Staff and Patient Protection in Radiation Oncology Departments During Coronavirus Disease 2019 (COVID-19) Pandemic

Abstract

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, researchers and clinicians in the radiation oncology sector have been paying attention to the supply of radiation therapy (RT) and the safeguard of patients with regard to their infectious status. Based on the experience of 2 RT departments in Apulia (Brindisi and Barletta), Italy, we argue that the Italian guidelines currently in place are far from adequate to ensure staff and patient safety and should be strengthened with urgency.On March 11, 2020, the staff of the RT department at A. Perrino Hospital in Brindisi was informed that 3 patients coming from the medical oncology ward were found to be COVID-19 positive. One of them had received RT treatment the previous month, on February 18, and it unclear whether, at that time, the patient was already COVID-19 positive. Moreover, some health care workers (HCWs) from our staff had met with the other 2 patients daily from March 2 to 6 without personal protective equipment (PPE). It should be noted that surgical masks for HCWs in this department have been available only since March 9 1 ; in another RT department (Ospedale Mons. Dimiccoli in Barletta), PPE has been available since March 10 (surgical masks and Filtering Face Piece Sources of support: This work had no specific funding.

Radiotherapy based management during Covid-19 pandemic – A systematic review of presented consensus and guidelines

“…Using these additional setup helpers caused controversy by having PPEs during the RT steps. Therefore, the centers suggested their novel approaches for making and forming the masks and tongue depressors facing this challenge during the pandemic ( Yanagihara et al, 2020 ; Portaluri et al, 2020 ).…”

Impact of the COVID-19 Pandemic on Radiotherapy Supply

“…The impetuous entrance of the COVID-19 pandemic in Italy in March 2020, after the onset and diffusion in China, found the health system largely unfit to face the large amount of infected patients [ 4 – 6 ]. Although social distancing and the need for staff preservation to avoid severe shortage by SARS-CoV-2 infection and related impairment of the full functioning of radiation therapy facilities were recommended in national guidelines and international praxis adopted in Asiatic countries, at the onset of the pandemic in the radiotherapy department, some authors reminded correctly that “suboptimal delivery of radiotherapy (including delays, interruptions, or omissions) has been demonstrated to compromise both local control and survival.” [ 7 8 ] They further recalled that “the findings of a systematic review demonstrate that delaying the initiation of adjuvant radiotherapy >8 weeks after surgery doubles the risk of local recurrence in patients with breast cancer.…”

Cancer care and COVID-19: tailoring recommendations for the African radiation oncology context

“…The COVID-19 pandemic posed major challenges for African radiation oncology professionals and cancer patients. Several modifications were required in daily practice to prevent the infection spread amongst already vulnerable patients and staff who come in regular direct contact with each other [7]. These measures were adapted based on COVID-19 WHO and international radiotherapy guideline recommendations [6].…”

“…Continuing cancer treatment in a cancer patient infected with COVID-19 is considered risky for the patient, staff as well as other patients concurrently receiving treatments within the facility. Radiation therapy may have a negative impact on the immune system, increasing the morbidity and mortality rate for such a patient [7]. The global shortage of PPE supply for health workers was prevalent on the continent.…”