Intensive Infection Control at a Canadian Tertiary Allergy and Clinical Immunology Clinic during COVID-19 to Provide Crucial Services

Abstract

RATIONALE: Several groups have made recommendations for adjustments during COVID-19 to facilitate the care of urgent/high-risk patients.Here we describe our Canadian multi-allergist tertiary allergy & clinical immunology clinic's observational data with intensive infection control measures to provide crucial services. METHODS: After instituting an intensive infection control protocol, we measured the daily number of patients seen (virtually and in-person), skin tests, target biologic therapy (TBT), venom (VIT) and allergy immunotherapy (AIT) administered as well as adverse safety events (allergy related and viral transmission related). RESULTS: Our protocol consisted of scheduling in-person visits by appointment-only, health screening during the reminder call (ensuring no COVID-19 symptoms, exposures, and recent high-risk travel history) and before clinic entry, providing obligatory hand sanitizer and mask at the door, scanning body temperature, disinfecting rooms in-between patients, daily deep cleaning after-hours, donning full personal protective equipment for any direct patient care, and performing spirometry in outdoor tents with plexiglass. AIT patients waited in their own vehicle, if possible, to be directly monitored by staff for 30 minutes to maximize physical distancing. For any concerns, patients immediately called over front door staff or honked their car horn. Since the pandemic, we provided virtual care and accommodated over 18,000 patients. On average per day, there were 25 new teleconsults, 12 skin tests, 40 TBT, 30 VIT, and 80 AIT patients. There have been no adverse safety events. CONCLUSIONS: By adopting intensive infection control measures, we can optimize reduction of viral transmission and maintain crucial allergy services to keep high-risk allergic conditions under control.