Genetic counseling in the time of COVID‐19: The Philippine experience with telegenetics

Abstract

COVID-19 is a disease caused by the novel coronavirus now known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).The first human cases were reported at Wuhan, China, in December of 2019 and subsequently spread to nearly every country leading the World Health Organization (WHO) to declare the outbreak as a pandemic or a Public Health Emergency of International Concern (WHO, 2020). The COVID-19 pandemic poses a significant challenge to healthcare professionals and health systems around the world, most notably the disruption of service delivery. Genetic counselors (GCs), as part of the healthcare team, play an important role in providing genetic services by helping patients and/or families "understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease", (Resta et al., 2006). Genetics and genetic counseling have become integral to health care as we learn more about genetic risks for disease (Bruder, 2020). The typical work setting for most GCs is in a clinic or hospital. However, during the COVID-19 pandemic, to help prevent the further spread of the virus, clinics and hospitals have restricted in-person delivery of healthcare services that are not deemed urgent, including genetic counseling. Patients' access to genetic counseling services has thus been limited, which prompted GCs to utilize an alternative way to provide counseling through telegenetics. An article from Pagliazzi et al. (2020) described their genetic counseling experience in Tuscany, Italy, when the pandemic hit. It was widely known that Italy was one of the hardest-hit countries during the pandemic. A pediatric tertiary hospital in Tuscany stratified their scheduled visits and assessed which cases would be seen via faceto-face and which would be seen via telemedicine. All prenatal visits were face to face since the patient still had to go the hospital for

Newborn Screening Long-Term Follow-Up Clinics (Continuity Clinics) in the Philippines during the COVID-19 Pandemic: Continuing Quality Patient Care

“…In order to minimize patient contact, telemedicine consultations were initiated across all NBSCCs and quickly became an effective means of patient contact. Telemedicine and telegenetics visits were readily accepted as an alternative to face-to-face clinic visits, but these were not without difficulties [ 15 ]. Three continuity clinics (21.4%) reported difficulty conducting telemedicine consultations due to poor internet connections or lack of proper equipment to conduct consultations.…”

Integrating Genetic Services in the Philippine Public Health Delivery System: The Value of Networks

“…Telegenetic counseling is advantageous for patients since it decreases travel time and reduces time away from work. Disadvantages, on the other hand, include longer sessions due to unstable internet connections, poor mobile network signals, and an inability to assess nonverbal cues from patients [ 41 ]. More efficient counseling has been accomplished through a support network of partners who meet with and assist patients in local clinics using a combination of face-to-face contact and telegenetics.…”

“…The network of support from the different newborn screening stakeholders increased the availability of this service to a broader reach across the entire country. Various modes of telemedicine were performed, including video call, phone calls, and even social media, particularly Facebook messenger [ 41 ].…”

Overcoming challenges in sustaining newborn screening in low-middle-income countries: the Philippine newborn screening system

“…NSCs are divided internally into two cross-trained laboratory teams to enable continued laboratory services should COVID-positive cases arise in team members. Follow-up of patients shifted to teleconsultations as the main mode of patient contact [24][25][26][27] . As a result, the PNBSP is developing updated contingency plans to respond not only to pandemics but also to natural and man-made disasters.…”