescent and young adult population. Together we started a sarcoma multidisciplinary clinic and we see patients together once a month. Today we had several with sarcoma to see together; one was a person who had undergone a very complicated surgery and was recovering in a nursing home.

I became momentarily alarmed. In Rhode Island, as in other areas, nursing homes and other group settings are high-risk areas for infection, and most of our COVID-19 deaths were happening in this highly vulnerable segment of our population.

I worried that this patient might have it. Even if he had no symptoms, we could not rule out that he was an asymptomatic carrier. Still, we weren’t about to cancel the appointment. I alerted my team that our new patient would be coming from a nursing home and that we all would need to protect ourselves.

Our standard has been to wear a surgical mask, but I wondered whether Brad and I needed more. Shouldn’t we have personal protective equipment (PPE) in order to conduct the visit?

Like many institutions, however, we too are rationing PPE to areas where they were most needed, especially for staff involved in “aerosol-generating” procedures like intubation, where the risk for infection is greatly increased.

Fortunately, the cancer institute has its own supply of PPE, and after one inquiry we were provided with it for this visit, though not without caveats. “There are gowns, gloves, face shields, and surgical masks,” our stellar medical assistant informed us. “The face shield you will need to keep safe—it’s the only one you will get.”

Published at Tue, 21 Apr 2020 14:22:47 +0000

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