ABSTRACT
PURPOSE: The novel coronavirus (COVID-19) forced radiation oncology clinics to overhaul operational policies, but the effect on employee safety has not, to our knowledge, been reported. The New York Proton Center (NYPC), a large freestanding clinic in New York City, New York, presents a 1-month experience of employee-reported health outcomes after the infiltration of COVID-19 and enforcement of policies designed to mitigate its impact. MATERIALS AND METHODS: In March 2020, new operational policies were implemented, including rigorous and frequent sanitation, visitor and treatment restrictions, distribution of personal protective equipment, work-from-home orders, and isolated nursing and radiation therapy teams. Employees of NYPC were prospectively monitored for exposure and symptoms of COVID-19. Work hours lost because of illness or quarantines were quantified from March 1, 2020, to March 31, 2020. RESULTS: Among 95 total employees, 23 (24%) were quarantined because of symptoms (n = 15; 65%), high-risk exposure (n = 5; 22%), or self-quarantined with personal concern (n = 3; 13%). Of 44 full-time, on-site employees, 39% (n = 17, including 6 therapists and 5 nurses) missed significant work time, including 6 (14%) with confirmed COVID-19. At full capacity, NYPC would have used 7260 work hours during March 2020 from the full-time, on-site staff, which was reduced by 18.8% overall (25.2% of nursing and 13.3% of therapy work hours), all in the latter half of the month. Among the therapist lost work hours, 92% were from 2 of 7 distinct, isolated therapy teams (29%). Without isolation, the exposure was modeled to have been 100%. CONCLUSION: Despite losing significant staff hours in our department because of COVID-19, early and aggressive adoption of current, recommended policy guidelines outlined in this manuscript allowed NYPC to continue patient operations at full capacity.
ABSTRACT
PURPOSE: The emergence of the coronavirus disease (COVID-19) global pandemic has led to a significant shift in the delivery of health care, including an explosive growth of telemedicine services. This reverberated in the field of radiation oncology, with a recent American Society for Radiation Oncology (ASTRO) nationwide survey reporting 89% of surveyed clinics began to offer telemedicine programs to patients because of the pandemic. However, this survey did not study the perceptions and experiences of those clinicians delivering telemedicine services. METHODS AND MATERIALS: We investigated through a national physician survey the merits and limitations of radiation oncology tele-consultations. An anonymous web-based survey was distributed using SurveyMonkey (www.surveymonkey.com) via email. RESULTS: Seventy six respondents (16.1% overall response rate) completed the survey, with broad representation from both academic and community-based practices. Many respondents agreed that transitioning to tele-consultations was a needed step given the emergence of the pandemic, despite most having never previously offered this service. Despite many radiation oncologists having little prior experience with tele-consultations, a majority were satisfied in being able to explain the details of a medical diagnosis, provide results of imaging and bloodwork, and discuss recommendations around radiation treatments through this format. Nearly half of the respondents agreed that tele-consultations felt impersonal, with the inability to complete physical examinations noted as a contributor to the impersonality. Nevertheless, respondents still agreed that telemedicine will play an important role going forward, and almost 90% agreed that they would offer tele-consultations even after the pandemic has resolved.
ABSTRACT
It has been well documented from the early days of the 2019 novel coronavirus (COVID-19) pandemic that patients with a diagnosis of cancer are not only at higher risks of contracting a COVID-19 infection but also at higher risks of suffering severe, and possibly fatal, outcomes from the infection. Given that the United States has the greatest number of positive coronavirus cases, it is likely that many, if not all, radiation oncology clinics will be faced with the challenge of safely balancing a patient's risk of contracting COVID-19, while under active radiation treatment, against their risk of cancer progression if treatment is delayed. To address this challenge, the New York Proton Center established an internal algorithm that considers treatment-related, tumor-related, and patient-related characteristics. Despite having suffered staff shortages due to illness, this algorithm has allowed the center to maintain patient treatment volumes while keeping the rate of COVID-19 infection low.
ABSTRACT
The COVID-19 pandemic has rapidly spread across the world and now affects more people within the United States than any other country. New York City has emerged as the epicenter of the outbreak in the United States. Both locally and across the country, there is great concern in our ability to deliver appropriate medical care during this time. Radiation therapy is another essential clinical service that cannot afford to suffer prolonged delays without compromising patient outcomes. Early action and guidance are therefore critical to minimize transmission events and ensure safe and timely delivery of radiation therapy. The New York Proton Center (NYPC) is a high-volume free-standing multi-institutional proton center located in Manhattan. The purpose of this report is to describe the institutional patient experience and quantify the impact of treatment delays and interruptions over the first month of the COVID-19 outbreak. We also quantify the incidence of COVID-19 positive patients on census and provide guidance on proactive institutional policies to mitigate patient risk.