ABSTRACT
Objectives: In this Covid-19 pandemic, onco-hematological patients are at higher risk of severe infection because of both their immunosuppressive state caused by malignancy and treatments and their recurrent hospital accesses. At our cancer centre (IRST), following national authorities and scientific societies recommendations, we set up a model for reduction of risk of Covid-19 positive accesses through sequential actions on patients, caregivers and workers. In this work we give an estimate of reduction of risk of Covid-19 positive accesses. Methods: Covid-19 positive accesses baseline Absolute Risk (AR, ratio between the number of infected subjects accesses and the total number of accesses) for patients, caregivers and workers was estimated in the period from March, 11 to March, 31. Five risk reduction actions were implemented: (1) all procedures judged as deferrable by physicians have been postponed, (2) by-phone triage and (3) on-site triage have been activated to avoid accesses of suspected cases patients and caregivers. For workers (4) special leaves and (5) smartwork were encouraged. For each of these actions we estimated Absolute Risk Reduction (ARR) and Relative Risk Reduction (RRR). Results: In the analysis period we estimated 50 Covid-19 positive accesses: 14 for patients, 7 for caregivers, 29 for workers (AR 0.129%, 0.087%, 0.316% respectively). We measured 9 avoided accesses for patients (ARR: 0.084%, RRR: 65.4%), 5 for caregivers (ARR: 0.061%, RRR: 69.5%), 17 for workers (ARR: 0.184, RRR: 58.0%);for a total of 31 accesses potentially avoided thanks to the 5 actions. Conclusions: During the pandemic IRST never stopped providing care to the patients, the implemented actions allowed a risk reduction that can be an example of how to face this pandemia maintaining both continuity of care and safety for patients and staff in a context of frailty such as a cancer centre.