Could Earlier Availability of Boosters and Pediatric Vaccines Have Reduced Impact of COVID-19?

The objective is to evaluate the impact of the earlier availability of COVID-19 vaccinations to children and boosters to adults in the face of the Delta and Omicron variants. We employed an agent-based stochastic network simulation model with a modified SEIR compartment model populated with demographic and census data for North Carolina. We found that earlier availability of childhood vaccines and earlier availability of adult boosters could have reduced the peak hospitalizations of the Delta wave by 10% and the Omicron wave by 42%, and could have reduced cumulative deaths by 9% by July 2022. When studied separately, we found that earlier childhood vaccinations reduce cumulative deaths by 2,611 more than earlier adult boosters. Therefore, the results of our simulation model suggest that the timing of childhood vaccination and booster efforts could have resulted in a reduced disease burden and that prioritizing childhood vaccinations would most effectively reduce disease spread. © 2022 IEEE.

High-Quality Masks Reduce Covid-19 Infections and Death in the US

The objective is to evaluate the widespread adoption of masks on community transmission of SARS-CoV2. We employed an agent-based stochastic network simulation model and a variant of a SEIR disease model with one million agents in census tracts representing a population of 10.5 million. We evaluated scenarios with 25% to 90% mask-related reduction in viral transmission (mask efficacy). An individual wears a mask with a discrete probability values in [0-100%] (mask adherence). A mask order was initiated 3.5 months after the first confirmed case, with temporary state-wide distancing and voluntary quarantining of households. If 50% of the population wears masks that are 50% effective, this decreases the cumulative infection attack rate (CAR) by 27%, the peak prevalence by 54%, and the population mortality by 29%. If 90% wear masks that are 50% effective, this decreases the CAR by 38%, the peak prevalence by 75%, and the population mortality by 55%. © 2021 IEEE.

Our Experience Leading a Large Medical Physics Practice During the COVID-19 Pandemic.

PURPOSE: To provide a series of suggestions for other Medical Physics practices to follow in order to provide effective radiation therapy treatments during the COVID-19 pandemic. METHODS AND MATERIALS: We reviewed our entire Radiation Oncology infrastructure to identify a series of workflows and policy changes that we implemented during the pandemic that yielded more effective practices during this time. RESULTS: We identified a structured list of several suggestions that can help other Medical Physics practices overcome the challenges involved in delivering high quality radiotherapy services during this pandemic. CONCLUSIONS: Our facility encompasses 4 smaller Houston Area Locations (HALs), a main campus with 8 distinct services based on treatment site (ie. Thoracic, Head and Neck, Breast, Gastrointestinal, Gynecology, Genitourinary, Hematologic Malignancies, Melanoma and Sarcoma and Central Nervous System/Pediatrics), a Proton Center facility, an MR-Linac, a Gamma Knife clinic and an array of brachytherapy services. Due to the scope of our services, we have gained experience in dealing with the rapidly changing pandemic effects on our clinical practice. Our paper provides a resource to other Medical Physics practices in search of workflows that have been resilient during these challenging times.

Radiation Oncology Strategies to Flatten the Curve During the Coronavirus Disease 2019 (COVID-19) Pandemic: Experience From a Large Tertiary Cancer Center.

During the coronavirus disease 2019 pandemic, minimizing exposure risk for patients with cancer and health care personnel was of utmost importance. Here, we present steps taken to date to flatten the curve at the radiation oncology division of a tertiary cancer center with the goal of mitigating risk of exposure among patients and staff, and optimizing resource utilization. Response to the coronavirus disease 2019 pandemic in this large tertiary referral center included volume reduction, personal protective equipment recommendations, flexible clinic visit interaction types dictated by need and risk reduction, and numerous social distancing strategies. We hope these outlined considerations can assist the wider radiation oncology community as we collectively face this ongoing challenge.

Mitigating the impact of COVID-19 on oncology: Clinical and operational lessons from a prospective radiation oncology cohort tested for COVID-19.

BACKGROUND AND PURPOSE: The COVID-19 pandemic warrants operational initiatives to minimize transmission, particularly among cancer patients who are thought to be at high-risk. Within our department, a multidisciplinary tracer team prospectively monitored all patients under investigation, tracking their test status, treatment delays, clinical outcomes, employee exposures, and quarantines. MATERIALS AND METHODS: Prospective cohort tested for SARS-COV-2 infection over 35 consecutive days of the early pandemic (03/19/2020-04/22/2020). RESULTS: A total of 121 Radiation Oncology patients underwent RT-PCR testing during this timeframe. Of the 7 (6%) confirmed-positive cases, 6 patients were admitted (4 warranting intensive care), and 2 died from acute respiratory distress syndrome. Radiotherapy was deferred or interrupted for 40 patients awaiting testing. As the median turnaround time for RT-PCR testing decreased from 1.5 (IQR: 1-4) to ≤1-day (P < 0.001), the median treatment delay also decreased from 3.5 (IQR: 1.75-5) to 1 business day (IQR: 1-2) [P < 0.001]. Each patient was an exposure risk to a median of 5 employees (IQR: 3-6.5) through prolonged close contact. During this timeframe, 39 care-team members were quarantined for a median of 3 days (IQR: 2-11), with a peak of 17 employees simultaneously quarantined. Following implementation of a "dual PPE policy," newly quarantined employees decreased from 2.9 to 0.5 per day. CONCLUSION: The severe adverse events noted among these confirmed-positive cases support the notion that cancer patients are vulnerable to COVID-19. Active tracking, rapid diagnosis, and aggressive source control can mitigate the adverse effects on treatment delays, workforce incapacitation, and ideally outcomes.