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2.
Strahlenther Onkol ; 196(12): 1068-1079, 2020 12.
Article in English | MEDLINE | ID: covidwho-754691

ABSTRACT

PURPOSE: COVID-19 infection has manifested as a major threat to both patients and healthcare providers around the world. Radiation oncology institutions (ROI) deliver a major component of cancer treatment, with protocols that might span over several weeks, with the result of increasing susceptibility to COVID-19 infection and presenting with a more severe clinical course when compared with the general population. The aim of this manuscript is to investigate the impact of ROI protocols and performance on daily practice in the high-risk cancer patients during this pandemic. METHODS: We addressed the incidence of positive COVID-19 cases in both patients and health care workers (HCW), in addition to the protective measures adopted in ROIs in Germany, Austria and Switzerland using a specific questionnaire. RESULTS: The results of the questionnaire showed that a noteworthy number of ROIs were able to complete treatment in SARS-CoV­2 positive cancer patients, with only a short interruption. The ROIs reported a significant decrease in patient volume that was not impacted by the circumambient disease incidence, the type of ROI or the occurrence of positive cases. Of the ROIs 16.5% also reported infected HCWs. About half of the ROIs (50.5%) adopted a screening program for patients whereas only 23.3% also screened their HCWs. The range of protective measures included the creation of working groups, instituting home office work and protection with face masks. Regarding the therapeutic options offered, curative procedures were performed with either unchanged or moderately decreased schedules, whereas palliative or benign radiotherapy procedures were more often shortened. Most ROIs postponed or cancelled radiation treatment for benign indications (88.1%). The occurrence of SARS-CoV­2 infections did not affect the treatment options for curative procedures. Non-university-based ROIs seemed to be more willing to change their treatment options for curative and palliative cases than university-based ROIs. CONCLUSION: Most ROIs reported a deep impact of SARS-CoV­2 infections on their work routine. Modification and prioritization of treatment regimens and the application of protective measures preserved a well-functioning radiation oncology service and patient care.


Subject(s)
COVID-19/prevention & control , Cross Infection/prevention & control , Infection Control/methods , Neoplasms/radiotherapy , Pandemics , Personnel, Hospital/statistics & numerical data , SARS-CoV-2/isolation & purification , Appointments and Schedules , Austria/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing/statistics & numerical data , Cancer Care Facilities/statistics & numerical data , Comorbidity , Cross Infection/epidemiology , Cross-Sectional Studies , Germany/epidemiology , Hospitals, Community , Hospitals, University/statistics & numerical data , Humans , Incidence , Infection Control/organization & administration , Masks/statistics & numerical data , Masks/supply & distribution , Neoplasms/epidemiology , Palliative Care/statistics & numerical data , Procedures and Techniques Utilization , Risk , Surveys and Questionnaires , Switzerland/epidemiology , Telemedicine/statistics & numerical data , Teleworking/statistics & numerical data
3.
Eur J Med Res ; 25(1): 32, 2020 Aug 12.
Article in English | MEDLINE | ID: covidwho-713821

ABSTRACT

BACKGROUND: The German government has made it mandatory to wear respiratory masks covering mouth and nose (MNC) as an effective strategy to fight SARS-CoV-2 infections. In many countries, this directive has been extended on shopping malls or public transportation. The aim of this paper is to critically analyze the statutory regulation to wear protective masks during the COVID-19 crisis from a medical standpoint. METHODS: We performed an extensive query of the most recent publications addressing the prevention of viral infections including the use of face masks in the community as a method to prevent the spread of the infection. We addressed the issues of practicability, professional use, and acceptability based on the community and the environment where the user resided. RESULTS: Upon our critical review of the available literature, we found only weak evidence for wearing a face mask as an efficient hygienic tool to prevent the spread of a viral infection. However, the use of MNC seems to be linked to relevant protection during close contact scenarios by limiting pathogen-containing aerosol and liquid droplet dissemination. Importantly, we found evidence for significant respiratory compromise in patients with severe obstructive pulmonary disease, secondary to the development of hypercapnia. This could also happen in patients with lung infections, with or without SARS-CoV-2. CONCLUSION: Epidemiologists currently emphasize that wearing MNC will effectively interrupt airborne infections in the community. The government and the politicians have followed these recommendations and used them to both advise and, in some cases, mandate the general population to wear MNC in public locations. Overall, the results seem to suggest that there are some clinically relevant scenarios where the use of MNC necessitates more defined recommendations. Our critical evaluation of the literature both highlights the protective effects of certain types of face masks in defined risk groups, and emphasizes their potential risks.


Subject(s)
Coronavirus Infections/prevention & control , Masks/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Pre-Exposure Prophylaxis/methods , Respiratory Protective Devices/statistics & numerical data , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Equipment and Supplies Utilization/legislation & jurisprudence , Equipment and Supplies Utilization/statistics & numerical data , Humans , Masks/adverse effects , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pre-Exposure Prophylaxis/legislation & jurisprudence , Respiratory Protective Devices/adverse effects
4.
Eur J Med Res ; 25(1): 23, 2020 Jun 23.
Article in English | MEDLINE | ID: covidwho-612270

ABSTRACT

In the human population, social contacts are a key for transmission of bacteria and viruses. The use of face masks seems to be critical to prevent the transmission of SARS-CoV-2 for the period, in which therapeutic interventions are lacking. In this review, we describe the history of masks from the middle age to modern times.


Subject(s)
Communicable Disease Control/methods , History of Medicine , Masks/history , Communicable Disease Control/instrumentation , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , Masks/standards , Respiratory Protective Devices/history , Respiratory Protective Devices/standards
5.
Eur J Med Res ; 25(1): 16, 2020 May 13.
Article in English | MEDLINE | ID: covidwho-270845

ABSTRACT

The rapid spread of the corona virus pandemic is an existential problem for many people in numerous countries. So far, there is no effective vaccine protection or proven therapy available against the SARS-CoV-2 virus. In this review, we describe the role of passive immunization in times of the corona virus. Passive immunization could be a bridging technology to improve the immune defense of critically ill patients until better approaches with effective medications are available.


Subject(s)
Betacoronavirus/immunology , Coronavirus Infections/immunology , Coronavirus Infections/therapy , Immunization, Passive , Pneumonia, Viral/immunology , Pneumonia, Viral/therapy , COVID-19 , Humans , Immunization, Passive/trends , Pandemics , SARS-CoV-2
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